|
B0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$71,906.34
|
$86,287.61
|
$71,906.34
|
2025-09-11
|
|
C0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$63,944.91
|
$76,733.89
|
$63,944.91
|
2025-09-11
|
|
B1904
|
LOCAL
|
Guillain-barré M <38.50
|
9
|
9
|
—
|
—
|
$62,220.30
|
$74,664.36
|
$62,220.30
|
2025-09-11
|
|
D0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$62,074.03
|
$74,488.84
|
$62,074.03
|
2025-09-11
|
|
B1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
9
|
9
|
—
|
—
|
$58,527.86
|
$70,233.43
|
$58,527.86
|
2025-09-11
|
|
A0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$56,403.57
|
$67,684.28
|
$56,403.57
|
2025-09-11
|
|
B0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$52,597.18
|
$63,116.62
|
$52,597.18
|
2025-09-11
|
|
B0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
9
|
9
|
—
|
—
|
$51,833.52
|
$62,200.22
|
$51,833.52
|
2025-09-11
|
|
B0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
9
|
9
|
—
|
—
|
$51,301.17
|
$61,561.40
|
$51,301.17
|
2025-09-11
|
|
B0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
9
|
9
|
—
|
—
|
$49,432.00
|
$59,318.40
|
$49,432.00
|
2025-09-11
|
|
C1904
|
LOCAL
|
Guillain-barré M <38.50
|
9
|
9
|
—
|
—
|
$47,834.95
|
$57,401.94
|
$47,834.95
|
2025-09-11
|
|
C0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$46,773.65
|
$56,128.38
|
$46,773.65
|
2025-09-11
|
|
C1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
9
|
9
|
—
|
—
|
$46,690.31
|
$56,028.37
|
$46,690.31
|
2025-09-11
|
|
C0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
9
|
9
|
—
|
—
|
$46,095.03
|
$55,314.04
|
$46,095.03
|
2025-09-11
|
|
D0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$45,404.51
|
$54,485.41
|
$45,404.51
|
2025-09-11
|
|
B0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
9
|
9
|
—
|
—
|
$44,875.56
|
$53,850.67
|
$44,875.56
|
2025-09-11
|
|
D0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
9
|
9
|
—
|
—
|
$44,746.30
|
$53,695.56
|
$44,746.30
|
2025-09-11
|
|
D1904
|
LOCAL
|
Guillain-barré M <38.50
|
9
|
9
|
—
|
—
|
$44,635.75
|
$53,562.90
|
$44,635.75
|
2025-09-11
|
|
B1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
9
|
9
|
—
|
—
|
$44,594.93
|
$53,513.92
|
$44,594.93
|
2025-09-11
|
|
D1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
9
|
9
|
—
|
—
|
$44,326.20
|
$53,191.44
|
$44,326.20
|
2025-09-11
|
|
A1904
|
LOCAL
|
Guillain-barré M <38.50
|
9
|
9
|
—
|
—
|
$43,863.58
|
$52,636.30
|
$43,863.58
|
2025-09-11
|
|
B0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
9
|
9
|
—
|
—
|
$43,460.49
|
$52,152.59
|
$43,460.49
|
2025-09-11
|
|
C0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
9
|
9
|
—
|
—
|
$42,870.32
|
$51,444.38
|
$42,870.32
|
2025-09-11
|
|
B1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
9
|
9
|
—
|
—
|
$42,713.84
|
$51,256.61
|
$42,713.84
|
2025-09-11
|
|
B0604
|
LOCAL
|
Neurological M <43.50
|
9
|
9
|
—
|
—
|
$42,356.68
|
$50,828.02
|
$42,356.68
|
2025-09-11
|
|
A0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
9
|
9
|
—
|
—
|
$41,257.96
|
$49,509.55
|
$41,257.96
|
2025-09-11
|
|
B0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
9
|
9
|
—
|
—
|
$41,220.54
|
$49,464.65
|
$41,220.54
|
2025-09-11
|
|
B1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
9
|
9
|
—
|
—
|
$41,212.04
|
$49,454.45
|
$41,212.04
|
2025-09-11
|
|
A1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
9
|
9
|
—
|
—
|
$41,098.09
|
$49,317.71
|
$41,098.09
|
2025-09-11
|
|
A0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
9
|
9
|
—
|
—
|
$40,659.28
|
$48,791.14
|
$40,659.28
|
2025-09-11
|
|
B0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
9
|
9
|
—
|
—
|
$40,555.53
|
$48,666.64
|
$40,555.53
|
2025-09-11
|
|
A5104
|
LOCAL
|
Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More
|
9
|
9
|
—
|
—
|
$40,536.82
|
$48,644.18
|
$40,536.82
|
2025-09-11
|
|
B1604
|
LOCAL
|
Pain Syndrome M <43.50
|
9
|
9
|
—
|
—
|
$39,926.24
|
$47,911.49
|
$39,926.24
|
2025-09-11
|
|
C0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
9
|
9
|
—
|
—
|
$39,910.93
|
$47,893.12
|
$39,910.93
|
2025-09-11
|
|
B0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
9
|
9
|
—
|
—
|
$39,582.67
|
$47,499.20
|
$39,582.67
|
2025-09-11
|
|
B2102
|
LOCAL
|
Burns M <52.50
|
9
|
9
|
—
|
—
|
$39,417.70
|
$47,301.24
|
$39,417.70
|
2025-09-11
|
|
D0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
9
|
9
|
—
|
—
|
$39,176.18
|
$47,011.42
|
$39,176.18
|
2025-09-11
|
|
B1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
9
|
9
|
—
|
—
|
$39,137.06
|
$46,964.47
|
$39,137.06
|
2025-09-11
|
|
B1504
|
LOCAL
|
Pulmonary M <45.50
|
9
|
9
|
—
|
—
|
$38,682.95
|
$46,419.54
|
$38,682.95
|
2025-09-11
|
|
B1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
9
|
9
|
—
|
—
|
$38,000.93
|
$45,601.12
|
$38,000.93
|
2025-09-11
|
|
B2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
9
|
9
|
—
|
—
|
$37,778.13
|
$45,333.76
|
$37,778.13
|
2025-09-11
|
|
D0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
9
|
9
|
—
|
—
|
$37,704.99
|
$45,245.99
|
$37,704.99
|
2025-09-11
|
|
C0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
9
|
9
|
—
|
—
|
$37,691.39
|
$45,229.67
|
$37,691.39
|
2025-09-11
|
|
28730
|
CPT
|
Fusion Of Foot Bones
|
30
|
17
|
$57,929.13
|
$57,929.13
|
$28,964.57
|
$46,343.30
|
$37,653.93
|
2025-09-11
|
|
A0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
9
|
9
|
—
|
—
|
$37,334.22
|
$44,801.06
|
$37,334.22
|
2025-09-11
|
|
B1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
9
|
9
|
—
|
—
|
$37,140.33
|
$44,568.40
|
$37,140.33
|
2025-09-11
|
|
C0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
9
|
9
|
—
|
—
|
$36,960.04
|
$44,352.05
|
$36,960.04
|
2025-09-11
|
|
B0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
9
|
9
|
—
|
—
|
$36,919.22
|
$44,303.06
|
$36,919.22
|
2025-09-11
|
|
B0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
9
|
9
|
—
|
—
|
$36,772.96
|
$44,127.55
|
$36,772.96
|
2025-09-11
|
|
C0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
9
|
9
|
—
|
—
|
$36,657.30
|
$43,988.76
|
$36,657.30
|
2025-09-11
|
|
B1404
|
LOCAL
|
Cardiac M <45.50
|
9
|
9
|
—
|
—
|
$36,495.73
|
$43,794.88
|
$36,495.73
|
2025-09-11
|
|
B0904
|
LOCAL
|
Other Orthopedic M <44.5
|
9
|
9
|
—
|
—
|
$36,424.29
|
$43,709.15
|
$36,424.29
|
2025-09-11
|
|
B1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$36,424.29
|
$43,709.15
|
$36,424.29
|
2025-09-11
|
|
B2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
9
|
9
|
—
|
—
|
$35,840.92
|
$43,009.10
|
$35,840.92
|
2025-09-11
|
|
D0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
9
|
9
|
—
|
—
|
$35,584.10
|
$42,700.92
|
$35,584.10
|
2025-09-11
|
|
B1203
|
LOCAL
|
Osteoarthritis M <49.50 And A >=74.50
|
9
|
9
|
—
|
—
|
$35,417.42
|
$42,500.90
|
$35,417.42
|
2025-09-11
|
|
B0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
9
|
9
|
—
|
—
|
$35,058.55
|
$42,070.26
|
$35,058.55
|
2025-09-11
|
|
B0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
9
|
9
|
—
|
—
|
$35,033.04
|
$42,039.65
|
$35,033.04
|
2025-09-11
|
|
B1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
9
|
9
|
—
|
—
|
$34,881.67
|
$41,858.00
|
$34,881.67
|
2025-09-11
|
|
B0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$34,755.81
|
$41,706.97
|
$34,755.81
|
2025-09-11
|
|
A0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
9
|
9
|
—
|
—
|
$34,745.60
|
$41,694.72
|
$34,745.60
|
2025-09-11
|
|
C1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
9
|
9
|
—
|
—
|
$34,663.97
|
$41,596.76
|
$34,663.97
|
2025-09-11
|
|
D0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
9
|
9
|
—
|
—
|
$34,442.86
|
$41,331.43
|
$34,442.86
|
2025-09-11
|
|
B1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
9
|
9
|
—
|
—
|
$34,111.21
|
$40,933.45
|
$34,111.21
|
2025-09-11
|
|
B1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
9
|
9
|
—
|
—
|
$33,992.15
|
$40,790.58
|
$33,992.15
|
2025-09-11
|
|
B0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
9
|
9
|
—
|
—
|
$33,774.45
|
$40,529.34
|
$33,774.45
|
2025-09-11
|
|
B1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$33,573.75
|
$40,288.50
|
$33,573.75
|
2025-09-11
|
|
D0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
9
|
9
|
—
|
—
|
$33,570.35
|
$40,284.42
|
$33,570.35
|
2025-09-11
|
|
B0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
9
|
9
|
—
|
—
|
$33,197.88
|
$39,837.46
|
$33,197.88
|
2025-09-11
|
|
C1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
9
|
9
|
—
|
—
|
$32,876.43
|
$39,451.72
|
$32,876.43
|
2025-09-11
|
|
C1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
9
|
9
|
—
|
—
|
$32,837.31
|
$39,404.77
|
$32,837.31
|
2025-09-11
|
|
A0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
9
|
9
|
—
|
—
|
$32,825.40
|
$39,390.48
|
$32,825.40
|
2025-09-11
|
|
C0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
9
|
9
|
—
|
—
|
$32,446.13
|
$38,935.36
|
$32,446.13
|
2025-09-11
|
|
B0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
9
|
9
|
—
|
—
|
$32,401.90
|
$38,882.28
|
$32,401.90
|
2025-09-11
|
|
C1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
9
|
9
|
—
|
—
|
$32,367.89
|
$38,841.47
|
$32,367.89
|
2025-09-11
|
|
A0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
9
|
9
|
—
|
—
|
$32,333.87
|
$38,800.64
|
$32,333.87
|
2025-09-11
|
|
B1603
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
9
|
9
|
—
|
—
|
$32,225.02
|
$38,670.02
|
$32,225.02
|
2025-09-11
|
|
D1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
9
|
9
|
—
|
—
|
$32,102.56
|
$38,523.07
|
$32,102.56
|
2025-09-11
|
|
33208
|
CPT
|
Ins/Rplc Pacemkr; Atr+vnt
|
30
|
17
|
$48,848.87
|
$48,848.87
|
$24,424.44
|
$39,079.10
|
$31,751.77
|
2025-09-11
|
|
33207
|
CPT
|
Insrt Heart Pm Venticular
|
30
|
17
|
$48,848.87
|
$48,848.87
|
$24,424.44
|
$39,079.10
|
$31,751.77
|
2025-09-11
|
|
B0303
|
LOCAL
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
9
|
9
|
—
|
—
|
$31,716.48
|
$38,059.78
|
$31,716.48
|
2025-09-11
|
|
C0604
|
LOCAL
|
Neurological M <43.50
|
9
|
9
|
—
|
—
|
$31,711.38
|
$38,053.66
|
$31,711.38
|
2025-09-11
|
|
A0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
9
|
9
|
—
|
—
|
$31,605.93
|
$37,927.12
|
$31,605.93
|
2025-09-11
|
|
C1504
|
LOCAL
|
Pulmonary M <45.50
|
9
|
9
|
—
|
—
|
$31,396.73
|
$37,676.08
|
$31,396.73
|
2025-09-11
|
|
B1503
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
9
|
9
|
—
|
—
|
$31,236.86
|
$37,484.23
|
$31,236.86
|
2025-09-11
|
|
D1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
9
|
9
|
—
|
—
|
$31,211.35
|
$37,453.62
|
$31,211.35
|
2025-09-11
|
|
B1803
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$31,083.79
|
$37,300.55
|
$31,083.79
|
2025-09-11
|
|
B0503
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
9
|
9
|
—
|
—
|
$31,058.27
|
$37,269.92
|
$31,058.27
|
2025-09-11
|
|
37236
|
CPT
|
Open/Perq Place Stent 1st
|
30
|
17
|
$47,189.05
|
$47,189.05
|
$23,594.53
|
$37,751.24
|
$30,672.88
|
2025-09-11
|
|
D1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
9
|
9
|
—
|
—
|
$30,641.58
|
$36,769.90
|
$30,641.58
|
2025-09-11
|
|
C0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
9
|
9
|
—
|
—
|
$30,619.47
|
$36,743.36
|
$30,619.47
|
2025-09-11
|
|
B1003
|
LOCAL
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
9
|
9
|
—
|
—
|
$30,570.14
|
$36,684.17
|
$30,570.14
|
2025-09-11
|
|
A5102
|
LOCAL
|
Expired, Orthopedic, Length Of Stay Is 14 Days Or More
|
9
|
9
|
—
|
—
|
$30,488.51
|
$36,586.21
|
$30,488.51
|
2025-09-11
|
|
B0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
9
|
9
|
—
|
—
|
$30,398.36
|
$36,478.03
|
$30,398.36
|
2025-09-11
|
|
C2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
9
|
9
|
—
|
—
|
$30,175.56
|
$36,210.67
|
$30,175.56
|
2025-09-11
|
|
C0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$30,141.54
|
$36,169.85
|
$30,141.54
|
2025-09-11
|
|
C1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$30,116.03
|
$36,139.24
|
$30,116.03
|
2025-09-11
|
|
A1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
9
|
9
|
—
|
—
|
$30,110.93
|
$36,133.12
|
$30,110.93
|
2025-09-11
|
|
B2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
9
|
9
|
—
|
—
|
$29,976.57
|
$35,971.88
|
$29,976.57
|
2025-09-11
|
|
D2102
|
LOCAL
|
Burns M <52.50
|
9
|
9
|
—
|
—
|
$29,952.76
|
$35,943.31
|
$29,952.76
|
2025-09-11
|
|
C2102
|
LOCAL
|
Burns M <52.50
|
9
|
9
|
—
|
—
|
$29,952.76
|
$35,943.31
|
$29,952.76
|
2025-09-11
|
|
D0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
9
|
9
|
—
|
—
|
$29,804.79
|
$35,765.75
|
$29,804.79
|
2025-09-11
|
|
B1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$29,784.38
|
$35,741.26
|
$29,784.38
|
2025-09-11
|
|
C1604
|
LOCAL
|
Pain Syndrome M <43.50
|
9
|
9
|
—
|
—
|
$29,655.12
|
$35,586.14
|
$29,655.12
|
2025-09-11
|
|
D0604
|
LOCAL
|
Neurological M <43.50
|
9
|
9
|
—
|
—
|
$29,604.09
|
$35,524.91
|
$29,604.09
|
2025-09-11
|
|
D1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
9
|
9
|
—
|
—
|
$29,566.67
|
$35,480.00
|
$29,566.67
|
2025-09-11
|
|
C1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
9
|
9
|
—
|
—
|
$29,537.76
|
$35,445.31
|
$29,537.76
|
2025-09-11
|
|
D1504
|
LOCAL
|
Pulmonary M <45.50
|
9
|
9
|
—
|
—
|
$29,527.56
|
$35,433.07
|
$29,527.56
|
2025-09-11
|
|
C0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
9
|
9
|
—
|
—
|
$29,522.45
|
$35,426.94
|
$29,522.45
|
2025-09-11
|
|
C0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
9
|
9
|
—
|
—
|
$29,420.41
|
$35,304.49
|
$29,420.41
|
2025-09-11
|
|
B0804
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
9
|
9
|
—
|
—
|
$29,231.62
|
$35,077.94
|
$29,231.62
|
2025-09-11
|
|
C0904
|
LOCAL
|
Other Orthopedic M <44.5
|
9
|
9
|
—
|
—
|
$29,173.79
|
$35,008.55
|
$29,173.79
|
2025-09-11
|
|
A1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
9
|
9
|
—
|
—
|
$29,124.47
|
$34,949.36
|
$29,124.47
|
2025-09-11
|
|
D0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
9
|
9
|
—
|
—
|
$29,005.41
|
$34,806.49
|
$29,005.41
|
2025-09-11
|
|
A1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
9
|
9
|
—
|
—
|
$28,939.08
|
$34,726.90
|
$28,939.08
|
2025-09-11
|
|
C0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
9
|
9
|
—
|
—
|
$28,855.74
|
$34,626.89
|
$28,855.74
|
2025-09-11
|
|
B1303
|
LOCAL
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$28,842.13
|
$34,610.56
|
$28,842.13
|
2025-09-11
|
|
C1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
9
|
9
|
—
|
—
|
$28,840.43
|
$34,608.52
|
$28,840.43
|
2025-09-11
|
|
C1404
|
LOCAL
|
Cardiac M <45.50
|
9
|
9
|
—
|
—
|
$28,750.29
|
$34,500.35
|
$28,750.29
|
2025-09-11
|
|
D1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$28,746.89
|
$34,496.27
|
$28,746.89
|
2025-09-11
|
|
C0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
9
|
9
|
—
|
—
|
$28,721.38
|
$34,465.66
|
$28,721.38
|
2025-09-11
|
|
B0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
9
|
9
|
—
|
—
|
$28,663.55
|
$34,396.26
|
$28,663.55
|
2025-09-11
|
|
D0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
9
|
9
|
—
|
—
|
$28,658.45
|
$34,390.14
|
$28,658.45
|
2025-09-11
|
|
C2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
9
|
9
|
—
|
—
|
$28,627.83
|
$34,353.40
|
$28,627.83
|
2025-09-11
|
|
B1902
|
LOCAL
|
Guillain-barré M >=51.50 And M <66.50
|
9
|
9
|
—
|
—
|
$28,309.78
|
$33,971.74
|
$28,309.78
|
2025-09-11
|
|
B1702
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
9
|
9
|
—
|
—
|
$28,253.66
|
$33,904.39
|
$28,253.66
|
2025-09-11
|
|
B0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
9
|
9
|
—
|
—
|
$28,246.85
|
$33,896.22
|
$28,246.85
|
2025-09-11
|
|
C1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
9
|
9
|
—
|
—
|
$28,236.65
|
$33,883.98
|
$28,236.65
|
2025-09-11
|
|
D2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
9
|
9
|
—
|
—
|
$28,189.03
|
$33,826.84
|
$28,189.03
|
2025-09-11
|
|
C0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
9
|
9
|
—
|
—
|
$28,131.20
|
$33,757.44
|
$28,131.20
|
2025-09-11
|
|
A0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
9
|
9
|
—
|
—
|
$28,092.08
|
$33,710.50
|
$28,092.08
|
2025-09-11
|
|
A1504
|
LOCAL
|
Pulmonary M <45.50
|
9
|
9
|
—
|
—
|
$27,620.96
|
$33,145.15
|
$27,620.96
|
2025-09-11
|
|
D0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$27,544.43
|
$33,053.32
|
$27,544.43
|
2025-09-11
|
|
D1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
9
|
9
|
—
|
—
|
$27,529.12
|
$33,034.94
|
$27,529.12
|
2025-09-11
|
|
B1502
|
LOCAL
|
Pulmonary M >=56.50 And M <68.50
|
9
|
9
|
—
|
—
|
$27,484.90
|
$32,981.88
|
$27,484.90
|
2025-09-11
|
|
C1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
9
|
9
|
—
|
—
|
$27,420.27
|
$32,904.32
|
$27,420.27
|
2025-09-11
|
|
D1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
9
|
9
|
—
|
—
|
$27,420.27
|
$32,904.32
|
$27,420.27
|
2025-09-11
|
|
D1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
9
|
9
|
—
|
—
|
$27,355.64
|
$32,826.77
|
$27,355.64
|
2025-09-11
|
|
B1102
|
LOCAL
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
9
|
9
|
—
|
—
|
$27,353.94
|
$32,824.73
|
$27,353.94
|
2025-09-11
|
|
B1202
|
LOCAL
|
Osteoarthritis M >=49.50 And M <61.50
|
9
|
9
|
—
|
—
|
$27,338.63
|
$32,806.36
|
$27,338.63
|
2025-09-11
|
|
B0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
9
|
9
|
—
|
—
|
$27,233.18
|
$32,679.82
|
$27,233.18
|
2025-09-11
|
|
D0904
|
LOCAL
|
Other Orthopedic M <44.5
|
9
|
9
|
—
|
—
|
$27,192.36
|
$32,630.83
|
$27,192.36
|
2025-09-11
|
|
D0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
9
|
9
|
—
|
—
|
$27,134.53
|
$32,561.44
|
$27,134.53
|
2025-09-11
|
|
C1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
9
|
9
|
—
|
—
|
$27,117.52
|
$32,541.02
|
$27,117.52
|
2025-09-11
|
|
B0502
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
9
|
9
|
—
|
—
|
$27,095.41
|
$32,514.49
|
$27,095.41
|
2025-09-11
|
|
D0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
9
|
9
|
—
|
—
|
$27,025.68
|
$32,430.82
|
$27,025.68
|
2025-09-11
|
|
C1203
|
LOCAL
|
Osteoarthritis M <49.50 And A >=74.50
|
9
|
9
|
—
|
—
|
$26,925.33
|
$32,310.40
|
$26,925.33
|
2025-09-11
|
|
A1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
9
|
9
|
—
|
—
|
$26,865.81
|
$32,238.97
|
$26,865.81
|
2025-09-11
|
|
D1604
|
LOCAL
|
Pain Syndrome M <43.50
|
9
|
9
|
—
|
—
|
$26,804.58
|
$32,165.50
|
$26,804.58
|
2025-09-11
|
|
A0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
9
|
9
|
—
|
—
|
$26,797.77
|
$32,157.32
|
$26,797.77
|
2025-09-11
|
|
D2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
9
|
9
|
—
|
—
|
$26,743.35
|
$32,092.02
|
$26,743.35
|
2025-09-11
|
|
A1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$26,743.35
|
$32,092.02
|
$26,743.35
|
2025-09-11
|
|
D1404
|
LOCAL
|
Cardiac M <45.50
|
9
|
9
|
—
|
—
|
$26,731.44
|
$32,077.73
|
$26,731.44
|
2025-09-11
|
|
A0604
|
LOCAL
|
Neurological M <43.50
|
9
|
9
|
—
|
—
|
$26,699.13
|
$32,038.96
|
$26,699.13
|
2025-09-11
|
|
A1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
9
|
9
|
—
|
—
|
$26,489.93
|
$31,787.92
|
$26,489.93
|
2025-09-11
|
|
D1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
9
|
9
|
—
|
—
|
$26,474.62
|
$31,769.54
|
$26,474.62
|
2025-09-11
|
|
B0402
|
LOCAL
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
9
|
9
|
—
|
—
|
$26,454.21
|
$31,745.05
|
$26,454.21
|
2025-09-11
|
|
B0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
9
|
9
|
—
|
—
|
$26,358.97
|
$31,630.76
|
$26,358.97
|
2025-09-11
|
|
B0702
|
LOCAL
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
9
|
9
|
—
|
—
|
$26,348.76
|
$31,618.51
|
$26,348.76
|
2025-09-11
|
|
A0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$26,250.12
|
$31,500.14
|
$26,250.12
|
2025-09-11
|
|
D0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
9
|
9
|
—
|
—
|
$26,207.60
|
$31,449.12
|
$26,207.60
|
2025-09-11
|
|
C1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$26,097.05
|
$31,316.46
|
$26,097.05
|
2025-09-11
|
|
B0803
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
9
|
9
|
—
|
—
|
$26,091.94
|
$31,310.33
|
$26,091.94
|
2025-09-11
|
|
B1002
|
LOCAL
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
9
|
9
|
—
|
—
|
$26,091.94
|
$31,310.33
|
$26,091.94
|
2025-09-11
|
|
A0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
9
|
9
|
—
|
—
|
$26,040.92
|
$31,249.10
|
$26,040.92
|
2025-09-11
|
|
D1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
9
|
9
|
—
|
—
|
$25,743.28
|
$30,891.94
|
$25,743.28
|
2025-09-11
|
|
A2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
9
|
9
|
—
|
—
|
$25,658.24
|
$30,789.89
|
$25,658.24
|
2025-09-11
|
|
D0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
9
|
9
|
—
|
—
|
$25,648.04
|
$30,777.65
|
$25,648.04
|
2025-09-11
|
|
A1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
9
|
9
|
—
|
—
|
$25,610.62
|
$30,732.74
|
$25,610.62
|
2025-09-11
|
|
B2101
|
LOCAL
|
Burns M >=52.50
|
9
|
9
|
—
|
—
|
$25,595.31
|
$30,714.37
|
$25,595.31
|
2025-09-11
|
|
A2102
|
LOCAL
|
Burns M <52.50
|
9
|
9
|
—
|
—
|
$25,580.00
|
$30,696.00
|
$25,580.00
|
2025-09-11
|
|
B1602
|
LOCAL
|
Pain Syndrome M >=58.50 And M <65.50
|
9
|
9
|
—
|
—
|
$25,517.07
|
$30,620.48
|
$25,517.07
|
2025-09-11
|
|
A0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
9
|
9
|
—
|
—
|
$25,472.85
|
$30,567.42
|
$25,472.85
|
2025-09-11
|
|
B0902
|
LOCAL
|
Other Orthopedic M >=51.50 And M <63.50
|
9
|
9
|
—
|
—
|
$25,455.85
|
$30,547.02
|
$25,455.85
|
2025-09-11
|
|
C0303
|
LOCAL
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
9
|
9
|
—
|
—
|
$25,374.21
|
$30,449.05
|
$25,374.21
|
2025-09-11
|
|
C1503
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
9
|
9
|
—
|
—
|
$25,352.10
|
$30,422.52
|
$25,352.10
|
2025-09-11
|
|
B1302
|
LOCAL
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
9
|
9
|
—
|
—
|
$25,352.10
|
$30,422.52
|
$25,352.10
|
2025-09-11
|
|
C0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
9
|
9
|
—
|
—
|
$25,285.77
|
$30,342.92
|
$25,285.77
|
2025-09-11
|
|
C1003
|
LOCAL
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
9
|
9
|
—
|
—
|
$25,282.36
|
$30,338.83
|
$25,282.36
|
2025-09-11
|
|
D1203
|
LOCAL
|
Osteoarthritis M <49.50 And A >=74.50
|
9
|
9
|
—
|
—
|
$25,246.65
|
$30,295.98
|
$25,246.65
|
2025-09-11
|
|
C0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
9
|
9
|
—
|
—
|
$25,064.66
|
$30,077.59
|
$25,064.66
|
2025-09-11
|
|
B2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
9
|
9
|
—
|
—
|
$25,032.35
|
$30,038.82
|
$25,032.35
|
2025-09-11
|
|
A0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
9
|
9
|
—
|
—
|
$25,005.13
|
$30,006.16
|
$25,005.13
|
2025-09-11
|
|
33217
|
CPT
|
Insert 2 Electrode Pm-defib
|
30
|
17
|
$38,328.90
|
$38,328.90
|
$19,164.45
|
$30,663.12
|
$24,913.78
|
2025-09-11
|
|
33216
|
CPT
|
Insert 1 Electrode Pm-defib
|
30
|
17
|
$38,328.90
|
$38,328.90
|
$19,164.45
|
$30,663.12
|
$24,913.78
|
2025-09-11
|
|
A0904
|
LOCAL
|
Other Orthopedic M <44.5
|
9
|
9
|
—
|
—
|
$24,879.27
|
$29,855.12
|
$24,879.27
|
2025-09-11
|
|
A1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
9
|
9
|
—
|
—
|
$24,818.05
|
$29,781.66
|
$24,818.05
|
2025-09-11
|
|
A1604
|
LOCAL
|
Pain Syndrome M <43.50
|
9
|
9
|
—
|
—
|
$24,812.94
|
$29,775.53
|
$24,812.94
|
2025-09-11
|
|
C1803
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$24,797.64
|
$29,757.17
|
$24,797.64
|
2025-09-11
|
|
A0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
9
|
9
|
—
|
—
|
$24,675.18
|
$29,610.22
|
$24,675.18
|
2025-09-11
|
|
A1404
|
LOCAL
|
Cardiac M <45.50
|
9
|
9
|
—
|
—
|
$24,596.94
|
$29,516.33
|
$24,596.94
|
2025-09-11
|
|
C0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
9
|
9
|
—
|
—
|
$24,346.92
|
$29,216.30
|
$24,346.92
|
2025-09-11
|
|
A2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
9
|
9
|
—
|
—
|
$24,341.82
|
$29,210.18
|
$24,341.82
|
2025-09-11
|
|
B1402
|
LOCAL
|
Cardiac M >=55.50 And M <68.50
|
9
|
9
|
—
|
—
|
$24,341.82
|
$29,210.18
|
$24,341.82
|
2025-09-11
|
|
A1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
9
|
9
|
—
|
—
|
$24,204.06
|
$29,044.87
|
$24,204.06
|
2025-09-11
|
|
B1802
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
9
|
9
|
—
|
—
|
$24,193.85
|
$29,032.62
|
$24,193.85
|
2025-09-11
|
|
D1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$24,170.04
|
$29,004.05
|
$24,170.04
|
2025-09-11
|
|
C0503
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
9
|
9
|
—
|
—
|
$24,161.54
|
$28,993.85
|
$24,161.54
|
2025-09-11
|
|
C2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
9
|
9
|
—
|
—
|
$23,943.84
|
$28,732.61
|
$23,943.84
|
2025-09-11
|
|
C1603
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
9
|
9
|
—
|
—
|
$23,935.33
|
$28,722.40
|
$23,935.33
|
2025-09-11
|
|
A0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
9
|
9
|
—
|
—
|
$23,921.73
|
$28,706.08
|
$23,921.73
|
2025-09-11
|
|
A1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
9
|
9
|
—
|
—
|
$23,869.00
|
$28,642.80
|
$23,869.00
|
2025-09-11
|
|
C1303
|
LOCAL
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$23,848.59
|
$28,618.31
|
$23,848.59
|
2025-09-11
|
|
D1503
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
9
|
9
|
—
|
—
|
$23,843.49
|
$28,612.19
|
$23,843.49
|
2025-09-11
|
|
D0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
9
|
9
|
—
|
—
|
$23,743.14
|
$28,491.77
|
$23,743.14
|
2025-09-11
|
|
C0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
9
|
9
|
—
|
—
|
$23,618.98
|
$28,342.78
|
$23,618.98
|
2025-09-11
|
|
D0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
9
|
9
|
—
|
—
|
$23,605.38
|
$28,326.46
|
$23,605.38
|
2025-09-11
|
|
D1803
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$23,542.45
|
$28,250.94
|
$23,542.45
|
2025-09-11
|
|
C0402
|
LOCAL
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
9
|
9
|
—
|
—
|
$23,525.44
|
$28,230.53
|
$23,525.44
|
2025-09-11
|
|
C1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$23,464.21
|
$28,157.05
|
$23,464.21
|
2025-09-11
|
|
C0804
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
9
|
9
|
—
|
—
|
$23,455.71
|
$28,146.85
|
$23,455.71
|
2025-09-11
|
|
B0802
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=57.50 And M <63.50
|
9
|
9
|
—
|
—
|
$23,442.10
|
$28,130.52
|
$23,442.10
|
2025-09-11
|
|
D0303
|
LOCAL
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
9
|
9
|
—
|
—
|
$23,309.44
|
$27,971.33
|
$23,309.44
|
2025-09-11
|
|
C0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
9
|
9
|
—
|
—
|
$23,265.22
|
$27,918.26
|
$23,265.22
|
2025-09-11
|
|
D1003
|
LOCAL
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
9
|
9
|
—
|
—
|
$23,095.14
|
$27,714.17
|
$23,095.14
|
2025-09-11
|
|
A1203
|
LOCAL
|
Osteoarthritis M <49.50 And A >=74.50
|
9
|
9
|
—
|
—
|
$23,079.83
|
$27,695.80
|
$23,079.83
|
2025-09-11
|
|
D0402
|
LOCAL
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
9
|
9
|
—
|
—
|
$22,836.62
|
$27,403.94
|
$22,836.62
|
2025-09-11
|
|
D0503
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
9
|
9
|
—
|
—
|
$22,826.41
|
$27,391.69
|
$22,826.41
|
2025-09-11
|
|
D1303
|
LOCAL
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$22,763.48
|
$27,316.18
|
$22,763.48
|
2025-09-11
|
|
B1701
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50
|
9
|
9
|
—
|
—
|
$22,741.37
|
$27,289.64
|
$22,741.37
|
2025-09-11
|
|
D0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
9
|
9
|
—
|
—
|
$22,693.75
|
$27,232.50
|
$22,693.75
|
2025-09-11
|
|
B0202
|
LOCAL
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
9
|
9
|
—
|
—
|
$22,681.84
|
$27,218.21
|
$22,681.84
|
2025-09-11
|
|
B0601
|
LOCAL
|
Neurological M >=64.50
|
9
|
9
|
—
|
—
|
$22,598.50
|
$27,118.20
|
$22,598.50
|
2025-09-11
|
|
B1201
|
LOCAL
|
Osteoarthritis M >=61.50
|
9
|
9
|
—
|
—
|
$22,581.50
|
$27,097.80
|
$22,581.50
|
2025-09-11
|
|
D2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
9
|
9
|
—
|
—
|
$22,367.20
|
$26,840.64
|
$22,367.20
|
2025-09-11
|
|
C1502
|
LOCAL
|
Pulmonary M >=56.50 And M <68.50
|
9
|
9
|
—
|
—
|
$22,307.67
|
$26,769.20
|
$22,307.67
|
2025-09-11
|
|
A1503
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
9
|
9
|
—
|
—
|
$22,304.27
|
$26,765.12
|
$22,304.27
|
2025-09-11
|
|
B1601
|
LOCAL
|
Pain Syndrome M >=65.50
|
9
|
9
|
—
|
—
|
$22,266.85
|
$26,720.22
|
$22,266.85
|
2025-09-11
|
|
C1102
|
LOCAL
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
9
|
9
|
—
|
—
|
$21,987.92
|
$26,385.50
|
$21,987.92
|
2025-09-11
|
|
D1102
|
LOCAL
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
9
|
9
|
—
|
—
|
$21,987.92
|
$26,385.50
|
$21,987.92
|
2025-09-11
|
|
A0303
|
LOCAL
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
9
|
9
|
—
|
—
|
$21,969.21
|
$26,363.05
|
$21,969.21
|
2025-09-11
|
|
C1702
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
9
|
9
|
—
|
—
|
$21,962.41
|
$26,354.89
|
$21,962.41
|
2025-09-11
|
|
A0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
9
|
9
|
—
|
—
|
$21,936.89
|
$26,324.27
|
$21,936.89
|
2025-09-11
|
|
A1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
9
|
9
|
—
|
—
|
$21,928.39
|
$26,314.07
|
$21,928.39
|
2025-09-11
|
|
A1803
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$21,828.04
|
$26,193.65
|
$21,828.04
|
2025-09-11
|
|
D1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$21,816.14
|
$26,179.37
|
$21,816.14
|
2025-09-11
|
|
C1902
|
LOCAL
|
Guillain-barré M >=51.50 And M <66.50
|
9
|
9
|
—
|
—
|
$21,765.11
|
$26,118.13
|
$21,765.11
|
2025-09-11
|
|
B1501
|
LOCAL
|
Pulmonary M >=68.50
|
9
|
9
|
—
|
—
|
$21,666.47
|
$25,999.76
|
$21,666.47
|
2025-09-11
|
|
D1603
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
9
|
9
|
—
|
—
|
$21,634.15
|
$25,960.98
|
$21,634.15
|
2025-09-11
|
|
B0501
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=60.50
|
9
|
9
|
—
|
—
|
$21,598.43
|
$25,918.12
|
$21,598.43
|
2025-09-11
|
|
D0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
9
|
9
|
—
|
—
|
$21,583.13
|
$25,899.76
|
$21,583.13
|
2025-09-11
|
|
C1002
|
LOCAL
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
9
|
9
|
—
|
—
|
$21,578.03
|
$25,893.64
|
$21,578.03
|
2025-09-11
|
|
A1102
|
LOCAL
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
9
|
9
|
—
|
—
|
$21,544.01
|
$25,852.81
|
$21,544.01
|
2025-09-11
|
|
B1101
|
LOCAL
|
Amputation Non-lower Extremity M >=58.50
|
9
|
9
|
—
|
—
|
$21,515.10
|
$25,818.12
|
$21,515.10
|
2025-09-11
|
|
C0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
9
|
9
|
—
|
—
|
$21,460.67
|
$25,752.80
|
$21,460.67
|
2025-09-11
|
|
D0804
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
9
|
9
|
—
|
—
|
$21,385.84
|
$25,663.01
|
$21,385.84
|
2025-09-11
|
|
B0701
|
LOCAL
|
Fracture Of Lower Extremity M >=61.50
|
9
|
9
|
—
|
—
|
$21,331.41
|
$25,597.69
|
$21,331.41
|
2025-09-11
|
|
A0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
9
|
9
|
—
|
—
|
$21,288.89
|
$25,546.67
|
$21,288.89
|
2025-09-11
|
|
A1303
|
LOCAL
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
9
|
9
|
—
|
—
|
$21,176.64
|
$25,411.97
|
$21,176.64
|
2025-09-11
|
|
D0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
9
|
9
|
—
|
—
|
$21,130.72
|
$25,356.86
|
$21,130.72
|
2025-09-11
|
|
B0102
|
LOCAL
|
Stroke M >=63.50 And M <72.50
|
9
|
9
|
—
|
—
|
$21,129.01
|
$25,354.81
|
$21,129.01
|
2025-09-11
|
|
C0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
9
|
9
|
—
|
—
|
$21,089.90
|
$25,307.88
|
$21,089.90
|
2025-09-11
|
|
C0502
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
9
|
9
|
—
|
—
|
$21,077.99
|
$25,293.59
|
$21,077.99
|
2025-09-11
|
|
A0503
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
9
|
9
|
—
|
—
|
$21,035.47
|
$25,242.56
|
$21,035.47
|
2025-09-11
|
|
D1502
|
LOCAL
|
Pulmonary M >=56.50 And M <68.50
|
9
|
9
|
—
|
—
|
$20,979.34
|
$25,175.21
|
$20,979.34
|
2025-09-11
|
|
C1302
|
LOCAL
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
9
|
9
|
—
|
—
|
$20,962.34
|
$25,154.81
|
$20,962.34
|
2025-09-11
|
|
C0803
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
9
|
9
|
—
|
—
|
$20,936.82
|
$25,124.18
|
$20,936.82
|
2025-09-11
|
|
C1202
|
LOCAL
|
Osteoarthritis M >=49.50 And M <61.50
|
9
|
9
|
—
|
—
|
$20,783.75
|
$24,940.50
|
$20,783.75
|
2025-09-11
|
|
A0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
9
|
9
|
—
|
—
|
$20,763.34
|
$24,916.01
|
$20,763.34
|
2025-09-11
|
|
A0402
|
LOCAL
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
9
|
9
|
—
|
—
|
$20,751.44
|
$24,901.73
|
$20,751.44
|
2025-09-11
|
|
A1003
|
LOCAL
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
9
|
9
|
—
|
—
|
$20,691.91
|
$24,830.29
|
$20,691.91
|
2025-09-11
|
|
B0801
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=63.50
|
9
|
9
|
—
|
—
|
$20,676.60
|
$24,811.92
|
$20,676.60
|
2025-09-11
|
|
B1001
|
LOCAL
|
Amputation Lower Extremity M >=64.50
|
9
|
9
|
—
|
—
|
$20,596.66
|
$24,715.99
|
$20,596.66
|
2025-09-11
|
|
A0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
9
|
9
|
—
|
—
|
$20,567.75
|
$24,681.30
|
$20,567.75
|
2025-09-11
|
|
B0401
|
LOCAL
|
Traumatic Spinal Cord Injury M >=56.50
|
9
|
9
|
—
|
—
|
$20,511.62
|
$24,613.94
|
$20,511.62
|
2025-09-11
|
|
B0901
|
LOCAL
|
Other Orthopedic M >=63.50
|
9
|
9
|
—
|
—
|
$20,438.49
|
$24,526.19
|
$20,438.49
|
2025-09-11
|
|
C0902
|
LOCAL
|
Other Orthopedic M >=51.50 And M <63.50
|
9
|
9
|
—
|
—
|
$20,389.17
|
$24,467.00
|
$20,389.17
|
2025-09-11
|
|
B0301
|
LOCAL
|
Non-traumatic Brain Injury M >=65.50
|
9
|
9
|
—
|
—
|
$20,387.47
|
$24,464.96
|
$20,387.47
|
2025-09-11
|
|
C0702
|
LOCAL
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
9
|
9
|
—
|
—
|
$20,382.36
|
$24,458.83
|
$20,382.36
|
2025-09-11
|
|
A2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
9
|
9
|
—
|
—
|
$20,358.55
|
$24,430.26
|
$20,358.55
|
2025-09-11
|
|
D1702
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
9
|
9
|
—
|
—
|
$20,339.84
|
$24,407.81
|
$20,339.84
|
2025-09-11
|
|
D1902
|
LOCAL
|
Guillain-barré M >=51.50 And M <66.50
|
9
|
9
|
—
|
—
|
$20,309.23
|
$24,371.08
|
$20,309.23
|
2025-09-11
|
|
B2001
|
LOCAL
|
Miscellaneous M >=66.50
|
9
|
9
|
—
|
—
|
$20,076.22
|
$24,091.46
|
$20,076.22
|
2025-09-11
|
|
A1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
9
|
9
|
—
|
—
|
$20,074.52
|
$24,089.42
|
$20,074.52
|
2025-09-11
|
|
D0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
9
|
9
|
—
|
—
|
$20,033.70
|
$24,040.44
|
$20,033.70
|
2025-09-11
|
|
A1603
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
9
|
9
|
—
|
—
|
$20,026.90
|
$24,032.28
|
$20,026.90
|
2025-09-11
|
|
D1302
|
LOCAL
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
9
|
9
|
—
|
—
|
$20,009.89
|
$24,011.87
|
$20,009.89
|
2025-09-11
|
|
C2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
9
|
9
|
—
|
—
|
$19,994.58
|
$23,993.50
|
$19,994.58
|
2025-09-11
|
|
A1902
|
LOCAL
|
Guillain-barré M >=51.50 And M <66.50
|
9
|
9
|
—
|
—
|
$19,957.16
|
$23,948.59
|
$19,957.16
|
2025-09-11
|
|
A0804
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
9
|
9
|
—
|
—
|
$19,945.26
|
$23,934.31
|
$19,945.26
|
2025-09-11
|
|
D0502
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
9
|
9
|
—
|
—
|
$19,914.64
|
$23,897.57
|
$19,914.64
|
2025-09-11
|
|
A0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
9
|
9
|
—
|
—
|
$19,894.24
|
$23,873.09
|
$19,894.24
|
2025-09-11
|
|
D1002
|
LOCAL
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
9
|
9
|
—
|
—
|
$19,712.25
|
$23,654.70
|
$19,712.25
|
2025-09-11
|
|
A1502
|
LOCAL
|
Pulmonary M >=56.50 And M <68.50
|
9
|
9
|
—
|
—
|
$19,625.51
|
$23,550.61
|
$19,625.51
|
2025-09-11
|
|
D1202
|
LOCAL
|
Osteoarthritis M >=49.50 And M <61.50
|
9
|
9
|
—
|
—
|
$19,487.74
|
$23,385.29
|
$19,487.74
|
2025-09-11
|
|
C2101
|
LOCAL
|
Burns M >=52.50
|
9
|
9
|
—
|
—
|
$19,448.63
|
$23,338.36
|
$19,448.63
|
2025-09-11
|
|
D2101
|
LOCAL
|
Burns M >=52.50
|
9
|
9
|
—
|
—
|
$19,448.63
|
$23,338.36
|
$19,448.63
|
2025-09-11
|
|
D0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
9
|
9
|
—
|
—
|
$19,372.09
|
$23,246.51
|
$19,372.09
|
2025-09-11
|
|
D0702
|
LOCAL
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
9
|
9
|
—
|
—
|
$19,307.46
|
$23,168.95
|
$19,307.46
|
2025-09-11
|
|
C1802
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
9
|
9
|
—
|
—
|
$19,300.66
|
$23,160.79
|
$19,300.66
|
2025-09-11
|
|
B1401
|
LOCAL
|
Cardiac M >=68.50
|
9
|
9
|
—
|
—
|
$19,193.51
|
$23,032.21
|
$19,193.51
|
2025-09-11
|
|
C1402
|
LOCAL
|
Cardiac M >=55.50 And M <68.50
|
9
|
9
|
—
|
—
|
$19,176.50
|
$23,011.80
|
$19,176.50
|
2025-09-11
|
|
27893
|
CPT
|
Decompression Of Leg
|
30
|
17
|
$29,426.43
|
$29,426.43
|
$14,713.22
|
$23,541.14
|
$19,127.18
|
2025-09-11
|
|
24685
|
CPT
|
Treat Ulnar Fracture
|
30
|
17
|
$29,426.43
|
$29,426.43
|
$14,713.22
|
$23,541.14
|
$19,127.18
|
2025-09-11
|
|
D0803
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
9
|
9
|
—
|
—
|
$19,088.06
|
$22,905.67
|
$19,088.06
|
2025-09-11
|
|
D0902
|
LOCAL
|
Other Orthopedic M >=51.50 And M <63.50
|
9
|
9
|
—
|
—
|
$19,003.02
|
$22,803.62
|
$19,003.02
|
2025-09-11
|
|
C1602
|
LOCAL
|
Pain Syndrome M >=58.50 And M <65.50
|
9
|
9
|
—
|
—
|
$18,953.69
|
$22,744.43
|
$18,953.69
|
2025-09-11
|
|
C0802
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=57.50 And M <63.50
|
9
|
9
|
—
|
—
|
$18,810.83
|
$22,573.00
|
$18,810.83
|
2025-09-11
|
|
C0202
|
LOCAL
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
9
|
9
|
—
|
—
|
$18,681.57
|
$22,417.88
|
$18,681.57
|
2025-09-11
|
|
D2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
9
|
9
|
—
|
—
|
$18,678.16
|
$22,413.79
|
$18,678.16
|
2025-09-11
|