|
B0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
13
|
13
|
$76,426.03
|
$76,426.03
|
$76,426.03
|
$76,426.03
|
$76,426.03
|
2025-08-25
|
|
C0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
13
|
13
|
$68,774.23
|
$68,774.23
|
$68,774.23
|
$68,774.23
|
$68,774.23
|
2025-08-25
|
|
B1904
|
HCPCS
|
Guillain-barr� M <38.50
|
13
|
13
|
$67,246.45
|
$67,246.45
|
$67,246.45
|
$67,246.45
|
$67,246.45
|
2025-08-25
|
|
D0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
13
|
13
|
$66,534.95
|
$66,534.95
|
$66,534.95
|
$66,534.95
|
$66,534.95
|
2025-08-25
|
|
B1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
13
|
13
|
$62,721.92
|
$62,721.92
|
$62,721.92
|
$62,721.92
|
$62,721.92
|
2025-08-25
|
|
A0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
13
|
13
|
$60,449.55
|
$60,449.55
|
$60,449.55
|
$60,449.55
|
$60,449.55
|
2025-08-25
|
|
B0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
13
|
13
|
$56,305.59
|
$56,305.59
|
$56,305.59
|
$56,305.59
|
$56,305.59
|
2025-08-25
|
|
B0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
13
|
13
|
$55,623.51
|
$55,623.51
|
$55,623.51
|
$55,623.51
|
$55,623.51
|
2025-08-25
|
|
B0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
13
|
13
|
$54,400.92
|
$54,400.92
|
$54,400.92
|
$54,400.92
|
$54,400.92
|
2025-08-25
|
|
B0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
13
|
13
|
$53,248.19
|
$53,248.19
|
$53,248.19
|
$53,248.19
|
$53,248.19
|
2025-08-25
|
|
C1904
|
HCPCS
|
Guillain-barr� M <38.50
|
13
|
13
|
$51,823.36
|
$51,823.36
|
$51,823.36
|
$51,823.36
|
$51,823.36
|
2025-08-25
|
|
C0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
13
|
13
|
$50,666.95
|
$50,666.95
|
$50,666.95
|
$50,666.95
|
$50,666.95
|
2025-08-25
|
|
C1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
13
|
13
|
$50,598.92
|
$50,598.92
|
$50,598.92
|
$50,598.92
|
$50,598.92
|
2025-08-25
|
|
D0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
13
|
13
|
$49,019.66
|
$49,019.66
|
$49,019.66
|
$49,019.66
|
$49,019.66
|
2025-08-25
|
|
C0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
13
|
13
|
$48,953.47
|
$48,953.47
|
$48,953.47
|
$48,953.47
|
$48,953.47
|
2025-08-25
|
|
D1904
|
HCPCS
|
Guillain-barr� M <38.50
|
13
|
13
|
$48,322.87
|
$48,322.87
|
$48,322.87
|
$48,322.87
|
$48,322.87
|
2025-08-25
|
|
B0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
13
|
13
|
$48,208.88
|
$48,208.88
|
$48,208.88
|
$48,208.88
|
$48,208.88
|
2025-08-25
|
|
B1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
13
|
13
|
$47,980.91
|
$47,980.91
|
$47,980.91
|
$47,980.91
|
$47,980.91
|
2025-08-25
|
|
D1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
13
|
13
|
$47,697.78
|
$47,697.78
|
$47,697.78
|
$47,697.78
|
$47,697.78
|
2025-08-25
|
|
D0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
13
|
13
|
$47,359.50
|
$47,359.50
|
$47,359.50
|
$47,359.50
|
$47,359.50
|
2025-08-25
|
|
A1904
|
HCPCS
|
Guillain-barr� M <38.50
|
13
|
13
|
$47,298.83
|
$47,298.83
|
$47,298.83
|
$47,298.83
|
$47,298.83
|
2025-08-25
|
|
B0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
13
|
13
|
$46,830.02
|
$46,830.02
|
$46,830.02
|
$46,830.02
|
$46,830.02
|
2025-08-25
|
|
C0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
13
|
13
|
$46,199.42
|
$46,199.42
|
$46,199.42
|
$46,199.42
|
$46,199.42
|
2025-08-25
|
|
B1903
|
HCPCS
|
Guillain-barr� M >=38.50 And M <51.50
|
13
|
13
|
$45,995.34
|
$45,995.34
|
$45,995.34
|
$45,995.34
|
$45,995.34
|
2025-08-25
|
|
B0604
|
HCPCS
|
Neurological M <43.50
|
13
|
13
|
$45,690.15
|
$45,690.15
|
$45,690.15
|
$45,690.15
|
$45,690.15
|
2025-08-25
|
|
A0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
13
|
13
|
$44,535.58
|
$44,535.58
|
$44,535.58
|
$44,535.58
|
$44,535.58
|
2025-08-25
|
|
B1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
13
|
13
|
$44,360.93
|
$44,360.93
|
$44,360.93
|
$44,360.93
|
$44,360.93
|
2025-08-25
|
|
A1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
13
|
13
|
$44,206.49
|
$44,206.49
|
$44,206.49
|
$44,206.49
|
$44,206.49
|
2025-08-25
|
|
B0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
13
|
13
|
$44,079.64
|
$44,079.64
|
$44,079.64
|
$44,079.64
|
$44,079.64
|
2025-08-25
|
|
74080531
|
CDM
|
Occ/emb Tumor/organ Infar
|
58
|
34
|
$53,714.22
|
$53,714.22
|
$34,377.10
|
$56,399.93
|
$44,045.66
|
2026-03-16
|
|
74080532
|
CDM
|
Occ/emb Hemorrhag/lymph
|
58
|
34
|
$53,714.22
|
$53,714.22
|
$34,377.10
|
$56,399.93
|
$44,045.66
|
2026-03-16
|
|
74080530
|
CDM
|
Occ/emb Non Hemorr Art
|
58
|
34
|
$53,714.22
|
$53,714.22
|
$34,377.10
|
$56,399.93
|
$44,045.66
|
2026-03-16
|
|
74080529
|
CDM
|
Occ/emb Non Hemorr Venous
|
58
|
34
|
$53,714.22
|
$53,714.22
|
$34,377.10
|
$56,399.93
|
$44,045.66
|
2026-03-16
|
|
A5104
|
HCPCS
|
Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More
|
13
|
13
|
$43,745.03
|
$43,745.03
|
$43,745.03
|
$43,745.03
|
$43,745.03
|
2025-08-25
|
|
B0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
13
|
13
|
$43,713.78
|
$43,713.78
|
$43,713.78
|
$43,713.78
|
$43,713.78
|
2025-08-25
|
|
C0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
13
|
13
|
$43,143.84
|
$43,143.84
|
$43,143.84
|
$43,143.84
|
$43,143.84
|
2025-08-25
|
|
A0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
13
|
13
|
$43,028.02
|
$43,028.02
|
$43,028.02
|
$43,028.02
|
$43,028.02
|
2025-08-25
|
|
B0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
13
|
13
|
$42,840.49
|
$42,840.49
|
$42,840.49
|
$42,840.49
|
$42,840.49
|
2025-08-25
|
|
B1604
|
HCPCS
|
Pain Syndrome M <43.50
|
13
|
13
|
$42,548.17
|
$42,548.17
|
$42,548.17
|
$42,548.17
|
$42,548.17
|
2025-08-25
|
|
B2102
|
HCPCS
|
Burns M <52.50
|
13
|
13
|
$42,448.90
|
$42,448.90
|
$42,448.90
|
$42,448.90
|
$42,448.90
|
2025-08-25
|
|
D0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
13
|
13
|
$42,311.01
|
$42,311.01
|
$42,311.01
|
$42,311.01
|
$42,311.01
|
2025-08-25
|
|
B1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
13
|
13
|
$42,242.98
|
$42,242.98
|
$42,242.98
|
$42,242.98
|
$42,242.98
|
2025-08-25
|
|
B1504
|
HCPCS
|
Pulmonary M <45.50
|
13
|
13
|
$41,340.29
|
$41,340.29
|
$41,340.29
|
$41,340.29
|
$41,340.29
|
2025-08-25
|
|
B1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
13
|
13
|
$40,911.92
|
$40,911.92
|
$40,911.92
|
$40,911.92
|
$40,911.92
|
2025-08-25
|
|
D0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
13
|
13
|
$40,766.68
|
$40,766.68
|
$40,766.68
|
$40,766.68
|
$40,766.68
|
2025-08-25
|
|
B2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
13
|
13
|
$40,740.94
|
$40,740.94
|
$40,740.94
|
$40,740.94
|
$40,740.94
|
2025-08-25
|
|
B1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
13
|
13
|
$40,696.81
|
$40,696.81
|
$40,696.81
|
$40,696.81
|
$40,696.81
|
2025-08-25
|
|
C0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
13
|
13
|
$40,630.63
|
$40,630.63
|
$40,630.63
|
$40,630.63
|
$40,630.63
|
2025-08-25
|
|
A0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
13
|
13
|
$40,354.86
|
$40,354.86
|
$40,354.86
|
$40,354.86
|
$40,354.86
|
2025-08-25
|
|
B0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
13
|
13
|
$40,022.09
|
$40,022.09
|
$40,022.09
|
$40,022.09
|
$40,022.09
|
2025-08-25
|
|
B1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
13
|
13
|
$39,977.97
|
$39,977.97
|
$39,977.97
|
$39,977.97
|
$39,977.97
|
2025-08-25
|
|
C0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
13
|
13
|
$39,954.06
|
$39,954.06
|
$39,954.06
|
$39,954.06
|
$39,954.06
|
2025-08-25
|
|
B0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
13
|
13
|
$39,726.09
|
$39,726.09
|
$39,726.09
|
$39,726.09
|
$39,726.09
|
2025-08-25
|
|
C0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
13
|
13
|
$39,665.42
|
$39,665.42
|
$39,665.42
|
$39,665.42
|
$39,665.42
|
2025-08-25
|
|
B1404
|
HCPCS
|
Cardiac M <45.50
|
13
|
13
|
$39,325.30
|
$39,325.30
|
$39,325.30
|
$39,325.30
|
$39,325.30
|
2025-08-25
|
|
B0904
|
HCPCS
|
Other Orthopedic M <44.5
|
13
|
13
|
$39,211.31
|
$39,211.31
|
$39,211.31
|
$39,211.31
|
$39,211.31
|
2025-08-25
|
|
B2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
13
|
13
|
$38,654.25
|
$38,654.25
|
$38,654.25
|
$38,654.25
|
$38,654.25
|
2025-08-25
|
|
B1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
13
|
13
|
$38,463.05
|
$38,463.05
|
$38,463.05
|
$38,463.05
|
$38,463.05
|
2025-08-25
|
|
D0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
13
|
13
|
$38,374.80
|
$38,374.80
|
$38,374.80
|
$38,374.80
|
$38,374.80
|
2025-08-25
|
|
B1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
13
|
13
|
$38,102.71
|
$38,102.71
|
$38,102.71
|
$38,102.71
|
$38,102.71
|
2025-08-25
|
|
B0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
13
|
13
|
$37,760.75
|
$37,760.75
|
$37,760.75
|
$37,760.75
|
$37,760.75
|
2025-08-25
|
|
74080268
|
CDM
|
Insert Tips
|
58
|
34
|
$45,988.74
|
$45,988.74
|
$29,432.79
|
$48,288.18
|
$37,710.77
|
2026-03-16
|
|
B0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
13
|
13
|
$37,657.79
|
$37,657.79
|
$37,657.79
|
$37,657.79
|
$37,657.79
|
2025-08-25
|
|
A0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
13
|
13
|
$37,571.38
|
$37,571.38
|
$37,571.38
|
$37,571.38
|
$37,571.38
|
2025-08-25
|
|
C1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
13
|
13
|
$37,519.90
|
$37,519.90
|
$37,519.90
|
$37,519.90
|
$37,519.90
|
2025-08-25
|
|
B0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
13
|
13
|
$37,483.13
|
$37,483.13
|
$37,483.13
|
$37,483.13
|
$37,483.13
|
2025-08-25
|
|
D0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
13
|
13
|
$37,211.04
|
$37,211.04
|
$37,211.04
|
$37,211.04
|
$37,211.04
|
2025-08-25
|
|
B1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
13
|
13
|
$36,841.50
|
$36,841.50
|
$36,841.50
|
$36,841.50
|
$36,841.50
|
2025-08-25
|
|
74080483
|
CDM
|
Revise Tips
|
58
|
34
|
$44,794.32
|
$44,794.32
|
$28,668.36
|
$47,034.04
|
$36,731.34
|
2026-03-16
|
|
B1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
13
|
13
|
$36,619.04
|
$36,619.04
|
$36,619.04
|
$36,619.04
|
$36,619.04
|
2025-08-25
|
|
B0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
13
|
13
|
$36,426.00
|
$36,426.00
|
$36,426.00
|
$36,426.00
|
$36,426.00
|
2025-08-25
|
|
D0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
13
|
13
|
$36,304.66
|
$36,304.66
|
$36,304.66
|
$36,304.66
|
$36,304.66
|
2025-08-25
|
|
B1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
13
|
13
|
$36,153.91
|
$36,153.91
|
$36,153.91
|
$36,153.91
|
$36,153.91
|
2025-08-25
|
|
C1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
13
|
13
|
$35,788.05
|
$35,788.05
|
$35,788.05
|
$35,788.05
|
$35,788.05
|
2025-08-25
|
|
B0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
13
|
13
|
$35,718.18
|
$35,718.18
|
$35,718.18
|
$35,718.18
|
$35,718.18
|
2025-08-25
|
|
A0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
13
|
13
|
$35,492.05
|
$35,492.05
|
$35,492.05
|
$35,492.05
|
$35,492.05
|
2025-08-25
|
|
C1903
|
HCPCS
|
Guillain-barr� M >=38.50 And M <51.50
|
13
|
13
|
$35,446.09
|
$35,446.09
|
$35,446.09
|
$35,446.09
|
$35,446.09
|
2025-08-25
|
|
B0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
13
|
13
|
$35,065.52
|
$35,065.52
|
$35,065.52
|
$35,065.52
|
$35,065.52
|
2025-08-25
|
|
C0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
13
|
13
|
$35,032.43
|
$35,032.43
|
$35,032.43
|
$35,032.43
|
$35,032.43
|
2025-08-25
|
|
C1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
13
|
13
|
$35,021.40
|
$35,021.40
|
$35,021.40
|
$35,021.40
|
$35,021.40
|
2025-08-25
|
|
A0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
13
|
13
|
$34,865.12
|
$34,865.12
|
$34,865.12
|
$34,865.12
|
$34,865.12
|
2025-08-25
|
|
D1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
13
|
13
|
$34,699.66
|
$34,699.66
|
$34,699.66
|
$34,699.66
|
$34,699.66
|
2025-08-25
|
|
C0604
|
HCPCS
|
Neurological M <43.50
|
13
|
13
|
$34,300.71
|
$34,300.71
|
$34,300.71
|
$34,300.71
|
$34,300.71
|
2025-08-25
|
|
B1603
|
HCPCS
|
Pain Syndrome M >=43.50 And M <58.50
|
13
|
13
|
$34,280.48
|
$34,280.48
|
$34,280.48
|
$34,280.48
|
$34,280.48
|
2025-08-25
|
|
B0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
13
|
13
|
$34,265.78
|
$34,265.78
|
$34,265.78
|
$34,265.78
|
$34,265.78
|
2025-08-25
|
|
A0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
13
|
13
|
$34,197.75
|
$34,197.75
|
$34,197.75
|
$34,197.75
|
$34,197.75
|
2025-08-25
|
|
C1504
|
HCPCS
|
Pulmonary M <45.50
|
13
|
13
|
$33,776.74
|
$33,776.74
|
$33,776.74
|
$33,776.74
|
$33,776.74
|
2025-08-25
|
|
D1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
13
|
13
|
$33,734.45
|
$33,734.45
|
$33,734.45
|
$33,734.45
|
$33,734.45
|
2025-08-25
|
|
B0503
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
13
|
13
|
$33,657.24
|
$33,657.24
|
$33,657.24
|
$33,657.24
|
$33,657.24
|
2025-08-25
|
|
A5102
|
HCPCS
|
Expired, Orthopedic, Length Of Stay Is 14 Days Or More
|
13
|
13
|
$33,502.80
|
$33,502.80
|
$33,502.80
|
$33,502.80
|
$33,502.80
|
2025-08-25
|
|
B1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
13
|
13
|
$33,489.93
|
$33,489.93
|
$33,489.93
|
$33,489.93
|
$33,489.93
|
2025-08-25
|
|
B1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
13
|
13
|
$33,421.91
|
$33,421.91
|
$33,421.91
|
$33,421.91
|
$33,421.91
|
2025-08-25
|
|
C0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
13
|
13
|
$33,103.85
|
$33,103.85
|
$33,103.85
|
$33,103.85
|
$33,103.85
|
2025-08-25
|
|
D1903
|
HCPCS
|
Guillain-barr� M >=38.50 And M <51.50
|
13
|
13
|
$33,050.53
|
$33,050.53
|
$33,050.53
|
$33,050.53
|
$33,050.53
|
2025-08-25
|
|
B1003
|
HCPCS
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
13
|
13
|
$33,015.60
|
$33,015.60
|
$33,015.60
|
$33,015.60
|
$33,015.60
|
2025-08-25
|
|
B0903
|
HCPCS
|
Other Orthopedic M >=44.50 And M <51.50
|
13
|
13
|
$32,725.12
|
$32,725.12
|
$32,725.12
|
$32,725.12
|
$32,725.12
|
2025-08-25
|
|
C2102
|
HCPCS
|
Burns M <52.50
|
13
|
13
|
$32,612.97
|
$32,612.97
|
$32,612.97
|
$32,612.97
|
$32,612.97
|
2025-08-25
|
|
D2102
|
HCPCS
|
Burns M <52.50
|
13
|
13
|
$32,612.97
|
$32,612.97
|
$32,612.97
|
$32,612.97
|
$32,612.97
|
2025-08-25
|
|
C2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
13
|
13
|
$32,598.27
|
$32,598.27
|
$32,598.27
|
$32,598.27
|
$32,598.27
|
2025-08-25
|
|
C1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
13
|
13
|
$32,585.40
|
$32,585.40
|
$32,585.40
|
$32,585.40
|
$32,585.40
|
2025-08-25
|
|
C0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
13
|
13
|
$32,522.89
|
$32,522.89
|
$32,522.89
|
$32,522.89
|
$32,522.89
|
2025-08-25
|
|
A1903
|
HCPCS
|
Guillain-barr� M >=38.50 And M <51.50
|
13
|
13
|
$32,350.07
|
$32,350.07
|
$32,350.07
|
$32,350.07
|
$32,350.07
|
2025-08-25
|
|
B2003
|
HCPCS
|
Miscellaneous M >=46.50 And M <55.50
|
13
|
13
|
$32,335.36
|
$32,335.36
|
$32,335.36
|
$32,335.36
|
$32,335.36
|
2025-08-25
|
|
C1604
|
HCPCS
|
Pain Syndrome M <43.50
|
13
|
13
|
$32,210.34
|
$32,210.34
|
$32,210.34
|
$32,210.34
|
$32,210.34
|
2025-08-25
|
|
D0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
13
|
13
|
$32,188.28
|
$32,188.28
|
$32,188.28
|
$32,188.28
|
$32,188.28
|
2025-08-25
|
|
B1403
|
HCPCS
|
Cardiac M >=45.50 And M <55.50
|
13
|
13
|
$32,169.90
|
$32,169.90
|
$32,169.90
|
$32,169.90
|
$32,169.90
|
2025-08-25
|
|
C0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
13
|
13
|
$32,140.48
|
$32,140.48
|
$32,140.48
|
$32,140.48
|
$32,140.48
|
2025-08-25
|
|
B1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
13
|
13
|
$32,092.68
|
$32,092.68
|
$32,092.68
|
$32,092.68
|
$32,092.68
|
2025-08-25
|
|
D0604
|
HCPCS
|
Neurological M <43.50
|
13
|
13
|
$32,004.43
|
$32,004.43
|
$32,004.43
|
$32,004.43
|
$32,004.43
|
2025-08-25
|
|
C1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
13
|
13
|
$31,991.56
|
$31,991.56
|
$31,991.56
|
$31,991.56
|
$31,991.56
|
2025-08-25
|
|
D1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
13
|
13
|
$31,962.15
|
$31,962.15
|
$31,962.15
|
$31,962.15
|
$31,962.15
|
2025-08-25
|
|
D1504
|
HCPCS
|
Pulmonary M <45.50
|
13
|
13
|
$31,899.64
|
$31,899.64
|
$31,899.64
|
$31,899.64
|
$31,899.64
|
2025-08-25
|
|
C0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
13
|
13
|
$31,835.29
|
$31,835.29
|
$31,835.29
|
$31,835.29
|
$31,835.29
|
2025-08-25
|
|
A1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
13
|
13
|
$31,515.40
|
$31,515.40
|
$31,515.40
|
$31,515.40
|
$31,515.40
|
2025-08-25
|
|
C0904
|
HCPCS
|
Other Orthopedic M <44.5
|
13
|
13
|
$31,511.72
|
$31,511.72
|
$31,511.72
|
$31,511.72
|
$31,511.72
|
2025-08-25
|
|
B0804
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
13
|
13
|
$31,502.53
|
$31,502.53
|
$31,502.53
|
$31,502.53
|
$31,502.53
|
2025-08-25
|
|
D0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
13
|
13
|
$31,370.15
|
$31,370.15
|
$31,370.15
|
$31,370.15
|
$31,370.15
|
2025-08-25
|
|
A1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
13
|
13
|
$31,265.36
|
$31,265.36
|
$31,265.36
|
$31,265.36
|
$31,265.36
|
2025-08-25
|
|
C0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
13
|
13
|
$31,210.21
|
$31,210.21
|
$31,210.21
|
$31,210.21
|
$31,210.21
|
2025-08-25
|
|
D1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
13
|
13
|
$31,147.70
|
$31,147.70
|
$31,147.70
|
$31,147.70
|
$31,147.70
|
2025-08-25
|
|
D0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
13
|
13
|
$31,094.38
|
$31,094.38
|
$31,094.38
|
$31,094.38
|
$31,094.38
|
2025-08-25
|
|
C1404
|
HCPCS
|
Cardiac M <45.50
|
13
|
13
|
$31,064.97
|
$31,064.97
|
$31,064.97
|
$31,064.97
|
$31,064.97
|
2025-08-25
|
|
C0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
13
|
13
|
$31,042.90
|
$31,042.90
|
$31,042.90
|
$31,042.90
|
$31,042.90
|
2025-08-25
|
|
B0602
|
HCPCS
|
Neurological M >=52.50 And M <64.50
|
13
|
13
|
$30,928.92
|
$30,928.92
|
$30,928.92
|
$30,928.92
|
$30,928.92
|
2025-08-25
|
|
C2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
13
|
13
|
$30,928.92
|
$30,928.92
|
$30,928.92
|
$30,928.92
|
$30,928.92
|
2025-08-25
|
|
C1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
13
|
13
|
$30,798.38
|
$30,798.38
|
$30,798.38
|
$30,798.38
|
$30,798.38
|
2025-08-25
|
|
B1902
|
HCPCS
|
Guillain-barr� M >=51.50 And M <66.50
|
13
|
13
|
$30,614.54
|
$30,614.54
|
$30,614.54
|
$30,614.54
|
$30,614.54
|
2025-08-25
|
|
C1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
13
|
13
|
$30,590.64
|
$30,590.64
|
$30,590.64
|
$30,590.64
|
$30,590.64
|
2025-08-25
|
|
C0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
13
|
13
|
$30,559.38
|
$30,559.38
|
$30,559.38
|
$30,559.38
|
$30,559.38
|
2025-08-25
|
|
74080527
|
CDM
|
Stnt Plc Transc Vein Ini
|
58
|
34
|
$37,173.90
|
$37,173.90
|
$23,791.30
|
$39,032.60
|
$30,482.60
|
2026-03-16
|
|
D2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
13
|
13
|
$30,474.81
|
$30,474.81
|
$30,474.81
|
$30,474.81
|
$30,474.81
|
2025-08-25
|
|
B1702
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
13
|
13
|
$30,419.66
|
$30,419.66
|
$30,419.66
|
$30,419.66
|
$30,419.66
|
2025-08-25
|
|
B0203
|
HCPCS
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
13
|
13
|
$30,373.69
|
$30,373.69
|
$30,373.69
|
$30,373.69
|
$30,373.69
|
2025-08-25
|
|
A0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
13
|
13
|
$30,357.15
|
$30,357.15
|
$30,357.15
|
$30,357.15
|
$30,357.15
|
2025-08-25
|
|
74080525
|
CDM
|
Stnt Plc Transcth Art Ini
|
58
|
34
|
$37,018.86
|
$37,018.86
|
$23,692.07
|
$38,869.80
|
$30,355.47
|
2026-03-16
|
|
74080548
|
CDM
|
Verteb Augm Lumbar W Imag
|
58
|
34
|
$36,922.98
|
$36,922.98
|
$23,630.71
|
$38,769.13
|
$30,276.84
|
2026-03-16
|
|
74080547
|
CDM
|
Verteb Augm Thorac W Imag
|
58
|
34
|
$36,922.98
|
$36,922.98
|
$23,630.71
|
$38,769.13
|
$30,276.84
|
2026-03-16
|
|
74080549
|
CDM
|
Verteb Augm Ea Add W Imag
|
58
|
34
|
$36,922.98
|
$36,922.98
|
$23,630.71
|
$38,769.13
|
$30,276.84
|
2026-03-16
|
|
76085035
|
CDM
|
Sm153 Lexidron To 150mci
|
27
|
16
|
$39,834.06
|
$39,834.06
|
$25,493.80
|
$36,647.34
|
$30,273.89
|
2025-08-25
|
|
C1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
13
|
13
|
$29,838.69
|
$29,838.69
|
$29,838.69
|
$29,838.69
|
$29,838.69
|
2025-08-25
|
|
D1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
13
|
13
|
$29,838.69
|
$29,838.69
|
$29,838.69
|
$29,838.69
|
$29,838.69
|
2025-08-25
|
|
A1504
|
HCPCS
|
Pulmonary M <45.50
|
13
|
13
|
$29,787.21
|
$29,787.21
|
$29,787.21
|
$29,787.21
|
$29,787.21
|
2025-08-25
|
|
D0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
13
|
13
|
$29,785.38
|
$29,785.38
|
$29,785.38
|
$29,785.38
|
$29,785.38
|
2025-08-25
|
|
D1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
13
|
13
|
$29,586.82
|
$29,586.82
|
$29,586.82
|
$29,586.82
|
$29,586.82
|
2025-08-25
|
|
B1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
13
|
13
|
$29,548.21
|
$29,548.21
|
$29,548.21
|
$29,548.21
|
$29,548.21
|
2025-08-25
|
|
C1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
13
|
13
|
$29,542.70
|
$29,542.70
|
$29,542.70
|
$29,542.70
|
$29,542.70
|
2025-08-25
|
|
B1202
|
HCPCS
|
Osteoarthritis M >=49.50 And M <61.50
|
13
|
13
|
$29,461.80
|
$29,461.80
|
$29,461.80
|
$29,461.80
|
$29,461.80
|
2025-08-25
|
|
D1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
13
|
13
|
$29,437.90
|
$29,437.90
|
$29,437.90
|
$29,437.90
|
$29,437.90
|
2025-08-25
|
|
D0904
|
HCPCS
|
Other Orthopedic M <44.5
|
13
|
13
|
$29,390.10
|
$29,390.10
|
$29,390.10
|
$29,390.10
|
$29,390.10
|
2025-08-25
|
|
B0103
|
HCPCS
|
Stroke M >=50.50 And M <63.50
|
13
|
13
|
$29,369.88
|
$29,369.88
|
$29,369.88
|
$29,369.88
|
$29,369.88
|
2025-08-25
|
|
B0502
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
13
|
13
|
$29,366.20
|
$29,366.20
|
$29,366.20
|
$29,366.20
|
$29,366.20
|
2025-08-25
|
|
B1502
|
HCPCS
|
Pulmonary M >=56.50 And M <68.50
|
13
|
13
|
$29,358.85
|
$29,358.85
|
$29,358.85
|
$29,358.85
|
$29,358.85
|
2025-08-25
|
|
D0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
13
|
13
|
$29,331.27
|
$29,331.27
|
$29,331.27
|
$29,331.27
|
$29,331.27
|
2025-08-25
|
|
D0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
13
|
13
|
$29,252.21
|
$29,252.21
|
$29,252.21
|
$29,252.21
|
$29,252.21
|
2025-08-25
|
|
C1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
13
|
13
|
$29,156.61
|
$29,156.61
|
$29,156.61
|
$29,156.61
|
$29,156.61
|
2025-08-25
|
|
A1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
13
|
13
|
$29,086.75
|
$29,086.75
|
$29,086.75
|
$29,086.75
|
$29,086.75
|
2025-08-25
|
|
A0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
13
|
13
|
$28,972.76
|
$28,972.76
|
$28,972.76
|
$28,972.76
|
$28,972.76
|
2025-08-25
|
|
D1604
|
HCPCS
|
Pain Syndrome M <43.50
|
13
|
13
|
$28,923.12
|
$28,923.12
|
$28,923.12
|
$28,923.12
|
$28,923.12
|
2025-08-25
|
|
D2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
13
|
13
|
$28,913.93
|
$28,913.93
|
$28,913.93
|
$28,913.93
|
$28,913.93
|
2025-08-25
|
|
A1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
13
|
13
|
$28,890.03
|
$28,890.03
|
$28,890.03
|
$28,890.03
|
$28,890.03
|
2025-08-25
|
|
A0604
|
HCPCS
|
Neurological M <43.50
|
13
|
13
|
$28,875.32
|
$28,875.32
|
$28,875.32
|
$28,875.32
|
$28,875.32
|
2025-08-25
|
|
D1404
|
HCPCS
|
Cardiac M <45.50
|
13
|
13
|
$28,858.78
|
$28,858.78
|
$28,858.78
|
$28,858.78
|
$28,858.78
|
2025-08-25
|
|
D1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
13
|
13
|
$28,579.33
|
$28,579.33
|
$28,579.33
|
$28,579.33
|
$28,579.33
|
2025-08-25
|
|
A1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
13
|
13
|
$28,562.78
|
$28,562.78
|
$28,562.78
|
$28,562.78
|
$28,562.78
|
2025-08-25
|
|
B0702
|
HCPCS
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
13
|
13
|
$28,498.43
|
$28,498.43
|
$28,498.43
|
$28,498.43
|
$28,498.43
|
2025-08-25
|
|
B0302
|
HCPCS
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
13
|
13
|
$28,417.54
|
$28,417.54
|
$28,417.54
|
$28,417.54
|
$28,417.54
|
2025-08-25
|
|
A0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
13
|
13
|
$28,408.35
|
$28,408.35
|
$28,408.35
|
$28,408.35
|
$28,408.35
|
2025-08-25
|
|
B0402
|
HCPCS
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
13
|
13
|
$28,400.99
|
$28,400.99
|
$28,400.99
|
$28,400.99
|
$28,400.99
|
2025-08-25
|
|
D0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
13
|
13
|
$28,358.71
|
$28,358.71
|
$28,358.71
|
$28,358.71
|
$28,358.71
|
2025-08-25
|
|
B1302
|
HCPCS
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
13
|
13
|
$28,340.32
|
$28,340.32
|
$28,340.32
|
$28,340.32
|
$28,340.32
|
2025-08-25
|
|
C1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
13
|
13
|
$28,270.46
|
$28,270.46
|
$28,270.46
|
$28,270.46
|
$28,270.46
|
2025-08-25
|
|
A0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
13
|
13
|
$28,252.08
|
$28,252.08
|
$28,252.08
|
$28,252.08
|
$28,252.08
|
2025-08-25
|
|
B1002
|
HCPCS
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
13
|
13
|
$28,134.41
|
$28,134.41
|
$28,134.41
|
$28,134.41
|
$28,134.41
|
2025-08-25
|
|
76085037
|
CDM
|
Strontium Sr-89 Thera/mci
|
27
|
16
|
$37,014.78
|
$37,014.78
|
$23,689.46
|
$34,053.60
|
$28,131.23
|
2025-08-25
|
|
B0803
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
13
|
13
|
$28,092.13
|
$28,092.13
|
$28,092.13
|
$28,092.13
|
$28,092.13
|
2025-08-25
|
|
36224
|
CPT
|
Place Cath Int Carotid Art Bi
|
58
|
34
|
$34,146.37
|
$34,146.37
|
$21,853.68
|
$35,853.69
|
$28,000.02
|
2026-03-16
|
|
B2101
|
HCPCS
|
Burns M >=52.50
|
13
|
13
|
$27,888.05
|
$27,888.05
|
$27,888.05
|
$27,888.05
|
$27,888.05
|
2025-08-25
|
|
D1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
13
|
13
|
$27,847.61
|
$27,847.61
|
$27,847.61
|
$27,847.61
|
$27,847.61
|
2025-08-25
|
|
A2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
13
|
13
|
$27,748.33
|
$27,748.33
|
$27,748.33
|
$27,748.33
|
$27,748.33
|
2025-08-25
|
|
D0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
13
|
13
|
$27,711.56
|
$27,711.56
|
$27,711.56
|
$27,711.56
|
$27,711.56
|
2025-08-25
|
|
A0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
13
|
13
|
$27,586.54
|
$27,586.54
|
$27,586.54
|
$27,586.54
|
$27,586.54
|
2025-08-25
|
|
A2102
|
HCPCS
|
Burns M <52.50
|
13
|
13
|
$27,509.33
|
$27,509.33
|
$27,509.33
|
$27,509.33
|
$27,509.33
|
2025-08-25
|
|
C0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
13
|
13
|
$27,459.69
|
$27,459.69
|
$27,459.69
|
$27,459.69
|
$27,459.69
|
2025-08-25
|
|
B0902
|
HCPCS
|
Other Orthopedic M >=51.50 And M <63.50
|
13
|
13
|
$27,419.24
|
$27,419.24
|
$27,419.24
|
$27,419.24
|
$27,419.24
|
2025-08-25
|
|
C1003
|
HCPCS
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
13
|
13
|
$27,373.28
|
$27,373.28
|
$27,373.28
|
$27,373.28
|
$27,373.28
|
2025-08-25
|
|
C0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
13
|
13
|
$27,345.70
|
$27,345.70
|
$27,345.70
|
$27,345.70
|
$27,345.70
|
2025-08-25
|
|
B1602
|
HCPCS
|
Pain Syndrome M >=58.50 And M <65.50
|
13
|
13
|
$27,330.99
|
$27,330.99
|
$27,330.99
|
$27,330.99
|
$27,330.99
|
2025-08-25
|
|
C1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
13
|
13
|
$27,307.09
|
$27,307.09
|
$27,307.09
|
$27,307.09
|
$27,307.09
|
2025-08-25
|
|
A1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
13
|
13
|
$27,303.41
|
$27,303.41
|
$27,303.41
|
$27,303.41
|
$27,303.41
|
2025-08-25
|
|
D1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
13
|
13
|
$27,239.07
|
$27,239.07
|
$27,239.07
|
$27,239.07
|
$27,239.07
|
2025-08-25
|
|
C0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
13
|
13
|
$27,095.67
|
$27,095.67
|
$27,095.67
|
$27,095.67
|
$27,095.67
|
2025-08-25
|
|
A0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
13
|
13
|
$27,033.16
|
$27,033.16
|
$27,033.16
|
$27,033.16
|
$27,033.16
|
2025-08-25
|
|
C1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
13
|
13
|
$27,016.61
|
$27,016.61
|
$27,016.61
|
$27,016.61
|
$27,016.61
|
2025-08-25
|
|
B2002
|
HCPCS
|
Miscellaneous M >=55.50 And M <66.50
|
13
|
13
|
$27,009.26
|
$27,009.26
|
$27,009.26
|
$27,009.26
|
$27,009.26
|
2025-08-25
|
|
A1604
|
HCPCS
|
Pain Syndrome M <43.50
|
13
|
13
|
$26,917.33
|
$26,917.33
|
$26,917.33
|
$26,917.33
|
$26,917.33
|
2025-08-25
|
|
A0904
|
HCPCS
|
Other Orthopedic M <44.5
|
13
|
13
|
$26,898.95
|
$26,898.95
|
$26,898.95
|
$26,898.95
|
$26,898.95
|
2025-08-25
|
|
A1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
13
|
13
|
$26,871.37
|
$26,871.37
|
$26,871.37
|
$26,871.37
|
$26,871.37
|
2025-08-25
|
|
A0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
13
|
13
|
$26,713.26
|
$26,713.26
|
$26,713.26
|
$26,713.26
|
$26,713.26
|
2025-08-25
|
|
A1404
|
HCPCS
|
Cardiac M <45.50
|
13
|
13
|
$26,564.34
|
$26,564.34
|
$26,564.34
|
$26,564.34
|
$26,564.34
|
2025-08-25
|
|
A2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
13
|
13
|
$26,327.18
|
$26,327.18
|
$26,327.18
|
$26,327.18
|
$26,327.18
|
2025-08-25
|
|
C0903
|
HCPCS
|
Other Orthopedic M >=44.50 And M <51.50
|
13
|
13
|
$26,297.76
|
$26,297.76
|
$26,297.76
|
$26,297.76
|
$26,297.76
|
2025-08-25
|
|
B1402
|
HCPCS
|
Cardiac M >=55.50 And M <68.50
|
13
|
13
|
$26,262.83
|
$26,262.83
|
$26,262.83
|
$26,262.83
|
$26,262.83
|
2025-08-25
|
|
A1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
13
|
13
|
$26,196.64
|
$26,196.64
|
$26,196.64
|
$26,196.64
|
$26,196.64
|
2025-08-25
|
|
D1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
13
|
13
|
$26,145.17
|
$26,145.17
|
$26,145.17
|
$26,145.17
|
$26,145.17
|
2025-08-25
|
|
C0503
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
13
|
13
|
$26,106.56
|
$26,106.56
|
$26,106.56
|
$26,106.56
|
$26,106.56
|
2025-08-25
|
|
B1802
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
13
|
13
|
$25,985.22
|
$25,985.22
|
$25,985.22
|
$25,985.22
|
$25,985.22
|
2025-08-25
|
|
C1603
|
HCPCS
|
Pain Syndrome M >=43.50 And M <58.50
|
13
|
13
|
$25,952.12
|
$25,952.12
|
$25,952.12
|
$25,952.12
|
$25,952.12
|
2025-08-25
|
|
C2003
|
HCPCS
|
Miscellaneous M >=46.50 And M <55.50
|
13
|
13
|
$25,873.07
|
$25,873.07
|
$25,873.07
|
$25,873.07
|
$25,873.07
|
2025-08-25
|
|
A0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
13
|
13
|
$25,819.75
|
$25,819.75
|
$25,819.75
|
$25,819.75
|
$25,819.75
|
2025-08-25
|
|
A1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
13
|
13
|
$25,810.56
|
$25,810.56
|
$25,810.56
|
$25,810.56
|
$25,810.56
|
2025-08-25
|
|
D1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
13
|
13
|
$25,790.34
|
$25,790.34
|
$25,790.34
|
$25,790.34
|
$25,790.34
|
2025-08-25
|
|
C1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
13
|
13
|
$25,696.57
|
$25,696.57
|
$25,696.57
|
$25,696.57
|
$25,696.57
|
2025-08-25
|
|
D0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
13
|
13
|
$25,676.35
|
$25,676.35
|
$25,676.35
|
$25,676.35
|
$25,676.35
|
2025-08-25
|
|
C0402
|
HCPCS
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
13
|
13
|
$25,556.85
|
$25,556.85
|
$25,556.85
|
$25,556.85
|
$25,556.85
|
2025-08-25
|
|
D0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
13
|
13
|
$25,514.56
|
$25,514.56
|
$25,514.56
|
$25,514.56
|
$25,514.56
|
2025-08-25
|
|
C0804
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
13
|
13
|
$25,494.34
|
$25,494.34
|
$25,494.34
|
$25,494.34
|
$25,494.34
|
2025-08-25
|
|
C0103
|
HCPCS
|
Stroke M >=50.50 And M <63.50
|
13
|
13
|
$25,483.31
|
$25,483.31
|
$25,483.31
|
$25,483.31
|
$25,483.31
|
2025-08-25
|
|
D1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
13
|
13
|
$25,466.76
|
$25,466.76
|
$25,466.76
|
$25,466.76
|
$25,466.76
|
2025-08-25
|
|
C1403
|
HCPCS
|
Cardiac M >=45.50 And M <55.50
|
13
|
13
|
$25,411.61
|
$25,411.61
|
$25,411.61
|
$25,411.61
|
$25,411.61
|
2025-08-25
|
|
B0802
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=57.50 And M <63.50
|
13
|
13
|
$25,321.52
|
$25,321.52
|
$25,321.52
|
$25,321.52
|
$25,321.52
|
2025-08-25
|
|
D0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
13
|
13
|
$25,231.44
|
$25,231.44
|
$25,231.44
|
$25,231.44
|
$25,231.44
|
2025-08-25
|
|
C0203
|
HCPCS
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
13
|
13
|
$25,174.44
|
$25,174.44
|
$25,174.44
|
$25,174.44
|
$25,174.44
|
2025-08-25
|
|
D1003
|
HCPCS
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
13
|
13
|
$24,981.40
|
$24,981.40
|
$24,981.40
|
$24,981.40
|
$24,981.40
|
2025-08-25
|
|
A1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
13
|
13
|
$24,966.69
|
$24,966.69
|
$24,966.69
|
$24,966.69
|
$24,966.69
|
2025-08-25
|
|
D0402
|
HCPCS
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
13
|
13
|
$24,724.01
|
$24,724.01
|
$24,724.01
|
$24,724.01
|
$24,724.01
|
2025-08-25
|
|
D0503
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
13
|
13
|
$24,667.02
|
$24,667.02
|
$24,667.02
|
$24,667.02
|
$24,667.02
|
2025-08-25
|
|
D1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
13
|
13
|
$24,562.23
|
$24,562.23
|
$24,562.23
|
$24,562.23
|
$24,562.23
|
2025-08-25
|
|
D0903
|
HCPCS
|
Other Orthopedic M >=44.50 And M <51.50
|
13
|
13
|
$24,527.30
|
$24,527.30
|
$24,527.30
|
$24,527.30
|
$24,527.30
|
2025-08-25
|
|
B1701
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50
|
13
|
13
|
$24,473.98
|
$24,473.98
|
$24,473.98
|
$24,473.98
|
$24,473.98
|
2025-08-25
|
|
B0601
|
HCPCS
|
Neurological M >=64.50
|
13
|
13
|
$24,378.38
|
$24,378.38
|
$24,378.38
|
$24,378.38
|
$24,378.38
|
2025-08-25
|
|
B0202
|
HCPCS
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
13
|
13
|
$24,314.03
|
$24,314.03
|
$24,314.03
|
$24,314.03
|
$24,314.03
|
2025-08-25
|
|
B1201
|
HCPCS
|
Osteoarthritis M >=61.50
|
13
|
13
|
$24,266.23
|
$24,266.23
|
$24,266.23
|
$24,266.23
|
$24,266.23
|
2025-08-25
|
|
D2003
|
HCPCS
|
Miscellaneous M >=46.50 And M <55.50
|
13
|
13
|
$24,187.17
|
$24,187.17
|
$24,187.17
|
$24,187.17
|
$24,187.17
|
2025-08-25
|
|
A1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
13
|
13
|
$24,082.38
|
$24,082.38
|
$24,082.38
|
$24,082.38
|
$24,082.38
|
2025-08-25
|
|
C1502
|
HCPCS
|
Pulmonary M >=56.50 And M <68.50
|
13
|
13
|
$23,988.62
|
$23,988.62
|
$23,988.62
|
$23,988.62
|
$23,988.62
|
2025-08-25
|
|
C1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
13
|
13
|
$23,931.62
|
$23,931.62
|
$23,931.62
|
$23,931.62
|
$23,931.62
|
2025-08-25
|
|
D1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
13
|
13
|
$23,931.62
|
$23,931.62
|
$23,931.62
|
$23,931.62
|
$23,931.62
|
2025-08-25
|
|
A0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
13
|
13
|
$23,793.74
|
$23,793.74
|
$23,793.74
|
$23,793.74
|
$23,793.74
|
2025-08-25
|
|
C1702
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
13
|
13
|
$23,786.38
|
$23,786.38
|
$23,786.38
|
$23,786.38
|
$23,786.38
|
2025-08-25
|
|
A1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
13
|
13
|
$23,745.94
|
$23,745.94
|
$23,745.94
|
$23,745.94
|
$23,745.94
|
2025-08-25
|
|
A0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
13
|
13
|
$23,714.68
|
$23,714.68
|
$23,714.68
|
$23,714.68
|
$23,714.68
|
2025-08-25
|
|
D1403
|
HCPCS
|
Cardiac M >=45.50 And M <55.50
|
13
|
13
|
$23,606.21
|
$23,606.21
|
$23,606.21
|
$23,606.21
|
$23,606.21
|
2025-08-25
|
|
A1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
13
|
13
|
$23,604.37
|
$23,604.37
|
$23,604.37
|
$23,604.37
|
$23,604.37
|
2025-08-25
|
|
C1902
|
HCPCS
|
Guillain-barr� M >=51.50 And M <66.50
|
13
|
13
|
$23,593.34
|
$23,593.34
|
$23,593.34
|
$23,593.34
|
$23,593.34
|
2025-08-25
|
|
B1601
|
HCPCS
|
Pain Syndrome M >=65.50
|
13
|
13
|
$23,567.60
|
$23,567.60
|
$23,567.60
|
$23,567.60
|
$23,567.60
|
2025-08-25
|
|
B0501
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=60.50
|
13
|
13
|
$23,457.29
|
$23,457.29
|
$23,457.29
|
$23,457.29
|
$23,457.29
|
2025-08-25
|
|
D0103
|
HCPCS
|
Stroke M >=50.50 And M <63.50
|
13
|
13
|
$23,337.79
|
$23,337.79
|
$23,337.79
|
$23,337.79
|
$23,337.79
|
2025-08-25
|
|
A1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
13
|
13
|
$23,328.60
|
$23,328.60
|
$23,328.60
|
$23,328.60
|
$23,328.60
|
2025-08-25
|
|
C1002
|
HCPCS
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
13
|
13
|
$23,324.92
|
$23,324.92
|
$23,324.92
|
$23,324.92
|
$23,324.92
|
2025-08-25
|
|
D1603
|
HCPCS
|
Pain Syndrome M >=43.50 And M <58.50
|
13
|
13
|
$23,302.86
|
$23,302.86
|
$23,302.86
|
$23,302.86
|
$23,302.86
|
2025-08-25
|
|
C0602
|
HCPCS
|
Neurological M >=52.50 And M <64.50
|
13
|
13
|
$23,220.13
|
$23,220.13
|
$23,220.13
|
$23,220.13
|
$23,220.13
|
2025-08-25
|
|
B1501
|
HCPCS
|
Pulmonary M >=68.50
|
13
|
13
|
$23,210.94
|
$23,210.94
|
$23,210.94
|
$23,210.94
|
$23,210.94
|
2025-08-25
|
|
B1101
|
HCPCS
|
Amputation Non-lower Extremity M >=58.50
|
13
|
13
|
$23,131.88
|
$23,131.88
|
$23,131.88
|
$23,131.88
|
$23,131.88
|
2025-08-25
|
|
D0804
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
13
|
13
|
$23,119.01
|
$23,119.01
|
$23,119.01
|
$23,119.01
|
$23,119.01
|
2025-08-25
|
|
B0701
|
HCPCS
|
Fracture Of Lower Extremity M >=61.50
|
13
|
13
|
$23,100.63
|
$23,100.63
|
$23,100.63
|
$23,100.63
|
$23,100.63
|
2025-08-25
|
|
A0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
13
|
13
|
$23,021.57
|
$23,021.57
|
$23,021.57
|
$23,021.57
|
$23,021.57
|
2025-08-25
|
|
D0203
|
HCPCS
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
13
|
13
|
$22,872.65
|
$22,872.65
|
$22,872.65
|
$22,872.65
|
$22,872.65
|
2025-08-25
|
|
B0102
|
HCPCS
|
Stroke M >=63.50 And M <72.50
|
13
|
13
|
$22,782.57
|
$22,782.57
|
$22,782.57
|
$22,782.57
|
$22,782.57
|
2025-08-25
|
|
A1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
13
|
13
|
$22,782.57
|
$22,782.57
|
$22,782.57
|
$22,782.57
|
$22,782.57
|
2025-08-25
|
|
C0502
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
13
|
13
|
$22,778.89
|
$22,778.89
|
$22,778.89
|
$22,778.89
|
$22,778.89
|
2025-08-25
|
|
C0302
|
HCPCS
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
13
|
13
|
$22,773.38
|
$22,773.38
|
$22,773.38
|
$22,773.38
|
$22,773.38
|
2025-08-25
|
|
C0803
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
13
|
13
|
$22,734.77
|
$22,734.77
|
$22,734.77
|
$22,734.77
|
$22,734.77
|
2025-08-25
|
|
A0503
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
13
|
13
|
$22,732.93
|
$22,732.93
|
$22,732.93
|
$22,732.93
|
$22,732.93
|
2025-08-25
|
|
C1302
|
HCPCS
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
13
|
13
|
$22,692.48
|
$22,692.48
|
$22,692.48
|
$22,692.48
|
$22,692.48
|
2025-08-25
|
|
36226
|
CPT
|
Place Cath Vertebral Art Bi
|
58
|
34
|
$27,654.17
|
$27,654.17
|
$17,698.67
|
$29,036.88
|
$22,676.42
|
2026-03-16
|
|
D1502
|
HCPCS
|
Pulmonary M >=56.50 And M <68.50
|
13
|
13
|
$22,655.71
|
$22,655.71
|
$22,655.71
|
$22,655.71
|
$22,655.71
|
2025-08-25
|
|
C1202
|
HCPCS
|
Osteoarthritis M >=49.50 And M <61.50
|
13
|
13
|
$22,543.56
|
$22,543.56
|
$22,543.56
|
$22,543.56
|
$22,543.56
|
2025-08-25
|
|
A0402
|
HCPCS
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
13
|
13
|
$22,462.67
|
$22,462.67
|
$22,462.67
|
$22,462.67
|
$22,462.67
|
2025-08-25
|
|
A0903
|
HCPCS
|
Other Orthopedic M >=44.50 And M <51.50
|
13
|
13
|
$22,447.96
|
$22,447.96
|
$22,447.96
|
$22,447.96
|
$22,447.96
|
2025-08-25
|
|
A1003
|
HCPCS
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
13
|
13
|
$22,324.78
|
$22,324.78
|
$22,324.78
|
$22,324.78
|
$22,324.78
|
2025-08-25
|
|
B0801
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=63.50
|
13
|
13
|
$22,311.91
|
$22,311.91
|
$22,311.91
|
$22,311.91
|
$22,311.91
|
2025-08-25
|
|
A0103
|
HCPCS
|
Stroke M >=50.50 And M <63.50
|
13
|
13
|
$22,258.60
|
$22,258.60
|
$22,258.60
|
$22,258.60
|
$22,258.60
|
2025-08-25
|
|
B0401
|
HCPCS
|
Traumatic Spinal Cord Injury M >=56.50
|
13
|
13
|
$22,216.31
|
$22,216.31
|
$22,216.31
|
$22,216.31
|
$22,216.31
|
2025-08-25
|
|
B1001
|
HCPCS
|
Amputation Lower Extremity M >=64.50
|
13
|
13
|
$22,172.19
|
$22,172.19
|
$22,172.19
|
$22,172.19
|
$22,172.19
|
2025-08-25
|
|
36901
|
CPT
|
Intro Dial Graft
|
58
|
34
|
$26,970.62
|
$26,970.62
|
$17,261.20
|
$28,319.15
|
$22,115.91
|
2026-03-16
|
|
C0902
|
HCPCS
|
Other Orthopedic M >=51.50 And M <63.50
|
13
|
13
|
$22,034.30
|
$22,034.30
|
$22,034.30
|
$22,034.30
|
$22,034.30
|
2025-08-25
|
|
A2003
|
HCPCS
|
Miscellaneous M >=46.50 And M <55.50
|
13
|
13
|
$22,023.27
|
$22,023.27
|
$22,023.27
|
$22,023.27
|
$22,023.27
|
2025-08-25
|
|
C0702
|
HCPCS
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
13
|
13
|
$22,021.43
|
$22,021.43
|
$22,021.43
|
$22,021.43
|
$22,021.43
|
2025-08-25
|
|
B0901
|
HCPCS
|
Other Orthopedic M >=63.50
|
13
|
13
|
$22,006.73
|
$22,006.73
|
$22,006.73
|
$22,006.73
|
$22,006.73
|
2025-08-25
|
|
D1902
|
HCPCS
|
Guillain-barr� M >=51.50 And M <66.50
|
13
|
13
|
$21,999.37
|
$21,999.37
|
$21,999.37
|
$21,999.37
|
$21,999.37
|
2025-08-25
|
|
D1702
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
13
|
13
|
$21,997.53
|
$21,997.53
|
$21,997.53
|
$21,997.53
|
$21,997.53
|
2025-08-25
|
|
B0301
|
HCPCS
|
Non-traumatic Brain Injury M >=65.50
|
13
|
13
|
$21,997.53
|
$21,997.53
|
$21,997.53
|
$21,997.53
|
$21,997.53
|
2025-08-25
|
|
A1403
|
HCPCS
|
Cardiac M >=45.50 And M <55.50
|
13
|
13
|
$21,730.95
|
$21,730.95
|
$21,730.95
|
$21,730.95
|
$21,730.95
|
2025-08-25
|
|
D1302
|
HCPCS
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
13
|
13
|
$21,690.51
|
$21,690.51
|
$21,690.51
|
$21,690.51
|
$21,690.51
|
2025-08-25
|
|
A1603
|
HCPCS
|
Pain Syndrome M >=43.50 And M <58.50
|
13
|
13
|
$21,686.83
|
$21,686.83
|
$21,686.83
|
$21,686.83
|
$21,686.83
|
2025-08-25
|
|
D0602
|
HCPCS
|
Neurological M >=52.50 And M <64.50
|
13
|
13
|
$21,664.77
|
$21,664.77
|
$21,664.77
|
$21,664.77
|
$21,664.77
|
2025-08-25
|
|
B2001
|
HCPCS
|
Miscellaneous M >=66.50
|
13
|
13
|
$21,651.90
|
$21,651.90
|
$21,651.90
|
$21,651.90
|
$21,651.90
|
2025-08-25
|
|
C2002
|
HCPCS
|
Miscellaneous M >=55.50 And M <66.50
|
13
|
13
|
$21,611.45
|
$21,611.45
|
$21,611.45
|
$21,611.45
|
$21,611.45
|
2025-08-25
|
|
A0203
|
HCPCS
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
13
|
13
|
$21,547.10
|
$21,547.10
|
$21,547.10
|
$21,547.10
|
$21,547.10
|
2025-08-25
|
|
A0804
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
13
|
13
|
$21,541.59
|
$21,541.59
|
$21,541.59
|
$21,541.59
|
$21,541.59
|
2025-08-25
|
|
A1902
|
HCPCS
|
Guillain-barr� M >=51.50 And M <66.50
|
13
|
13
|
$21,534.23
|
$21,534.23
|
$21,534.23
|
$21,534.23
|
$21,534.23
|
2025-08-25
|
|
D0502
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
13
|
13
|
$21,523.20
|
$21,523.20
|
$21,523.20
|
$21,523.20
|
$21,523.20
|
2025-08-25
|
|
C2101
|
HCPCS
|
Burns M >=52.50
|
13
|
13
|
$21,425.76
|
$21,425.76
|
$21,425.76
|
$21,425.76
|
$21,425.76
|
2025-08-25
|
|
D2101
|
HCPCS
|
Burns M >=52.50
|
13
|
13
|
$21,425.76
|
$21,425.76
|
$21,425.76
|
$21,425.76
|
$21,425.76
|
2025-08-25
|
|
D1002
|
HCPCS
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
13
|
13
|
$21,287.88
|
$21,287.88
|
$21,287.88
|
$21,287.88
|
$21,287.88
|
2025-08-25
|
|
A1502
|
HCPCS
|
Pulmonary M >=56.50 And M <68.50
|
13
|
13
|
$21,155.50
|
$21,155.50
|
$21,155.50
|
$21,155.50
|
$21,155.50
|
2025-08-25
|
|
D1202
|
HCPCS
|
Osteoarthritis M >=49.50 And M <61.50
|
13
|
13
|
$21,061.74
|
$21,061.74
|
$21,061.74
|
$21,061.74
|
$21,061.74
|
2025-08-25
|
|
C1802
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
13
|
13
|
$20,962.46
|
$20,962.46
|
$20,962.46
|
$20,962.46
|
$20,962.46
|
2025-08-25
|
|
D0302
|
HCPCS
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
13
|
13
|
$20,925.69
|
$20,925.69
|
$20,925.69
|
$20,925.69
|
$20,925.69
|
2025-08-25
|
|
D0702
|
HCPCS
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
13
|
13
|
$20,866.86
|
$20,866.86
|
$20,866.86
|
$20,866.86
|
$20,866.86
|
2025-08-25
|