Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

Providence St Luke's Rehabilitation Medical Center

Spokane, WA · CCN 503025 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

Tte w/doppler complete

This hospital’s price: $636 across 5 payers · range $208-$1,448

Source: https://pricetransparency.providence.org/wamt/live/352347032_providence-st-lukes-rehabilitation-medical-center_standardcharges.json · observed 2026-04-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

13,374 distinct procedures filed
13 distinct payers
99,681 rate rows
2026-04-01 last MRF observed
Data quality

75,940 of 99,681 rate rows are consumer-grade (76.2%)

23,741 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 19,294
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 4,445
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/wamt/live/352347032_providence-st-lukes-rehabilitation-medical-center_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-01
Content fingerprint 40f493f8732d7f62… · 24,422,879 bytes · first seen 2026-05-14

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
0100T
OTHER 		Prosth Retina Receive&Gen 1 $483,001.61 $483,001.61 $483,001.61 nat. median
$5,128
outlier · 94.2×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 5 $108,243.35 $272,264.89 $115,279.17 nat. median
$111,503
1.0× median
C9741
HCPCS 		Impl Pressure Sensor W/angio 1 $95,046.57 $95,046.57 $95,046.57 nat. median
$12,039
outlier · 7.9×
0312T
OTHER 		Laps Impltj Nstim Vagus 1 $87,091.69 $87,091.69 $87,091.69 nat. median
$18,162
outlier · 4.8×
0424T
OTHER 		Insj/rplc Nstim Apnea Compl 1 $87,091.69 $87,091.69 $87,091.69 nat. median
$22,425
outlier · 3.9×
38240
HCPCS 		Transplt Allo Hct/donor 5 $70,093.51 $126,168.31 $74,649.58 nat. median
$12,855
outlier · 5.8×
J9600
HCPCS 		Porfimer Sodium Injection 1 $68,327.01 $68,327.01 $68,327.01 nat. median
$30,131
outlier · 2.3×
98
MS_DRG 		Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 1 $61,813.33 $61,813.33 $61,813.33 nat. median
$21,174
outlier · 2.9×
A9543
HCPCS 		Y90 Ibritumomab, Rx 5 $56,824.55 $155,217.98 $60,518.15 nat. median
$63,643
1.0× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 5 $56,269.19 $130,217.35 $59,926.69 nat. median
$65,720
0.9× median
L8614
HCPCS 		Cochlear Device 1 $57,848.23 $57,848.23 $57,848.23 nat. median
$22,385
outlier · 2.6×
0268T
OTHER 		Implt/rpl Crtd Sns Dev Gen 1 $57,326.89 $57,326.89 $57,326.89 nat. median
$28,036
outlier · 2.0×
0316T
OTHER 		Replc Vagus Nerve Pls Gen 1 $57,326.89 $57,326.89 $57,326.89 nat. median
$14,923
outlier · 3.8×
0427T
OTHER 		Insj/rplc Nstim Apnea Pls Gn 1 $57,326.89 $57,326.89 $57,326.89 nat. median
$22,408
outlier · 2.6×
0431T
OTHER 		Rmvl/rplc Nstim Apnea Pls Gn 1 $57,326.89 $57,326.89 $57,326.89 nat. median
$22,408
outlier · 2.6×
0426T
OTHER 		Insj/rplc Nstim Apnea Stm Ld 1 $57,326.89 $57,326.89 $57,326.89 nat. median
$13,762
outlier · 4.2×
0302T
OTHER 		Icar Ischm Mntrng Sys Compl 1 $53,989.29 $53,989.29 $53,989.29 nat. median
$6,405
outlier · 8.4×
64568
HCPCS 		Inc For Vagus N Elect Impl 5 $49,082.95 $88,349.30 $52,273.33 nat. median
$27,679
1.9× median
L7181
HCPCS 		Electronic Elbo Simultaneous 5 $48,155.50 $121,125.71 $51,285.61 nat. median
$50,453
1.0× median
L7180
HCPCS 		Electronic Elbow Sequential 5 $44,853.57 $112,820.33 $47,769.06 nat. median
$46,980
1.0× median
37227
HCPCS 		Fem/popl Revasc Stnt & Ather 1 $47,598.49 $47,598.49 $47,598.49 nat. median
$18,411
outlier · 2.6×
37231
HCPCS 		Tib/per Revasc Stent & Ather 1 $47,598.49 $47,598.49 $47,598.49 nat. median
$18,375
outlier · 2.6×
0387T
OTHER 		Leadless C Pm Ins/rpl Ventr 1 $47,598.49 $47,598.49 $47,598.49 nat. median
$6,095
outlier · 7.8×
37229
HCPCS 		Tib/per Revasc W/ather 1 $47,598.49 $47,598.49 $47,598.49 nat. median
$17,132
outlier · 2.8×
C9606
HCPCS 		Perc D-e Cor Revasc W Ami S 1 $47,598.49 $47,598.49 $47,598.49 nat. median
$17,833
outlier · 2.7×
37230
HCPCS 		Tib/per Revasc W/stent 1 $47,598.49 $47,598.49 $47,598.49 nat. median
$16,909
outlier · 2.8×
69715
HCPCS 		Temple Bne Implnt W/Stimulat 1 $47,347.30 $47,347.30 $47,347.30 nat. median
$7,021
outlier · 6.7×
552
MS_DRG 		Medical Back Problems Without Mcc 2 $32,704.97 $60,449.66 $46,577.32 nat. median
$9,833
outlier · 4.7×
C9746
HCPCS 		Trans Imp Balloon Cont 1 $46,250.82 $46,250.82 $46,250.82 nat. median
$4,751
outlier · 9.7×
543
MS_DRG 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 $44,081.82 $44,081.82 $44,081.82 nat. median
$10,651
outlier · 4.1×
J9226
HCPCS 		Supprelin La Implant 5 $41,173.43 $93,391.83 $43,849.70 nat. median
$55,159
0.8× median
69930
HCPCS 		Implant Cochlear Device 5 $36,742.30 $102,515.11 $39,130.54 nat. median
$29,205
1.3× median
70
MS_DRG 		Other Cerebrovascular Disorders With Mcc 2 $35,462.97 $42,137.55 $38,800.26 nat. median
$16,327
outlier · 2.4×
0408T
OTHER 		Insj/rplc Cardiac Modulj Sys 5 $34,978.01 $70,839.94 $37,251.58 nat. median
$31,346
1.2× median
33270
HCPCS 		Ins/rep Subq Defibrillator 5 $34,978.01 $98,297.62 $37,251.58 nat. median
$32,113
1.2× median
33249
HCPCS 		Insj/rplcmt Defib W/lead(s) 5 $34,978.01 $98,297.62 $37,251.58 nat. median
$31,584
1.2× median
33264
HCPCS 		Rmvl & Rplcmt Dfb Gen Mlt Ld 5 $34,978.01 $98,297.62 $37,251.58 nat. median
$31,564
1.2× median
33231
HCPCS 		Insrt Pulse Gen W/mult Leads 5 $34,978.01 $98,297.62 $37,251.58 nat. median
$30,121
1.2× median
949
MS_DRG 		Aftercare With Cc/Mcc 4 $27,300.39 $49,415.66 $36,669.02 nat. median
$11,791
outlier · 3.1×
61886
HCPCS 		Implant Neurostim Arrays 5 $34,386.10 $87,091.69 $36,621.20 nat. median
$27,176
1.3× median
63685
HCPCS 		Insrt/redo Spine N Generator 5 $34,386.10 $87,091.69 $36,621.20 nat. median
$21,040
1.7× median
61885
HCPCS 		Insrt/redo Neurostim 1 Array 5 $34,386.10 $61,894.99 $36,621.20 nat. median
$19,858
1.8× median
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 4 $3,953.11 $37,078.14 $35,590.18 nat. median
$17,070
outlier · 2.1×
92
MS_DRG 		Other Disorders Of Nervous System With Cc 2 $29,750.53 $40,643.24 $35,196.88 nat. median
$10,613
outlier · 3.3×
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 10 $12,781.12 $46,999.46 $34,713.00 nat. median
$21,152
1.6× median
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 11 $9,000.71 $73,027.99 $33,729.88 nat. median
$12,550
outlier · 2.7×
54
MS_DRG 		Nervous System Neoplasms With Mcc 1 $33,246.20 $33,246.20 $33,246.20 nat. median
$14,763
outlier · 2.3×
21243
HCPCS 		Reconstruction Of Jaw Joint 5 $30,236.65 $54,425.96 $32,202.03 nat. median
$12,517
outlier · 2.6×
20696
HCPCS 		Comp Multiplane Ext Fixation 5 $30,236.65 $54,425.96 $32,202.03 nat. median
$11,690
outlier · 2.8×
22558
HCPCS 		Lumbar Spine Fusion 5 $4,964.59 $54,425.96 $31,597.29 nat. median
$8,334
outlier · 3.8×

Other procedures at this hospital

Browse this hospital's 13,374 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
0100T OTHER Prosth Retina Receive&Gen 1 1 — — $483,001.61 $483,001.61 $483,001.61 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 8 5 — — $108,243.35 $272,264.89 $115,279.17 2026-04-01
C9741 HCPCS Impl Pressure Sensor W/angio 1 1 — — $95,046.57 $95,046.57 $95,046.57 2026-04-01
0312T OTHER Laps Impltj Nstim Vagus 1 1 — — $87,091.69 $87,091.69 $87,091.69 2026-04-01
0424T OTHER Insj/rplc Nstim Apnea Compl 1 1 — — $87,091.69 $87,091.69 $87,091.69 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 8 5 — — $70,093.51 $126,168.31 $74,649.58 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 1 1 — — $68,327.01 $68,327.01 $68,327.01 2026-04-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 1 1 — — $61,813.33 $61,813.33 $61,813.33 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 8 5 — — $56,824.55 $155,217.98 $60,518.15 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 5 — — $56,269.19 $130,217.35 $59,926.69 2026-04-01
L8614 HCPCS Cochlear Device 1 1 — — $57,848.23 $57,848.23 $57,848.23 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 1 1 — — $57,326.89 $57,326.89 $57,326.89 2026-04-01
0316T OTHER Replc Vagus Nerve Pls Gen 1 1 — — $57,326.89 $57,326.89 $57,326.89 2026-04-01
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 1 1 — — $57,326.89 $57,326.89 $57,326.89 2026-04-01
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 1 1 — — $57,326.89 $57,326.89 $57,326.89 2026-04-01
0426T OTHER Insj/rplc Nstim Apnea Stm Ld 1 1 — — $57,326.89 $57,326.89 $57,326.89 2026-04-01
0302T OTHER Icar Ischm Mntrng Sys Compl 1 1 — — $53,989.29 $53,989.29 $53,989.29 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 8 5 — — $49,082.95 $88,349.30 $52,273.33 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 8 5 — — $48,155.50 $121,125.71 $51,285.61 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 8 5 — — $44,853.57 $112,820.33 $47,769.06 2026-04-01
37230 HCPCS Tib/per Revasc W/stent 1 1 — — $47,598.49 $47,598.49 $47,598.49 2026-04-01
37229 HCPCS Tib/per Revasc W/ather 1 1 — — $47,598.49 $47,598.49 $47,598.49 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 1 1 — — $47,598.49 $47,598.49 $47,598.49 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 1 1 — — $47,598.49 $47,598.49 $47,598.49 2026-04-01
C9606 HCPCS Perc D-e Cor Revasc W Ami S 1 1 — — $47,598.49 $47,598.49 $47,598.49 2026-04-01
0387T OTHER Leadless C Pm Ins/rpl Ventr 1 1 — — $47,598.49 $47,598.49 $47,598.49 2026-04-01
69715 HCPCS Temple Bne Implnt W/Stimulat 1 1 — — $47,347.30 $47,347.30 $47,347.30 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 2 2 — — $32,704.97 $60,449.66 $46,577.32 2026-04-01
C9746 HCPCS Trans Imp Balloon Cont 1 1 — — $46,250.82 $46,250.82 $46,250.82 2026-04-01
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $44,081.82 $44,081.82 $44,081.82 2026-04-01
J9226 HCPCS Supprelin La Implant 8 5 — — $41,173.43 $93,391.83 $43,849.70 2026-04-01
69930 HCPCS Implant Cochlear Device 8 5 — — $36,742.30 $102,515.11 $39,130.54 2026-04-01
70 MS_DRG Other Cerebrovascular Disorders With Mcc 2 2 — — $35,462.97 $42,137.55 $38,800.26 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 8 5 — — $34,978.01 $98,297.62 $37,251.58 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 8 5 — — $34,978.01 $98,297.62 $37,251.58 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 8 5 — — $34,978.01 $98,297.62 $37,251.58 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 8 5 — — $34,978.01 $98,297.62 $37,251.58 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 8 5 — — $34,978.01 $70,839.94 $37,251.58 2026-04-01
949 MS_DRG Aftercare With Cc/Mcc 4 4 — — $27,300.39 $49,415.66 $36,669.02 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 8 5 — — $34,386.10 $87,091.69 $36,621.20 2026-04-01
61886 HCPCS Implant Neurostim Arrays 8 5 — — $34,386.10 $87,091.69 $36,621.20 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 8 5 — — $34,386.10 $61,894.99 $36,621.20 2026-04-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 4 4 — — $3,953.11 $37,078.14 $35,590.18 2026-04-01
92 MS_DRG Other Disorders Of Nervous System With Cc 2 2 — — $29,750.53 $40,643.24 $35,196.88 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 13 10 — — $12,781.12 $46,999.46 $34,713.00 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 15 11 — — $9,000.71 $73,027.99 $33,729.88 2026-04-01
54 MS_DRG Nervous System Neoplasms With Mcc 1 1 — — $33,246.20 $33,246.20 $33,246.20 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 8 5 — — $30,236.65 $54,425.96 $32,202.03 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 8 5 — — $30,236.65 $54,425.96 $32,202.03 2026-04-01
22630 HCPCS Lumbar Spine Fusion 8 5 — — $5,046.97 $54,425.96 $31,597.29 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 8 5 — — $5,970.30 $54,425.96 $31,597.29 2026-04-01
22558 HCPCS Lumbar Spine Fusion 8 5 — — $4,964.59 $54,425.96 $31,597.29 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 8 5 — — $3,129.04 $54,425.96 $31,597.29 2026-04-01
92941 HCPCS Prq Card Revasc Mi 1 Vsl 1 1 — — $31,402.83 $31,402.83 $31,402.83 2026-04-01
37226 HCPCS Fem/popl Revasc W/stent 1 1 — — $31,402.83 $31,402.83 $31,402.83 2026-04-01
37228 HCPCS Tib/per Revasc W/tla 1 1 — — $31,402.83 $31,402.83 $31,402.83 2026-04-01
37225 HCPCS Fem/popl Revas W/ather 1 1 — — $31,402.83 $31,402.83 $31,402.83 2026-04-01
37221 HCPCS Iliac Revasc W/stent 1 1 — — $31,402.83 $31,402.83 $31,402.83 2026-04-01
0398T OTHER Mrgfus Strtctc Les Abltj 1 1 — — $31,396.61 $31,396.61 $31,396.61 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 8 5 — — $29,126.58 $54,048.44 $31,019.80 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 8 5 — — $29,126.58 $54,048.44 $31,019.80 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 8 5 — — $29,126.58 $54,048.44 $31,019.80 2026-04-01
69718 HCPCS Revise Temple Bone Implant 1 1 — — $30,787.16 $30,787.16 $30,787.16 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 8 5 — — $28,851.23 $72,569.59 $30,726.56 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 8 5 — — $28,715.00 $72,226.95 $30,581.47 2026-04-01
0304T OTHER Icar Ischm Mntrng Sys Device 1 1 — — $30,311.95 $30,311.95 $30,311.95 2026-04-01
J9266 HCPCS Pegaspargase Injection 8 5 — — $28,424.06 $51,163.31 $30,271.62 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 2 — — $24,397.70 $35,161.07 $29,779.39 2026-04-01
71 MS_DRG Other Cerebrovascular Disorders With Cc 1 1 — — $28,813.09 $28,813.09 $28,813.09 2026-04-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 10 8 — — $11,093.75 $44,251.10 $28,045.71 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 8 5 — — $24,787.00 $70,839.94 $26,398.16 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 8 5 — — $24,787.00 $70,839.94 $26,398.16 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 8 5 — — $24,787.00 $70,839.94 $26,398.16 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 8 5 — — $24,787.00 $70,839.94 $26,398.16 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 8 5 — — $24,787.00 $70,839.94 $26,398.16 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 8 5 — — $24,787.00 $70,839.94 $26,398.16 2026-04-01
L8679 HCPCS Imp Neurosti Pls Gn Any Type 1 1 — — $26,203.04 $26,203.04 $26,203.04 2026-04-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 4 4 — — $16,798.46 $35,819.03 $25,932.74 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 1 1 — — $25,562.20 $25,562.20 $25,562.20 2026-04-01
100 MS_DRG Seizures With Mcc 1 1 — — $24,860.46 $24,860.46 $24,860.46 2026-04-01
945 MS_DRG Rehabilitation With Cc/Mcc 12 9 — — $4,725.47 $48,937.17 $24,691.65 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 8 5 — — $23,096.04 $46,250.82 $24,597.28 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 8 5 — — $22,533.92 $56,679.63 $23,998.62 2026-04-01
C9747 HCPCS Ablation, Hifu, Prostate 1 1 — — $23,997.57 $23,997.57 $23,997.57 2026-04-01
L5858 HCPCS Stance Phase Only 8 5 — — $22,336.47 $56,182.98 $23,788.34 2026-04-01
64580 HCPCS Implant Neuroelectrodes 8 5 — — $21,618.41 $57,326.89 $23,023.61 2026-04-01
63655 HCPCS Implant Neuroelectrodes 8 5 — — $21,618.41 $57,326.89 $23,023.61 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 8 5 — — $21,618.41 $57,326.89 $23,023.61 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 4 4 — — $15,860.21 $59,275.40 $22,979.79 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 8 5 — — $21,464.16 $53,989.29 $22,859.33 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 8 5 — — $21,464.16 $53,989.29 $22,859.33 2026-04-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 3 3 — — $19,962.18 $37,551.64 $22,731.34 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 8 5 — — $21,127.66 $53,142.50 $22,500.96 2026-04-01
0454T OTHER Insj/rplcmt Subq Electrode 1 1 — — $22,464.56 $22,464.56 $22,464.56 2026-04-01
33282 HCPCS Implant Pat-active Ht Record 1 1 — — $22,464.56 $22,464.56 $22,464.56 2026-04-01
0303T OTHER Icar Ischm Mntrng Sys Eltrd 1 1 — — $22,464.56 $22,464.56 $22,464.56 2026-04-01
0453T OTHER Insj/rplcmt Mech-elec Ntrfce 1 1 — — $22,464.56 $22,464.56 $22,464.56 2026-04-01
49657 HCPCS Lap Inc Hern Recur Comp 1 1 — — $22,442.88 $22,442.88 $22,442.88 2026-04-01
49655 HCPCS Lap Inc Hern Repair Comp 1 1 — — $22,442.88 $22,442.88 $22,442.88 2026-04-01
49654 HCPCS Lap Inc Hernia Repair 1 1 — — $22,442.88 $22,442.88 $22,442.88 2026-04-01
49656 HCPCS Lap Inc Hernia Repair Recur 1 1 — — $22,442.88 $22,442.88 $22,442.88 2026-04-01
E0783 HCPCS Programmable Infusion Pump 3 1 — — $2,934.81 $29,347.21 $22,010.47 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
0238T OTHER Trluml Perip Athrc Iliac Art 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
37242 HCPCS Vasc Embolize/occlude Artery 8 5 — — $20,427.76 $36,769.96 $21,755.56 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
C9602 HCPCS Perc D-e Cor Stent Ather S 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
92933 HCPCS Prq Card Stent/ath/angio 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
93580 HCPCS Transcath Closure Of Asd 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 8 5 — — $20,427.76 $47,598.49 $21,755.56 2026-04-01
E0786 HCPCS Implantable Pump Replacement 3 1 — — $2,862.58 $28,626.41 $21,469.83 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 8 5 — — $20,084.78 $50,304.68 $21,390.29 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 8 5 — — $20,084.78 $50,304.68 $21,390.29 2026-04-01
62360 HCPCS Insert Spine Infusion Device 8 5 — — $20,084.78 $50,304.68 $21,390.29 2026-04-01
37182 HCPCS Insert Hepatic Shunt (tips) 8 5 — — $2,739.55 $36,769.96 $21,347.00 2026-04-01
37184 HCPCS Prim Art M-thrmbc 1st Vsl 8 5 — — $12,636.19 $36,769.96 $21,347.00 2026-04-01
61624 HCPCS Transcath Occlusion Cns 8 5 — — $3,684.04 $36,769.96 $21,347.00 2026-04-01
19324 HCPCS Enlarge Breast 1 1 — — $20,886.05 $20,886.05 $20,886.05 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 8 5 — — $19,564.01 $49,209.46 $20,835.67 2026-04-01
24363 HCPCS Replace Elbow Joint 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
24371 HCPCS Revise Reconst Elbow Joint 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
23616 HCPCS Treat Humerus Fracture 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
25446 HCPCS Wrist Replacement 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
25442 HCPCS Reconstruct Wrist Joint 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
22612 HCPCS Lumbar Spine Fusion 8 5 — — $19,538.71 $35,169.68 $20,808.73 2026-04-01
24361 HCPCS Reconstruct Elbow Joint 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
27279 HCPCS Arthrodesis Sacroiliac Joint 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
28705 HCPCS Fusion Of Foot Bones 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
22856 HCPCS Cerv Artific Diskectomy 8 5 — — $19,538.71 $47,347.30 $20,808.73 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 8 5 — — $19,535.67 $49,138.17 $20,805.49 2026-04-01
20838 HCPCS Replantation Foot Complete 8 5 — — $8,809.05 $35,169.68 $20,417.96 2026-04-01
20808 HCPCS Replantation Hand Complete 8 5 — — $13,031.79 $35,169.68 $20,417.96 2026-04-01
22556 HCPCS Thorax Spine Fusion 8 5 — — $5,372.89 $35,169.68 $20,417.96 2026-04-01
22818 HCPCS Kyphectomy 1-2 Segments 8 5 — — $7,102.70 $35,169.68 $20,417.96 2026-04-01
22819 HCPCS Kyphectomy 3 Or More 8 5 — — $8,681.28 $35,169.68 $20,417.96 2026-04-01
22586 HCPCS Prescrl Fuse With Instr L5-s1 8 5 — — $6,133.74 $35,169.68 $20,417.96 2026-04-01
22600 HCPCS Neck Spine Fusion 8 5 — — $4,148.87 $35,169.68 $20,417.96 2026-04-01
22610 HCPCS Thorax Spine Fusion 8 5 — — $4,072.20 $35,169.68 $20,417.96 2026-04-01
23472 HCPCS Reconstruct Shoulder Joint 8 5 — — $4,722.36 $35,169.68 $20,417.96 2026-04-01
20982 HCPCS Ablate Bone Tumor(s) Perq 8 5 — — $16,813.45 $35,169.68 $20,417.96 2026-04-01
20805 HCPCS Replant Forearm Complete 8 5 — — $10,124.74 $35,169.68 $20,417.96 2026-04-01
22810 HCPCS Ant Fusion 4-7 Vert Seg 8 5 — — $6,598.10 $35,169.68 $20,417.96 2026-04-01
22812 HCPCS Ant Fusion 8/> Vert Seg 8 5 — — $7,149.40 $35,169.68 $20,417.96 2026-04-01
22533 HCPCS Lat Lumbar Spine Fusion 8 5 — — $5,372.02 $35,169.68 $20,417.96 2026-04-01
27295 HCPCS Amputation Of Leg At Hip 8 5 — — $4,090.85 $35,169.68 $20,417.96 2026-04-01
22857 HCPCS Lumbar Artif Diskectomy 8 5 — — $5,772.04 $35,169.68 $20,417.96 2026-04-01
22861 HCPCS Revise Cerv Artific Disc 8 5 — — $6,321.92 $35,169.68 $20,417.96 2026-04-01
27487 HCPCS Revise/replace Knee Joint 8 5 — — $5,700.60 $35,169.68 $20,417.96 2026-04-01
20802 HCPCS Replantation Arm Complete 8 5 — — $8,981.22 $35,169.68 $20,417.96 2026-04-01
22804 HCPCS Post Fusion 13/> Vert Seg 8 5 — — $7,845.33 $35,169.68 $20,417.96 2026-04-01
27290 HCPCS Amputation Of Leg At Hip 8 5 — — $5,206.93 $35,169.68 $20,417.96 2026-04-01
22862 HCPCS Revise Lumbar Artif Disc 8 5 — — $6,900.04 $35,169.68 $20,417.96 2026-04-01
22808 HCPCS Ant Fusion 2-3 Vert Seg 8 5 — — $5,950.92 $35,169.68 $20,417.96 2026-04-01
22800 HCPCS Post Fusion <=6 Vert Seg 8 5 — — $4,371.66 $35,169.68 $20,417.96 2026-04-01
27703 HCPCS Reconstruction Ankle Joint 8 5 — — $3,600.76 $35,169.68 $20,417.96 2026-04-01
22802 HCPCS Post Fusion 7-12 Vert Seg 8 5 — — $6,792.79 $35,169.68 $20,417.96 2026-04-01
27280 HCPCS Fusion Of Sacroiliac Joint 8 5 — — $4,377.05 $35,169.68 $20,417.96 2026-04-01
J9216 HCPCS Interferon Gamma 1-b Inj 1 1 — — $20,312.19 $20,312.19 $20,312.19 2026-04-01
950 MS_DRG Aftercare Without Cc/Mcc 2 2 — — $8,554.58 $31,966.97 $20,260.78 2026-04-01
L8609 HCPCS Artificial Cornea 1 1 — — $19,696.16 $19,696.16 $19,696.16 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 3 — — $12,356.04 $27,171.73 $19,680.26 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 8 5 — — $18,479.11 $46,480.57 $19,680.25 2026-04-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 7 6 — — $15,456.11 $60,590.41 $19,623.99 2026-04-01
0308T OTHER Insj Ocular Telescope Prosth 8 5 — — $18,343.03 $61,153.44 $19,535.33 2026-04-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 2 2 — — $16,910.99 $22,125.57 $19,518.28 2026-04-01
946 MS_DRG Rehabilitation Without Cc/Mcc 5 5 — — $10,198.71 $27,306.74 $19,452.19 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 8 5 — — $17,983.62 $45,234.24 $19,152.56 2026-04-01
39503 HCPCS Repair Of Diaphragm Hernia 1 1 — — $19,110.86 $19,110.86 $19,110.86 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 8 5 — — $17,855.55 $44,912.11 $19,016.16 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 8 5 — — $17,771.01 $53,154.89 $18,926.12 2026-04-01
0404T OTHER Trnscrv Uterin Fibroid Abltj 1 1 — — $18,888.75 $18,888.75 $18,888.75 2026-04-01
L8682 HCPCS Implt Neurostim Radiofq Rec 1 1 — — $18,721.62 $18,721.62 $18,721.62 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 8 5 — — $17,463.78 $43,926.73 $18,598.93 2026-04-01
64565 HCPCS Implant Neuroelectrodes 1 1 — — $18,499.26 $18,499.26 $18,499.26 2026-04-01
0425T OTHER Insj/rplc Nstim Apnea Sen Ld 1 1 — — $18,499.26 $18,499.26 $18,499.26 2026-04-01
E2510 HCPCS Sgd W Multi Methods Msg/accs 3 1 — — $2,426.21 $24,261.83 $18,196.35 2026-04-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 1 1 — — $18,059.65 $18,059.65 $18,059.65 2026-04-01
975 MS_DRG HIV With Major Related Condition With Cc 1 1 — — $17,893.54 $17,893.54 $17,893.54 2026-04-01
47135 HCPCS Transplantation Of Liver 1 1 — — $17,279.90 $17,279.90 $17,279.90 2026-04-01
58 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Mcc 5 5 — — $10,980.14 $34,270.09 $17,246.33 2026-04-01
65770 HCPCS Revise Cornea With Implant 8 5 — — $16,164.80 $29,096.64 $17,215.51 2026-04-01
43116 HCPCS Partial Removal Of Esophagus 1 1 — — $17,173.29 $17,173.29 $17,173.29 2026-04-01
L6960 HCPCS Shldr Disartic Switch Contro 8 5 — — $15,924.82 $40,055.77 $16,959.94 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $16,864.68 $16,864.68 $16,864.68 2026-04-01
0275T OTHER Perq Lamot/lam Lumbar 1 1 — — $16,813.45 $16,813.45 $16,813.45 2026-04-01
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 6 6 — — $155.04 $37,124.53 $16,649.57 2026-04-01
67027 HCPCS Implant Eye Drug System 8 5 — — $15,548.40 $38,792.25 $16,559.04 2026-04-01
19357 HCPCS Breast Reconstruction 8 5 — — $15,356.73 $32,319.30 $16,354.91 2026-04-01
19298 HCPCS Place Breast Rad Tube/caths 8 5 — — $14,230.66 $27,642.11 $16,047.78 2026-04-01
33935 HCPCS Transplantation Heart/lung 1 1 — — $15,963.15 $15,963.15 $15,963.15 2026-04-01
49605 HCPCS Repair Umbilical Lesion 1 1 — — $15,867.97 $15,867.97 $15,867.97 2026-04-01
54400 HCPCS Insert Semi-rigid Prosthesis 8 5 — — $14,702.05 $46,250.82 $15,657.69 2026-04-01
53440 HCPCS Male Sling Procedure 8 5 — — $14,702.05 $26,463.70 $15,657.69 2026-04-01
32854 HCPCS Lung Transplant With Bypass 1 1 — — $15,650.17 $15,650.17 $15,650.17 2026-04-01
33945 HCPCS Transplantation Of Heart 1 1 — — $15,625.95 $15,625.95 $15,625.95 2026-04-01
L6955 HCPCS Above Elbow Myoelectronic CT 8 5 — — $14,621.82 $36,778.33 $15,572.24 2026-04-01
37224 HCPCS Fem/popl Revas W/tla 1 1 — — $15,537.14 $15,537.14 $15,537.14 2026-04-01
37220 HCPCS Iliac Revasc 1 1 — — $15,537.14 $15,537.14 $15,537.14 2026-04-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 1 — — $15,335.10 $15,335.10 $15,335.10 2026-04-01
Q0479 HCPCS Power Module Combo Vad, Rep 8 5 — — $14,389.66 $36,510.87 $15,324.99 2026-04-01
24579 HCPCS Treat Humerus Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
23615 HCPCS Treat Humerus Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24586 HCPCS Treat Elbow Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24587 HCPCS Treat Elbow Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
20692 HCPCS Apply Bone Fixation Device 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
22554 HCPCS Neck Spine Fusion 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
22551 HCPCS Neck Spine Fuse&remov Bel C2 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27446 HCPCS Revision Of Knee Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
23491 HCPCS Reinforce Shoulder Bones 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24575 HCPCS Treat Humerus Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27443 HCPCS Revision Of Knee Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27429 HCPCS Reconstruction Knee 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
69714 HCPCS Implant Temple Bone W/Stimul 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27438 HCPCS Revise Kneecap With Implant 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27428 HCPCS Reconstruction Knee 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27440 HCPCS Revision Of Knee Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
23485 HCPCS Revision Of Collar Bone 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24545 HCPCS Treat Humerus Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
25810 HCPCS Fusion/graft Of Wrist Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27441 HCPCS Revision Of Knee Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24515 HCPCS Treat Humerus Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24516 HCPCS Treat Humerus Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24546 HCPCS Treat Humerus Fracture 8 5 — — $14,306.71 $47,347.30 $15,236.65 2026-04-01
27442 HCPCS Revision Of Knee Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24410 HCPCS Revision Of Humerus 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
C9734 HCPCS U/s Trtmt, Not Leiomyomata 8 5 — — $14,306.71 $25,752.08 $15,236.65 2026-04-01
24370 HCPCS Revise Reconst Elbow Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
23470 HCPCS Reconstruct Shoulder Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24430 HCPCS Repair Of Humerus 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
25491 HCPCS Reinforce Ulna 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24366 HCPCS Reconstruct Head Of Radius 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24435 HCPCS Repair Humerus With Graft 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
25441 HCPCS Reconstruct Wrist Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
25444 HCPCS Reconstruct Wrist Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27415 HCPCS Osteochondral Knee Allograft 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
25365 HCPCS Revise Radius & Ulna 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27356 HCPCS Remove Femur Lesion/graft 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
25391 HCPCS Lengthen Radius Or Ulna 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24362 HCPCS Reconstruct Elbow Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
29867 HCPCS Allgrft Implnt Knee W/scope 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
29856 HCPCS Tibial Arthroscopy/surgery 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
29889 HCPCS Knee Arthroscopy/surgery 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28735 HCPCS Fusion Of Foot Bones 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28737 HCPCS Revision Of Foot Bones 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
23473 HCPCS Revis Reconst Shoulder Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
29907 HCPCS Subtalar Arthro W/fusion 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28715 HCPCS Fusion Of Foot Bones 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
23680 HCPCS Treat Dislocation/fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28725 HCPCS Fusion Of Foot Bones 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28730 HCPCS Fusion Of Foot Bones 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28320 HCPCS Repair Of Foot Bones 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27828 HCPCS Treat Lower Leg Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27870 HCPCS Fusion Of Ankle Joint Open 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27758 HCPCS Treatment Of Tibia Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27759 HCPCS Treatment Of Tibia Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27871 HCPCS Fusion Of Tibiofibular Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28297 HCPCS Correction Hallux Valgus 8 5 — — $14,306.71 $25,752.08 $15,236.65 2026-04-01
27709 HCPCS Incision Of Tibia & Fibula 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
27827 HCPCS Treat Lower Leg Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24802 HCPCS Fusion/graft Of Elbow Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
22869 HCPCS Insj Stablj Dev Without Dcmprn 8 5 — — $14,306.71 $47,347.30 $15,236.65 2026-04-01
24498 HCPCS Reinforce Humerus 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24346 HCPCS Reconstruct Elbow Med Ligmnt 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
23802 HCPCS Fusion Of Shoulder Joint 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24666 HCPCS Treat Radius Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
28420 HCPCS Treat/graft Heel Fracture 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
24365 HCPCS Reconstruct Head Of Radius 8 5 — — $14,306.71 $30,787.16 $15,236.65 2026-04-01
43123 HCPCS Partial Removal Of Esophagus 1 1 — — $15,142.54 $15,142.54 $15,142.54 2026-04-01
47142 HCPCS Partial Removal Donor Liver 1 1 — — $15,079.13 $15,079.13 $15,079.13 2026-04-01
43108 HCPCS Removal Of Esophagus 1 1 — — $14,991.90 $14,991.90 $14,991.90 2026-04-01
27486 HCPCS Revise/replace Knee Joint 8 5 — — $4,562.48 $25,752.08 $14,950.51 2026-04-01
22548 HCPCS Neck Spine Fusion 8 5 — — $6,218.50 $25,752.08 $14,950.51 2026-04-01
27488 HCPCS Removal Of Knee Prosthesis 8 5 — — $3,892.82 $25,752.08 $14,950.51 2026-04-01
22532 HCPCS Lat Thorax Spine Fusion 8 5 — — $5,717.30 $25,752.08 $14,950.51 2026-04-01
27447 HCPCS Total Knee Arthroplasty 8 5 — — $4,394.40 $25,752.08 $14,950.51 2026-04-01
22849 HCPCS Reinsert Spinal Fixation 8 5 — — $4,188.93 $25,752.08 $14,950.51 2026-04-01
22319 HCPCS Treat Odontoid Fx W/graft 8 5 — — $5,821.80 $25,752.08 $14,950.51 2026-04-01
22325 HCPCS Treat Spine Fracture 8 5 — — $4,633.68 $25,752.08 $14,950.51 2026-04-01
22326 HCPCS Treat Neck Spine Fracture 8 5 — — $4,783.89 $25,752.08 $14,950.51 2026-04-01
22318 HCPCS Treat Odontoid Fx Without Graft 8 5 — — $5,239.49 $25,752.08 $14,950.51 2026-04-01
22327 HCPCS Treat Thorax Spine Fracture 8 5 — — $4,827.88 $25,752.08 $14,950.51 2026-04-01
22590 HCPCS Spine & Skull Spinal Fusion 8 5 — — $5,067.09 $25,752.08 $14,950.51 2026-04-01
23474 HCPCS Revis Reconst Shoulder Joint 8 5 — — $5,691.41 $25,752.08 $14,950.51 2026-04-01
27511 HCPCS Treatment Of Thigh Fracture 8 5 — — $3,229.75 $25,752.08 $14,950.51 2026-04-01
23900 HCPCS Amputation Of Arm & Girdle 8 5 — — $4,496.50 $25,752.08 $14,950.51 2026-04-01
27284 HCPCS Fusion Of Hip Joint 8 5 — — $4,851.64 $25,752.08 $14,950.51 2026-04-01
27286 HCPCS Fusion Of Hip Joint 8 5 — — $5,284.70 $25,752.08 $14,950.51 2026-04-01
27132 HCPCS Total Hip Arthroplasty 8 5 — — $5,430.73 $25,752.08 $14,950.51 2026-04-01
24931 HCPCS Amputate Upper Arm & Implant 8 5 — — $2,608.46 $25,752.08 $14,950.51 2026-04-01
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