Hospital

BELLIN PSYCHIATRIC CENTER

Green Bay, WI · CCN 524038 · Rates published

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SHO ARTHRS SRG CAPSULORRAPHY

This hospital’s price: $5,056 across 12 payers · range $4,907-$7,413

Source: https://bellin-ghs.pt.panaceainc.com/MRFDownload/bellin-ghs/bellin-psychiatric · observed 2026-06-27

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.

19,903 distinct procedures filed

29 distinct payers

258,370 rate rows

2026-06-27 last MRF observed

Data quality

238,108 of 258,370 rate rows are consumer-grade (92.2%)

20,262 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 — reason	Rows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	12,818
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	6,943
per-diem day rate — not a per-procedure price	299
exceeds 10× this hospital's gross charge — excluded from medians	123
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	52
placeholder amount (≤ $0.02) — excluded from medians	14
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	10
percent-of-charges filed in the dollar field — excluded from medians	3

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://bellin-ghs.pt.panaceainc.com/MRFDownload/bellin-ghs/bellin-psychiatric
Found on page	https://bellin.org/patients-visitors/billing-insurance-services
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-11-09
Content fingerprint	6bcfb058ed0d23df… · 2,464,254 bytes · first seen 2026-11-06

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
J3391 HCPCS	Inj, Atidarsagene Autotemcel	2	$4,505,000.00	$4,505,000.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	3	$18,487.50	$3,685,266.67	$3,685,266.67	nat. median $3,691,450 1.0× median
J3389 HCPCS	Topi Adm Prad Zami Per Treat	2	$3,335,820.00	$3,335,820.00	$3,335,820.00	nat. median $3,335,820 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	3	$18,487.50	$3,327,859.73	$3,327,859.73	nat. median $3,324,572 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	2	$3,252,508.07	$3,252,508.08	$3,252,508.08	nat. median $3,286,000 1.0× median
J3387 HCPCS	Inj Elivaldogene Autotemecel	2	$3,180,000.00	$3,180,000.00	$3,180,000.00	nat. median $3,180,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	2	$2,939,968.88	$2,939,968.89	$2,939,968.89	nat. median $2,983,626 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	2	$2,332,000.00	$2,332,000.00	$2,332,000.00	nat. median $2,401,960 1.0× median
Q2057 HCPCS	Afamitresgene Autoleucel	3	$770,620.00	$1,125,105.20	$770,620.00	nat. median $813,967 0.9× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	2	$278,250.00	$278,250.00	$278,250.00	nat. median $319,951 0.9× median
J3403 HCPCS	Revakinagene, Per Implant	3	$265,000.00	$386,900.00	$265,000.00	nat. median $265,000 1.0× median
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	3	$201,669.02	$294,436.77	$201,669.02	nat. median $209,753 1.0× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	1	$166,352.64	$166,352.64	$166,352.64	nat. median $111,503 1.5× median
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	1	$142,621.55	$142,621.55	$142,621.55	nat. median $97,404 1.5× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	$69,640.12	$141,990.49	$105,815.30	nat. median $90,525 1.2× median
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	1	$103,202.57	$103,202.57	$103,202.57	nat. median $70,178 1.5× median
231 MS_DRG	Coronary Bypass With Ptca With Mcc	2	$60,154.31	$122,354.10	$91,254.21	nat. median $76,979 1.2× median
L7181 HCPCS	Electronic Elbo Simultaneous	2	$74,007.27	$97,089.55	$85,509.81	nat. median $50,552 1.7× median
L7180 HCPCS	Electronic Elbow Sequential	2	$71,879.99	$94,298.98	$83,052.08	nat. median $46,980 1.8× median
33231 HCPCS	Hchg 33231 Insert Cardio-defib Gen W/existing Mult	28	$15,708.99	$122,662.80	$68,654.03	nat. median $30,088 outlier · 2.3×
33264 HCPCS	Hchg 33264 Rem Gen W/repl Mult Lead	28	$15,708.99	$122,437.80	$68,449.02	nat. median $31,574 outlier · 2.2×
33270 HCPCS	Hchg 33270 Insert/replace Perm Subcut Implant Defib System	28	$15,708.99	$115,422.30	$66,502.65	nat. median $32,114 outlier · 2.1×
J9029 HCPCS	Instill Adstiladrin, Tx Dose	4	$18,487.50	$116,980.12	$64,274.79	nat. median $68,131 0.9× median
33249 HCPCS	Hchg 33249 Ins/rep Elect Lead, Sngl Chmbr	28	$15,708.99	$106,813.80	$63,688.97	nat. median $31,638 outlier · 2.0×
L2006 HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	1	$59,306.84	$59,306.84	$59,306.84	nat. median $39,926 1.5× median
233 MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	3	$13,839.00	$110,964.73	$54,652.41	nat. median $71,672 0.8× median
37277 HCPCS	Hchg 37277 Revasc Endovasc Fem/pop W/stent/ather Complex Lesn In	25	$9,174.32	$78,589.80	$54,270.62	nat. median $22,917 outlier · 2.4×
37286 HCPCS	Hchg 37286 Revascularization, Endovasc, Open/perc, Tibial/perone	25	$9,174.32	$78,589.80	$54,270.62	nat. median $21,777 outlier · 2.5×
37290 HCPCS	Hchg 37290 Revascularization, Endovasc, Open/perc, Tibial/perone	25	$9,174.32	$78,589.80	$54,270.62	nat. median $22,284 outlier · 2.4×
L8701 HCPCS	Ewh S/d Uprt Micro Sensor	1	$52,455.20	$52,455.20	$52,455.20	nat. median $35,670 1.5× median
L5856 HCPCS	Elec Knee-shin Swing/stance	2	$44,339.67	$58,169.21	$51,231.44	nat. median $30,151 1.7× median
L6880 HCPCS	Elec Hand Ind Art Digits	2	$44,130.32	$57,894.17	$50,989.21	nat. median $30,019 1.7× median
33230 HCPCS	Hchg 33230 Insert Cardio-defib Gen W/existing Dual	28	$11,132.11	$86,924.70	$50,732.40	nat. median $22,483 outlier · 2.3×
37288 HCPCS	Hchg 37288 Revascularization, Endovasc, Open/perc, Tibial/perone	25	$9,174.32	$71,445.60	$49,337.15	nat. median $21,968 outlier · 2.2×
37275 HCPCS	Hchg 37275 Revasc Endovasc Fem/pop W/stent/ather Sf Lesion Init	25	$9,174.32	$71,445.60	$49,337.15	nat. median $20,631 outlier · 2.4×
37284 HCPCS	Hchg 37284 Revascularization, Endovasc, Open/perc, Tibial/perone	25	$9,174.32	$71,445.60	$49,337.15	nat. median $20,253 outlier · 2.4×
33262 HCPCS	Hchg 33262 Rem Gen W/repl Single Lead	28	$11,132.11	$84,894.30	$48,968.88	nat. median $23,328 outlier · 2.1×
33263 HCPCS	Hchg 33263 Rem Gen W/repl Dual Lead	28	$11,132.11	$80,851.50	$47,927.24	nat. median $23,384 outlier · 2.0×
92930 HCPCS	Hchg 92930 Perc Transcath Placement Intracoronary Stent; 2 Or Mo	25	$9,174.32	$67,423.50	$46,559.68	nat. median $25,935 1.8× median
37292 HCPCS	Hchg 37292 Revascularization, Endovasc, Open/perc, Tibial/perone	25	$9,174.32	$67,423.50	$46,559.68	nat. median $21,412 outlier · 2.2×
37294 HCPCS	Hchg 37294 Revascularization, Endovasc, Open/perc, Tibial/perone	25	$9,174.32	$67,423.50	$46,559.68	nat. median $25,042 1.9× median
64654 HCPCS	1st Opn Implt Bat Modulj Sys	3	$1,518.63	$45,000.50	$45,000.50	nat. median $44,598 1.0× median
33276 HCPCS	Insj Phrnc Nrv Stim Sys	4	$1,488.89	$45,000.50	$45,000.50	nat. median $43,267 1.0× median
C9797 HCPCS	Hchg C9797 Vasc Embolization/occlusion Proc W/pressure-gen Cathe	25	$9,174.32	$64,644.30	$44,640.48	nat. median $18,718 outlier · 2.4×
L6700 HCPCS	Ue Add Ext Power Myoel	1	$44,265.29	$44,265.29	$44,265.29	nat. median $30,378 1.5× median
790 MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	1	$42,721.01	$42,721.01	$42,721.01	nat. median $50,769 0.8× median
93654 HCPCS	Hchg 93654 Ep And Ablation Ventricular Tachy	28	$13,081.05	$88,389.90	$41,579.53	nat. median $27,032 1.5× median
C2616 HCPCS	Hchg Brachytherapy Source, Nonstranded, Yttrium-90, Per Source (	28	$8,705.20	$64,930.50	$40,545.49	nat. median $26,672 1.5× median
37269 HCPCS	Hchg 37269 Revasc Endovasc Fem/pop W/stent Complex Lesn Init Vsl	25	$5,777.45	$57,465.00	$39,682.78	nat. median $14,742 outlier · 2.7×
L5858 HCPCS	Stance Phase Only	2	$34,327.58	$45,034.26	$39,663.09	nat. median $23,239 1.7× median

Other procedures at this hospital

Browse this hospital's 19,903 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J3391	HCPCS	Inj, Atidarsagene Autotemcel	4	2	—	—	$4,505,000.00	$4,505,000.00	$4,505,000.00	2026-06-27
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	5	3	—	—	$18,487.50	$3,685,266.67	$3,685,266.67	2026-06-27
J3389	HCPCS	Topi Adm Prad Zami Per Treat	4	2	—	—	$3,335,820.00	$3,335,820.00	$3,335,820.00	2026-06-27
J1413	HCPCS	Inj Delandistrogene Mox Rokl	5	3	—	—	$18,487.50	$3,327,859.73	$3,327,859.73	2026-06-27
J3394	HCPCS	Inj, Lovotibeglogene Autotem	4	2	—	—	$3,252,508.07	$3,252,508.08	$3,252,508.08	2026-06-27
J3387	HCPCS	Inj Elivaldogene Autotemecel	4	2	—	—	$3,180,000.00	$3,180,000.00	$3,180,000.00	2026-06-27
J3393	HCPCS	Inj, Betibeglogene Autotemce	4	2	—	—	$2,939,968.88	$2,939,968.89	$2,939,968.89	2026-06-27
J3392	HCPCS	Inj, Exagamglogene Autotem	4	2	—	—	$2,332,000.00	$2,332,000.00	$2,332,000.00	2026-06-27
Q2057	HCPCS	Afamitresgene Autoleucel	5	3	—	—	$770,620.00	$1,125,105.20	$770,620.00	2026-06-27
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	4	2	—	—	$278,250.00	$278,250.00	$278,250.00	2026-06-27
J3403	HCPCS	Revakinagene, Per Implant	5	3	—	—	$265,000.00	$386,900.00	$265,000.00	2026-06-27
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	5	3	—	—	$201,669.02	$294,436.77	$201,669.02	2026-06-27
Q0480	HCPCS	Driver Pneumatic Vad, Rep	1	1	—	—	$166,352.64	$166,352.64	$166,352.64	2026-06-27
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	1	1	—	—	$142,621.55	$142,621.55	$142,621.55	2026-06-27
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	—	—	$69,640.12	$141,990.49	$105,815.30	2026-06-27
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	1	1	—	—	$103,202.57	$103,202.57	$103,202.57	2026-06-27
231	MS_DRG	Coronary Bypass With Ptca With Mcc	2	2	—	—	$60,154.31	$122,354.10	$91,254.21	2026-06-27
L7181	HCPCS	Electronic Elbo Simultaneous	4	2	—	—	$74,007.27	$97,089.55	$85,509.81	2026-06-27
L7180	HCPCS	Electronic Elbow Sequential	4	2	—	—	$71,879.99	$94,298.98	$83,052.08	2026-06-27
33231	HCPCS	Hchg 33231 Insert Cardio-defib Gen W/existing Mult	44	28	$136,292.00	$63,103.20 54% off	$15,708.99	$122,662.80	$68,654.03	2026-06-27
33264	HCPCS	Hchg 33264 Rem Gen W/repl Mult Lead	44	28	$136,042.00	$62,987.45 54% off	$15,708.99	$122,437.80	$68,449.02	2026-06-27
33270	HCPCS	Hchg 33270 Insert/replace Perm Subcut Implant Defib System	44	28	$128,247.00	$59,378.36 54% off	$15,708.99	$115,422.30	$66,502.65	2026-06-27
J9029	HCPCS	Instill Adstiladrin, Tx Dose	6	4	—	—	$18,487.50	$116,980.12	$64,274.79	2026-06-27
33249	HCPCS	Hchg 33249 Ins/rep Elect Lead, Sngl Chmbr	44	28	$118,682.00	$54,949.77 54% off	$15,708.99	$106,813.80	$63,688.97	2026-06-27
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	1	1	—	—	$59,306.84	$59,306.84	$59,306.84	2026-06-27
233	MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	3	3	—	—	$13,839.00	$110,964.73	$54,652.41	2026-06-27
37277	HCPCS	Hchg 37277 Revasc Endovasc Fem/pop W/stent/ather Complex Lesn In	34	25	$87,322.00	$40,430.09 54% off	$9,174.32	$78,589.80	$54,270.62	2026-06-27
37286	HCPCS	Hchg 37286 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$87,322.00	$40,430.09 54% off	$9,174.32	$78,589.80	$54,270.62	2026-06-27
37290	HCPCS	Hchg 37290 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$87,322.00	$40,430.09 54% off	$9,174.32	$78,589.80	$54,270.62	2026-06-27
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	1	1	—	—	$52,455.20	$52,455.20	$52,455.20	2026-06-27
L5856	HCPCS	Elec Knee-shin Swing/stance	4	2	—	—	$44,339.67	$58,169.21	$51,231.44	2026-06-27
L6880	HCPCS	Elec Hand Ind Art Digits	4	2	—	—	$44,130.32	$57,894.17	$50,989.21	2026-06-27
33230	HCPCS	Hchg 33230 Insert Cardio-defib Gen W/existing Dual	44	28	$96,583.00	$44,717.93 54% off	$11,132.11	$86,924.70	$50,732.40	2026-06-27
37288	HCPCS	Hchg 37288 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$79,384.00	$36,754.79 54% off	$9,174.32	$71,445.60	$49,337.15	2026-06-27
37275	HCPCS	Hchg 37275 Revasc Endovasc Fem/pop W/stent/ather Sf Lesion Init	34	25	$79,384.00	$36,754.79 54% off	$9,174.32	$71,445.60	$49,337.15	2026-06-27
37284	HCPCS	Hchg 37284 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$79,384.00	$36,754.79 54% off	$9,174.32	$71,445.60	$49,337.15	2026-06-27
33262	HCPCS	Hchg 33262 Rem Gen W/repl Single Lead	44	28	$94,327.00	$43,673.40 54% off	$11,132.11	$84,894.30	$48,968.88	2026-06-27
33263	HCPCS	Hchg 33263 Rem Gen W/repl Dual Lead	44	28	$89,835.00	$41,593.61 54% off	$11,132.11	$80,851.50	$47,927.24	2026-06-27
92930	HCPCS	Hchg 92930 Perc Transcath Placement Intracoronary Stent; 2 Or Mo	34	25	$74,915.00	$34,685.65 54% off	$9,174.32	$67,423.50	$46,559.68	2026-06-27
37292	HCPCS	Hchg 37292 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$74,915.00	$34,685.65 54% off	$9,174.32	$67,423.50	$46,559.68	2026-06-27
37294	HCPCS	Hchg 37294 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$74,915.00	$34,685.65 54% off	$9,174.32	$67,423.50	$46,559.68	2026-06-27
64654	HCPCS	1st Opn Implt Bat Modulj Sys	5	3	—	—	$1,518.63	$45,000.50	$45,000.50	2026-06-27
33276	HCPCS	Insj Phrnc Nrv Stim Sys	6	4	—	—	$1,488.89	$45,000.50	$45,000.50	2026-06-27
C9797	HCPCS	Hchg C9797 Vasc Embolization/occlusion Proc W/pressure-gen Cathe	34	25	$71,827.00	$33,255.90 54% off	$9,174.32	$64,644.30	$44,640.48	2026-06-27
L6700	HCPCS	Ue Add Ext Power Myoel	1	1	—	—	$44,265.29	$44,265.29	$44,265.29	2026-06-27
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	1	1	—	—	$42,721.01	$42,721.01	$42,721.01	2026-06-27
93654	HCPCS	Hchg 93654 Ep And Ablation Ventricular Tachy	44	28	$98,211.00	$45,471.69 54% off	$13,081.05	$88,389.90	$41,579.53	2026-06-27
C2616	HCPCS	Hchg Brachytherapy Source, Nonstranded, Yttrium-90, Per Source (	45	28	$72,145.00	$33,403.14 54% off	$8,705.20	$64,930.50	$40,545.49	2026-06-27
37269	HCPCS	Hchg 37269 Revasc Endovasc Fem/pop W/stent Complex Lesn Init Vsl	34	25	$63,850.00	$29,562.55 54% off	$5,777.45	$57,465.00	$39,682.78	2026-06-27
L5858	HCPCS	Stance Phase Only	4	2	—	—	$34,327.58	$45,034.26	$39,663.09	2026-06-27
37260	HCPCS	Hchg 37260 Revasc Endovasc Iliac W/stent Complex Lesn Init Vesse	34	25	$62,778.00	$29,066.21 54% off	$5,777.45	$56,500.20	$39,016.53	2026-06-27
37282	HCPCS	Hchg 37282 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$62,778.00	$29,066.21 54% off	$5,777.45	$56,500.20	$39,016.53	2026-06-27
93653	HCPCS	Hchg 93653 Comp Ep Eval; W/trmt Supravent Tachy By Ablation	44	28	$89,044.00	$41,227.37 54% off	$13,081.05	$80,139.60	$39,003.61	2026-06-27
93656	HCPCS	Hchg 93656 Ep Trt Atrial Fib By Pulm Vein Isol	44	28	$86,527.00	$40,062.00 54% off	$13,081.05	$77,874.30	$38,296.32	2026-06-27
37273	HCPCS	Hchg 37273 Revasc Endovasc Fem/pop W/ather Complex Lesion Init V	34	25	$61,335.00	$28,398.11 54% off	$9,174.32	$55,201.50	$38,119.71	2026-06-27
L6975	HCPCS	Interscap-thor Myoelectronic	4	2	—	—	$32,751.32	$42,965.93	$37,841.43	2026-06-27
L5973	HCPCS	Ank-foot Sys Dors-plant Flex	4	2	—	—	$32,609.28	$42,780.13	$37,677.81	2026-06-27
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	3	—	—	$13,304.00	$121,969.47	$36,903.75	2026-06-27
33229	HCPCS	Hchg 33229 Rem Perm Pacemaker W/repl Mult	44	28	$80,575.00	$37,306.23 54% off	$6,982.94	$72,517.50	$36,289.62	2026-06-27
Q2056	HCPCS	Ciltacabtagene Car-pos T	15	12	—	—	$35,797.15	$857,968.37	$36,235.31	2026-06-27
Q2053	HCPCS	Brexucabtagene Car Pos T	15	12	—	—	$35,797.15	$714,597.29	$36,235.31	2026-06-27
Q2055	HCPCS	Idecabtagene Vicleucel Car	15	12	—	—	$35,797.15	$814,799.33	$36,235.31	2026-06-27
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	15	12	—	—	$35,797.15	$820,813.81	$36,235.31	2026-06-27
Q2042	HCPCS	Tisagenlecleucel Car-pos T	15	12	—	—	$35,797.15	$827,135.70	$36,235.31	2026-06-27
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	15	12	—	—	$35,797.15	$777,000.67	$36,235.31	2026-06-27
L8614	HCPCS	Cochlear Device	1	1	—	—	$36,164.72	$36,164.72	$36,164.72	2026-06-27
37267	HCPCS	Hchg 37267 Revasc Endovasc Fem/pop W/stent Sf Lesion Init Vessel	34	25	$58,046.00	$26,875.30 54% off	$5,777.45	$52,241.40	$36,075.59	2026-06-27
C9081	HCPCS	Idecabtagene Car Pos T	10	9	—	—	$35,797.15	$37,587.01	$35,797.15	2026-06-27
Q2040	HCPCS	Tisagenlecleucel Car-pos T	10	9	—	—	$35,797.15	$37,587.01	$35,797.15	2026-06-27
C9073	HCPCS	Brexucabtagene Autoleucel Ca	10	9	—	—	$35,797.15	$37,587.01	$35,797.15	2026-06-27
C9076	HCPCS	Lisocabtagene Car Pos T	10	9	—	—	$35,797.15	$37,587.01	$35,797.15	2026-06-27
C9098	HCPCS	Ciltacabtagene Car Pos T	10	9	—	—	$35,797.15	$37,587.01	$35,797.15	2026-06-27
37258	HCPCS	Hchg 37258 Revasc Endovasc Iliac W/stent Sf Lesion, Initial Vess	34	25	$57,071.00	$26,423.87 54% off	$5,777.45	$51,363.90	$35,469.62	2026-06-27
37280	HCPCS	Hchg 37280 Revascularization, Endovasc, Open/perc, Tibial/perone	34	25	$57,071.00	$26,423.87 54% off	$5,777.45	$51,363.90	$35,469.62	2026-06-27
33221	HCPCS	Hchg 33221 Insert Pacemaker W/existing Mult Leads	44	28	$76,285.00	$35,319.96 54% off	$6,982.94	$68,656.50	$35,139.79	2026-06-27
0870T	OTHER	Imp Subq Prtl Ascts Pmp Sys	4	2	—	—	$35,000.50	$35,000.50	$35,000.50	2026-06-27
37271	HCPCS	Hchg 37271 Revasc Endovasc Fem/pop W/ather Sf Lesion Init Vessel	34	25	$55,759.00	$25,816.42 54% off	$9,174.32	$50,183.10	$34,654.22	2026-06-27
Q0483	HCPCS	Monitor Elec Vad, Rep	1	1	—	—	$34,630.98	$34,630.98	$34,630.98	2026-06-27
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	3	—	—	$13,304.00	$111,445.15	$34,361.74	2026-06-27
L6970	HCPCS	Interscapular-thor Switch CT	4	2	—	—	$29,713.53	$38,981.37	$34,332.11	2026-06-27
33274	HCPCS	Hchg 33274 Transcather Insert/replace Perm Leadless Pacemaker, R	44	28	$69,913.00	$32,369.72 54% off	$6,982.94	$62,921.70	$33,007.43	2026-06-27
C9775	HCPCS	Hchg C9775 Revascularization, Endovasc, Tib/peroneal Art, W/lith	44	28	$71,827.00	$33,255.90 54% off	$9,174.32	$64,644.30	$32,204.44	2026-06-27
C9774	HCPCS	Hchg C9774 Revascularization, Endovasc, Tib/peroneal Art, W/lith	44	28	$71,827.00	$33,255.90 54% off	$9,174.32	$64,644.30	$32,163.34	2026-06-27
L6965	HCPCS	Shldr Disartic Myoelectronic	4	2	—	—	$27,759.56	$36,417.57	$32,074.10	2026-06-27
C9773	HCPCS	Hchg C9773 Revascularization, Endovasc, Tib/peroneal Artery, W/l	44	28	$71,827.00	$33,255.90 54% off	$9,174.32	$64,644.30	$31,995.80	2026-06-27
0915T	OTHER	Insj Perm Ccm-d Sys Pg&eltrd	4	2	—	—	$15,708.99	$33,582.45	$31,566.21	2026-06-27
0908T	OTHER	Opn Imp Int Nstm Sys Vgs Nrv	4	2	—	—	$15,443.17	$33,014.17	$31,032.04	2026-06-27
0909T	OTHER	Rplcmt Int Nstim Sys Vgs Nrv	4	2	—	—	$15,443.17	$33,014.17	$31,032.04	2026-06-27
L5859	HCPCS	Knee-shin Pro Flex/ext Cont	4	2	—	—	$26,799.21	$35,158.00	$30,964.76	2026-06-27
36906	HCPCS	Hchg 36906 Thrombectomy/thrombolysis Dialysis Circuit Any Method	44	28	$66,830.00	$30,942.29 54% off	$9,174.32	$60,147.00	$30,898.62	2026-06-27
A9543	HCPCS	Y90 Ibritumomab, Rx	14	11	—	—	$30,430.57	$56,824.55	$30,887.03	2026-06-27
37182	HCPCS	Hchg 37182 Insert Hepatic Shunt (tips)	44	28	$74,915.00	$34,685.65 54% off	$9,174.32	$67,423.50	$30,857.48	2026-06-27
0238T	OTHER	Hchg 0238t Translum Periph Ather;iliac Artery	44	28	$71,827.00	$33,255.90 54% off	$9,174.32	$64,644.30	$30,759.56	2026-06-27
C9767	HCPCS	Hchg C9767 Revascularization, Endovasc, Le, W/intravas Litho, St	44	28	$71,827.00	$33,255.90 54% off	$9,174.32	$64,644.30	$30,650.30	2026-06-27
64656	HCPCS	Revj/rplcmt Bat Mod Sys Pg	5	3	—	—	$1,167.99	$33,014.17	$30,538.02	2026-06-27
A9513	HCPCS	Lutetium Lu 177 Dotatat Ther	14	11	—	—	$320.76	$34,139.29	$30,430.57	2026-06-27
A9607	HCPCS	Lutetium Lu 177 Vipivotide	14	11	—	—	$259.31	$34,139.29	$30,430.57	2026-06-27
C9031	HCPCS	Lutetium Lu 177 Dotatate, Tx	10	9	—	—	$30,430.57	$34,139.29	$30,430.57	2026-06-27
793	MS_DRG	Full Term Neonate With Major Problems	1	1	—	—	$30,283.37	$30,283.37	$30,283.37	2026-06-27
Q0489	HCPCS	Pwr Pck Base Combo Vad, Rep	1	1	—	—	$30,023.19	$30,023.19	$30,023.19	2026-06-27
C9765	HCPCS	Hchg C9765 Revascularization, Endovasc, Le, W/intravas Litho And	44	28	$71,827.00	$33,255.90 54% off	$6,163.08	$64,644.30	$29,989.75	2026-06-27
C9766	HCPCS	Hchg C9766 Revascularization, Endovasc, Le, With Intravascular Lit	44	28	$71,827.00	$33,255.90 54% off	$6,163.08	$64,644.30	$29,989.75	2026-06-27
93590	HCPCS	Hchg 93590 Perq Transcath Cls Paravalvr Leak 1 Mitral Valve	44	28	$70,171.00	$32,489.17 54% off	$9,174.32	$63,153.90	$29,524.42	2026-06-27
93591	HCPCS	Hchg 93591 Perq Transcath Cls Paravalvr Leak 1 Aortic Valve	44	28	$70,171.00	$32,489.17 54% off	$9,174.32	$63,153.90	$29,524.42	2026-06-27
93582	HCPCS	Hchg 93582 Perc Transcath Closure Patent Ductus Arteriosus	44	28	$70,171.00	$32,489.17 54% off	$9,174.32	$63,153.90	$29,524.42	2026-06-27
791	MS_DRG	Prematurity With Major Problems	1	1	—	—	$29,507.90	$29,507.90	$29,507.90	2026-06-27
37298	HCPCS	Hchg 37298 Revascularization, Endovasc, Open/perc, Inframalleola	34	25	$47,177.00	$21,842.95 54% off	$5,777.45	$42,459.30	$29,320.51	2026-06-27
37296	HCPCS	Hchg 37296 Revascularization, Endovasc, Open/perc, Inframalleola	34	25	$47,177.00	$21,842.95 54% off	$5,777.45	$42,459.30	$29,320.51	2026-06-27
0913T	OTHER	Hchg 0913t Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art	34	25	$45,363.00	$21,003.07 54% off	$5,777.45	$40,826.70	$28,193.10	2026-06-27
92933	HCPCS	Hchg 92933 Perq Coro Ather W/de Stent W/angio; Single Art	44	28	$63,128.00	$29,228.26 54% off	$7,861.36	$56,815.20	$27,545.33	2026-06-27
93580	HCPCS	Hchg 93580 Perc Transcath Closure Of Asd	44	28	$63,128.00	$29,228.26 54% off	$9,174.32	$56,815.20	$27,545.33	2026-06-27
0871T	OTHER	Rplcmt Subq Prtl Ascites Pmp	4	2	—	—	$27,500.50	$27,500.50	$27,500.50	2026-06-27
0451T	OTHER	Insj/rplcmt Aortic Ventr Sys	10	9	—	—	$27,364.89	$29,809.54	$27,364.89	2026-06-27
33981	HCPCS	Replace Vad Pump Ext	11	10	—	—	$3,038.31	$29,809.54	$27,364.89	2026-06-27
33982	HCPCS	Replace Vad Intra Without Bp	11	10	—	—	$7,113.42	$29,809.54	$27,364.89	2026-06-27
33975	HCPCS	Implant Ventricular Device	11	10	—	—	$4,816.06	$29,809.54	$27,364.89	2026-06-27
0454T	OTHER	Insj/rplcmt Subq Electrode	13	10	—	—	$8,659.63	$29,809.54	$27,364.89	2026-06-27
0459T	OTHER	Relocaj Rplcmt Aortic Ventr	10	9	—	—	$27,364.89	$29,809.54	$27,364.89	2026-06-27
33976	HCPCS	Implant Ventricular Device	11	10	—	—	$5,844.93	$29,809.54	$27,364.89	2026-06-27
0453T	OTHER	Insj/rplcmt Mech-elec Ntrfce	13	10	—	—	$8,659.63	$29,809.54	$27,364.89	2026-06-27
33983	HCPCS	Replace Vad Intra W/bp	11	10	—	—	$8,382.88	$29,809.54	$27,364.89	2026-06-27
33979	HCPCS	Insert Intracorporeal Device	11	10	—	—	$7,088.68	$29,809.54	$27,364.89	2026-06-27
33995	HCPCS	Insj Perq Vad R Hrt Venous	11	10	—	—	$1,067.87	$29,809.54	$27,364.89	2026-06-27
33991	HCPCS	Insj Perq Vad L Hrt Artl&ven	11	10	—	—	$2,305.75	$29,809.54	$27,364.89	2026-06-27
0452T	OTHER	Insj/rplcmt Dev Vasc Seal	10	9	—	—	$27,364.89	$29,809.54	$27,364.89	2026-06-27
0960T	OTHER	Rpl S-sclp Eltr Ra Rcvr&tlmt	4	2	—	—	$13,579.60	$29,030.26	$27,287.32	2026-06-27
0956T	OTHER	Prt Crn Ch Cr&tun Elt S-sclp	4	2	—	—	$13,579.60	$29,030.26	$27,287.32	2026-06-27
L6960	HCPCS	Shldr Disartic Switch Contro	4	2	—	—	$23,432.61	$30,740.83	$27,074.40	2026-06-27
Q0481	HCPCS	Microprcsr Cu Elec Vad, Rep	1	1	—	—	$26,839.13	$26,839.13	$26,839.13	2026-06-27
92937	HCPCS	Hchg 92937 Perq Revasc Bypass Graft; Single Vessel	74	28	$49,826.00	$23,069.44 54% off	$5,777.45	$44,843.40	$26,138.04	2026-06-27
L6955	HCPCS	Above Elbow Myoelectronic CT	4	2	—	—	$22,275.15	$29,222.58	$25,737.24	2026-06-27
34846	HCPCS	Hchg 34846 Endovasc Rpr Visc/infra Renal Abd Aorta Incl 2 Endopr	43	28	$45,765.00	$21,189.20 54% off	$11,807.37	$41,188.50	$25,719.93	2026-06-27
92943	HCPCS	Hchg 92943 Perq Revasc Chronic; Single Vessel	74	28	$45,363.00	$21,003.07 54% off	$5,777.45	$40,826.70	$25,494.01	2026-06-27
L6945	HCPCS	Elbow Disart Myoelectronic C	4	2	—	—	$21,468.75	$28,164.29	$24,805.17	2026-06-27
92928	HCPCS	Hchg 92928 Perq Coro Stent W/angio; Single Artery	74	28	$43,762.00	$20,261.81 54% off	$5,777.45	$39,385.80	$24,594.24	2026-06-27
E0766RR	OTHER	Elec Stim Cancer Treatment	1	1	—	—	$24,577.10	$24,577.10	$24,577.10	2026-06-27
L7191	HCPCS	Elbow Child Myoelectronic CT	4	2	—	—	$20,654.66	$27,096.88	$23,865.07	2026-06-27
33287	HCPCS	Rmv&rplcmt Phrnc Nrv Stim Pg	6	4	—	—	$1,001.24	$33,014.17	$23,391.84	2026-06-27
61891	HCPCS	Rev/rplcmt Sk-mnt Crnl Nstm	6	4	—	—	$1,810.92	$33,014.17	$22,990.60	2026-06-27
L7186	HCPCS	Electron Elbow Child Switch	4	2	—	—	$19,636.67	$25,760.79	$22,688.33	2026-06-27
37256	HCPCS	Hchg 37256 Revasc Endovasc Iliac Complex Lesion Init Vessel	34	25	$36,098.00	$16,713.37 54% off	$2,848.42	$32,488.20	$22,434.90	2026-06-27
0923T	OTHER	Rmvl&rplcmt Perm Ccm-d Pg	4	2	—	—	$11,132.11	$23,798.05	$22,369.25	2026-06-27
0916T	OTHER	Insj Perm Ccm-d Sys Pg Only	4	2	—	—	$11,132.11	$23,798.05	$22,369.25	2026-06-27
L6940	HCPCS	Elbow Disarticulation Switch	4	2	—	—	$19,243.62	$25,245.31	$22,234.33	2026-06-27
L6950	HCPCS	Above Elbow Switch Control	4	2	—	—	$19,207.92	$25,198.87	$22,193.42	2026-06-27
Q0479	HCPCS	Power Module Combo Vad, Rep	1	1	—	—	$22,171.34	$22,171.34	$22,171.34	2026-06-27
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	15	12	—	—	$21,441.77	$79,430.00	$22,085.02	2026-06-27
J9226	HCPCS	Supprelin La Implant	15	12	—	—	$21,441.77	$78,597.32	$22,085.02	2026-06-27
37242	HCPCS	Hchg 37242 Vasc Emboliz/occlus Arterial	44	28	$43,205.00	$20,003.92 54% off	$9,174.32	$38,884.50	$21,946.97	2026-06-27
37265	HCPCS	Hchg 37265 Revasc Endovasc Fem/pop Complex Lesion Init Vessel	34	25	$35,025.00	$16,216.58 54% off	$2,848.42	$31,522.50	$21,768.04	2026-06-27
J9600	HCPCS	Porfimer Sodium Injection	14	11	—	—	$21,441.77	$24,228.42	$21,763.40	2026-06-27
69930	HCPCS	Implant Cochlear Device	15	12	—	—	$3,903.97	$77,967.59	$21,448.06	2026-06-27
S2235	HCPCS	Implant Auditory Brain Imp	10	9	—	—	$21,448.06	$23,001.54	$21,448.06	2026-06-27
J9298	HCPCS	Inj Nivol Relatlimab 3mg/1mg	15	12	—	—	$201.65	$22,675.58	$21,441.77	2026-06-27
Q9995	HCPCS	Inj. Emicizumab-kxwh, 0.5 Mg	10	9	—	—	$21,441.77	$22,675.58	$21,441.77	2026-06-27
J2350	HCPCS	Injection, Ocrelizumab, 1 Mg	15	12	—	—	$59.32	$22,675.58	$21,441.77	2026-06-27
J9210	HCPCS	Inj., Emapalumab-lzsg, 1 Mg	15	12	—	—	$384.13	$22,675.58	$21,441.77	2026-06-27
J0219	HCPCS	Inj Aval Alfa-nqpt 4mg	15	12	—	—	$81.29	$22,675.58	$21,441.77	2026-06-27
C9052	HCPCS	Injection, Ravulizumab-cwv	10	9	—	—	$21,441.77	$22,675.58	$21,441.77	2026-06-27
J7180	HCPCS	Factor Xiii Anti-hem Factor	15	12	—	—	$10.76	$22,675.58	$21,441.77	2026-06-27
J1303	HCPCS	Inj., Ravulizumab-cwvz 10 Mg	15	12	—	—	$224.80	$22,675.58	$21,441.77	2026-06-27
J7175	HCPCS	Inj, Factor X, (human), 1iu	15	12	—	—	$9.92	$22,675.58	$21,441.77	2026-06-27
J7170	HCPCS	Inj., Emicizumab-kxwh 0.5 Mg	15	12	—	—	$56.46	$22,675.58	$21,441.77	2026-06-27
J2840	HCPCS	Inj Sebelipase Alfa 1 Mg	14	11	—	—	$540.08	$22,675.58	$21,441.77	2026-06-27
J1300	HCPCS	Eculizumab Injection	10	9	—	—	$21,441.77	$22,675.58	$21,441.77	2026-06-27
J0221	HCPCS	Lumizyme Injection	15	12	—	—	$207.38	$22,675.58	$21,441.77	2026-06-27
J0223	HCPCS	Inj Givosiran 0.5 Mg	15	12	—	—	$120.68	$22,675.58	$21,441.77	2026-06-27
C9085	HCPCS	Inj Avalglucosid Alfa-ngpt	10	9	—	—	$21,441.77	$22,675.58	$21,441.77	2026-06-27
J9269	HCPCS	Inj. Tagraxofusp-erzs 10 Mcg	15	12	—	—	$357.02	$22,675.58	$21,441.77	2026-06-27
J2326	HCPCS	Inj, Nusinersen, 0.1mg	14	11	—	—	$1,286.14	$22,675.58	$21,441.77	2026-06-27
33214	HCPCS	Hchg 33214 Upgrade Pmkr System,sngl->dual	44	28	$43,956.00	$20,351.63 54% off	$5,230.85	$39,560.40	$21,170.24	2026-06-27
33213	HCPCS	Hchg 33213 Ins/rpl Pmkr P-gen Dual Chmber	44	28	$42,732.00	$19,784.92 54% off	$5,230.85	$38,458.80	$20,952.21	2026-06-27
33208	HCPCS	Hchg 33208 Ins/rpl Pace W/trans Elec-a&v	44	28	$41,465.00	$19,198.30 54% off	$5,230.85	$37,318.50	$20,614.39	2026-06-27
37254	HCPCS	Hchg 37254 Revasc Endovasc Iliac Sf Lesion, Init Vessel	34	25	$32,816.00	$15,193.81 54% off	$2,848.42	$29,534.40	$20,395.14	2026-06-27
33207	HCPCS	Hchg 33207 Ins/rpl Pace W/trans Elec-vent	44	28	$40,697.00	$18,842.71 54% off	$5,230.85	$36,627.30	$20,222.19	2026-06-27
37187	HCPCS	Hchg 37187 Venous Mechanical Thrombectomy	44	28	$45,363.00	$21,003.07 54% off	$3,587.22	$40,826.70	$20,184.20	2026-06-27
33228	HCPCS	Hchg 33228 Rem Perm Pacemaker W/repl Dual	44	28	$40,697.00	$18,842.71 54% off	$5,230.85	$36,627.30	$20,176.41	2026-06-27
50593	HCPCS	Hchg 50593 Perq Cryoablate Renal Tumor	44	28	$41,645.00	$19,281.64 54% off	$5,319.85	$37,480.50	$20,145.71	2026-06-27
33224	HCPCS	Hchg 33224 Insert Left Vent Pcg Elec	44	28	$40,697.00	$18,842.71 54% off	$5,230.85	$36,627.30	$20,124.38	2026-06-27
33206	HCPCS	Hchg 33206 Ins/rpl Pace W/trans Elec-atrl	44	28	$40,697.00	$18,842.71 54% off	$5,230.85	$36,627.30	$20,100.97	2026-06-27
0414T	OTHER	Rmvl & Rpl Car Modulj Pls Gn	14	11	—	—	$19,657.33	$37,013.77	$19,952.19	2026-06-27
0409T	OTHER	Insj/rplc Car Modulj Pls Gn	14	11	—	—	$19,657.33	$37,013.77	$19,952.19	2026-06-27
0614T	OTHER	Rmvl&rplcmt Ss Impl Dfb Pg	14	11	—	—	$19,657.33	$37,013.77	$19,952.19	2026-06-27
37238	HCPCS	Hchg 37238 Transcath Intravasc Stent Init Vein	44	28	$45,363.00	$21,003.07 54% off	$5,777.45	$40,826.70	$19,860.06	2026-06-27
37263	HCPCS	Hchg 37263 Revasc Endovasc Fem/pop Sf Lesion Init Vessel	34	25	$31,841.00	$14,742.38 54% off	$2,848.42	$28,656.90	$19,789.18	2026-06-27
0294T	OTHER	Ins Lt Atrl Mont Pres Lead	10	9	—	—	$19,657.33	$21,172.60	$19,657.33	2026-06-27
33289	HCPCS	Tcat Impl Wrls P-art Prs Snr	15	12	—	—	$1,086.98	$30,687.87	$19,657.33	2026-06-27
33240	HCPCS	Insrt Pulse Gen W/singl Lead	15	12	—	—	$1,357.25	$50,012.69	$19,657.33	2026-06-27
C9741	HCPCS	Impl Pressure Sensor W/angio	10	9	—	—	$19,657.33	$21,172.60	$19,657.33	2026-06-27
G0448	HCPCS	Place Perm Pacing Cardiovert	10	9	—	—	$19,657.33	$21,172.60	$19,657.33	2026-06-27
0520T	OTHER	Rmvl&rplcmt Pg Wcs New Eltrd	14	11	—	—	$10,343.71	$37,013.77	$19,657.33	2026-06-27
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	14	11	—	—	$15,708.99	$33,582.45	$19,657.33	2026-06-27
1013T	OTHER	Lap Srg Imp/rpl Eso Nea&pg/r	4	2	—	—	$9,709.06	$20,755.87	$19,509.72	2026-06-27
C9772	HCPCS	Hchg C9772 Revascularization, Endovasc, Tib/peroneal Artery, W/l	44	28	$45,363.00	$21,003.07 54% off	$5,777.45	$40,826.70	$19,354.84	2026-06-27
0816T	OTHER	Opn Insj/rplcmt Ins Ptn Subq	5	3	—	—	$9,709.06	$20,755.87	$19,199.13	2026-06-27
0817T	OTHER	Opn Insj/rplcmt Ins Ptn Subf	5	3	—	—	$9,709.06	$20,755.87	$19,199.13	2026-06-27
36903	HCPCS	Hchg 36903 Dialysis Fistula/shuntogram W/stent, Peripheral Incl	44	28	$41,928.00	$19,412.66 54% off	$5,777.45	$37,735.20	$19,110.22	2026-06-27
L6925	HCPCS	Wrist Disart Myoelectronic C	4	2	—	—	$16,529.81	$21,685.15	$19,098.79	2026-06-27
0795T	OTHER	Tcat Ins 2chmbr Ldls Pm Cmpl	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
0802T	OTHER	Tcat Rmv&rpl2chmb Ldls Pm Ra	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
0803T	OTHER	Tcat Rmv&rpl2chmb Ldls Pm Rv	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
0801T	OTHER	Tcat Rmv&rpl 2chmbr Ldls Pm	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
0823T	OTHER	Tcat Ins 1chmbr Ldls Pm Ra	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
0796T	OTHER	Tcat Ins 2chmbr Ldls Pm Ra	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
0825T	OTHER	Tcat Rmv&rpl1chmb Ldls Pm Ra	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
0797T	OTHER	Tcat Ins 2chmbr Ldls Pm Rv	5	3	—	—	$6,774.31	$20,607.78	$19,062.14	2026-06-27
L6935	HCPCS	Below Elbow Myoelectronic CT	4	2	—	—	$16,452.12	$21,583.15	$19,008.96	2026-06-27
37241	HCPCS	Hchg 27341 Vasc Emboliz/occlus Venous	44	28	$45,363.00	$21,003.07 54% off	$5,777.45	$40,826.70	$18,922.47	2026-06-27
C9764	HCPCS	Hchg C9764 Revascularization, Endovasc, Le, W/intravasc Litho	44	28	$45,363.00	$21,003.07 54% off	$3,587.22	$40,826.70	$18,922.47	2026-06-27
37236	HCPCS	Hchg 37236 Transcath Plc Intravasc Stent Init Artery	44	28	$41,928.00	$19,412.66 54% off	$5,777.45	$37,735.20	$18,741.85	2026-06-27
37244	HCPCS	Hchg 37244 Vasc Emboliz/occlus Art/ven Hemorrhage	44	28	$41,928.00	$19,412.66 54% off	$5,777.45	$37,735.20	$18,740.29	2026-06-27
37184	HCPCS	Hchg 37184 Primary Perc Translum Mech Thrombectomy, Noncoronary/	44	28	$33,216.00	$15,379.01 54% off	$6,163.08	$29,894.40	$18,667.39	2026-06-27
0981T	OTHER	Tcat Impl Wrls Ivc Snr	4	2	—	—	$9,174.32	$19,612.73	$18,435.21	2026-06-27
20002415-352	CDM	Hchg Optime Level 6 Base Charge	33	25	$28,378.00	$13,139.01 54% off	$7,321.52	$25,540.20	$18,247.05	2026-06-27
792	MS_DRG	Prematurity Without Major Problems	1	1	—	—	$18,220.85	$18,220.85	$18,220.85	2026-06-27
L5857	HCPCS	Elec Knee-shin Swing Only	4	2	—	—	$15,733.38	$20,640.52	$18,178.75	2026-06-27
0793T	OTHER	Prq Tcat Thrm Ablt Nrv P-art	5	3	—	—	$7,060.13	$19,612.73	$18,141.73	2026-06-27
36905	HCPCS	Hchg 36905 Thrombectomy/thrombolysis Dialysis Circuit, Any Metho	44	28	$41,928.00	$19,412.66 54% off	$5,777.45	$37,735.20	$17,957.24	2026-06-27
37243	HCPCS	Hchg 37243 Vasc Emboliz/occlus Tumor/ischemia/infarct	44	28	$41,928.00	$19,412.66 54% off	$5,777.45	$37,735.20	$17,957.24	2026-06-27
L8619	HCPCS	Coch Imp Ext Proc/contr Rplc	4	2	—	—	$15,525.09	$20,367.29	$17,938.11	2026-06-27
L7190	HCPCS	Elbow Adolescent Myoelectron	4	2	—	—	$15,498.98	$20,332.68	$17,907.63	2026-06-27
L6920	HCPCS	Wrist Disarticul Switch Ctrl	4	2	—	—	$15,472.52	$20,298.07	$17,877.14	2026-06-27
C8003	HCPCS	Imp Extar Knee Shck Absrb	4	2	—	—	$8,775.04	$18,759.16	$17,632.88	2026-06-27
L5991	HCPCS	Low Pros Ext Osseo Connector	1	1	—	—	$17,632.56	$17,632.56	$17,632.56	2026-06-27
E0783	HCPCS	Programmable Infusion Pump	1	1	—	—	$17,501.18	$17,501.18	$17,501.18	2026-06-27
C8005	HCPCS	Pef Bronch Ablt 3d Nav Ebus	4	2	—	—	$17,500.50	$17,500.50	$17,500.50	2026-06-27
0888T	OTHER	Histotripsy Mal Renal Tissue	4	2	—	—	$17,500.50	$17,500.50	$17,500.50	2026-06-27
0790T	OTHER	Revj Rplcmt/rmvl Vrt Tethrg	5	3	—	—	$8,775.04	$18,759.16	$17,352.17	2026-06-27
L6930	HCPCS	Below Elbow Switch Control	4	2	—	—	$14,902.20	$19,550.33	$17,218.59	2026-06-27
33217	HCPCS	Hchg 33217 Insert Two Transven Elect	44	28	$32,379.00	$14,991.48 54% off	$1,359.71	$29,141.10	$17,214.17	2026-06-27
33212	HCPCS	Hchg 33212 Ins/rpl Pmkr Pgen Only-sngl Ch	44	28	$33,998.00	$15,741.07 54% off	$4,141.53	$30,598.20	$17,190.96	2026-06-27
92924	HCPCS	Hchg 92924 Perq Card Angio/atherect; Single Artery	44	28	$39,012.00	$18,062.56 54% off	$5,777.45	$35,110.80	$17,137.84	2026-06-27
33285	HCPCS	Hchg 33285 Insertion Subq Cardiac Rhythm Monitor W/programming	44	28	$32,379.00	$14,991.48 54% off	$4,141.53	$29,141.10	$17,095.03	2026-06-27
64582	HCPCS	Opn Mpltj Hpglsl Nstm Ary Pg	15	12	—	—	$2,787.77	$60,207.04	$17,093.84	2026-06-27
64575	HCPCS	Opn Impltj Nea Perph Nerve	15	12	—	—	$1,256.87	$24,556.05	$17,093.84	2026-06-27
64580	HCPCS	Opn Impltj Nea Neuromuscular	15	12	—	—	$1,187.54	$35,629.34	$17,093.84	2026-06-27
64568	HCPCS	Opn Impltj Crnl Nrv Nea&pg	15	12	—	—	$2,486.13	$59,646.34	$17,093.84	2026-06-27
63685	HCPCS	Insrt/redo Spine N Generator	15	12	—	—	$1,465.65	$58,676.48	$17,093.84	2026-06-27
64553	HCPCS	Implant Neuroelectrodes	15	12	—	—	$628.29	$23,848.14	$17,093.84	2026-06-27
63664	HCPCS	Revise Spine Eltrd Plate	15	12	—	—	$3,245.00	$22,274.29	$17,093.84	2026-06-27
64569	HCPCS	Revise/repl Vagus N Eltrd	15	12	—	—	$3,070.57	$27,094.36	$17,093.84	2026-06-27
63655	HCPCS	Implant Neuroelectrodes	15	12	—	—	$3,247.79	$41,174.65	$17,093.84	2026-06-27
0431T	OTHER	Rmvl/rplc Nstim Apnea Pls Gn	13	10	—	—	$17,093.84	$57,472.82	$17,093.84	2026-06-27
0424T	OTHER	Insj/rplc Nstim Apnea Compl	13	10	—	—	$17,093.84	$32,185.04	$17,093.84	2026-06-27
0427T	OTHER	Insj/rplc Nstim Apnea Pls Gn	13	10	—	—	$17,093.84	$57,073.40	$17,093.84	2026-06-27
0312T	OTHER	Laps Impltj Nstim Vagus	13	10	—	—	$17,093.84	$32,185.04	$17,093.84	2026-06-27
0316T	OTHER	Replc Vagus Nerve Pls Gen	13	10	—	—	$17,093.84	$59,655.00	$17,093.84	2026-06-27
0466T	OTHER	Insj Ch Wal Respir Eltrd/ra	10	9	—	—	$17,093.84	$18,310.59	$17,093.84	2026-06-27
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	13	10	—	—	$17,093.84	$62,131.61	$17,093.84	2026-06-27
64590	HCPCS	Insrt/redo Pn/gastr Stimul	15	12	—	—	$649.31	$44,275.80	$17,093.84	2026-06-27
0268T	OTHER	Implt/rpl Crtd Sns Dev Gen	13	10	—	—	$17,093.84	$62,131.61	$17,093.84	2026-06-27
61867	HCPCS	Implant Neuroelectrode	11	10	—	—	$8,836.43	$18,310.59	$17,093.84	2026-06-27
61868	HCPCS	Implant Neuroelectrde Addl	11	10	—	—	$1,934.76	$18,310.59	$17,093.84	2026-06-27
61860	HCPCS	Implant Neuroelectrodes	11	10	—	—	$6,061.50	$18,310.59	$17,093.84	2026-06-27
61863	HCPCS	Implant Neuroelectrode	11	10	—	—	$5,835.52	$18,310.59	$17,093.84	2026-06-27
61864	HCPCS	Implant Neuroelectrde Addl	11	10	—	—	$1,099.09	$18,310.59	$17,093.84	2026-06-27
61870	HCPCS	Implant Neuroelectrodes	10	9	—	—	$17,093.84	$18,310.59	$17,093.84	2026-06-27
61850	HCPCS	Implant Neuroelectrodes	11	10	—	—	$3,810.54	$18,310.59	$17,093.84	2026-06-27
61886	HCPCS	Implant Neurostim Arrays	15	12	—	—	$3,305.57	$58,956.84	$17,093.84	2026-06-27
61885	HCPCS	Insrt/redo Neurostim 1 Array	15	12	—	—	$2,028.63	$44,657.91	$17,093.84	2026-06-27
E0786	HCPCS	Implantable Pump Replacement	1	1	—	—	$17,071.32	$17,071.32	$17,071.32	2026-06-27
33233	HCPCS	Hchg 33233 Rem Perm Pmkr Pulse Generator	44	28	$35,132.00	$16,266.12 54% off	$4,141.53	$31,618.80	$16,406.57	2026-06-27
33227	HCPCS	Hchg 33227 Rem Perm Pacemaker W/rpl Single	44	28	$32,379.00	$14,991.48 54% off	$4,141.53	$29,141.10	$16,402.49	2026-06-27
66683	HCPCS	Implantation Iris Prosthesis	5	3	—	—	$1,776.98	$17,611.18	$16,290.30	2026-06-27
27278	HCPCS	Arthrd Si Jt Plmt Iartic Dev	6	4	—	—	$1,644.95	$18,759.16	$15,841.31	2026-06-27
22836	HCPCS	Ant Thrc Vrt Body Tethrg <7	6	4	—	—	$6,053.75	$18,759.16	$15,841.31	2026-06-27
22837	HCPCS	Ant Thrc Vrt Body Tethrg 8+	6	4	—	—	$6,667.91	$18,759.16	$15,841.31	2026-06-27
22838	HCPCS	Rev Rplc/rmv Thrc Vrt Tethrg	6	4	—	—	$6,755.58	$18,759.16	$15,841.31	2026-06-27
L8679	HCPCS	Imp Neurosti Pls Gn Any Type	1	1	—	—	$15,826.56	$15,826.56	$15,826.56	2026-06-27
93650	HCPCS	Hchg 93650 Intracard Cath Ablat Av Node	44	28	$28,126.00	$13,022.34 54% off	$3,903.45	$25,313.40	$15,806.81	2026-06-27
0746T	OTHER	Car Ablt Rad Arr Cnv Loc Map	10	9	—	—	$15,643.75	$16,425.94	$15,643.75	2026-06-27
0745T	OTHER	Car Ablt Rad Arr N-invas Loc	10	9	—	—	$15,643.75	$16,425.94	$15,643.75	2026-06-27
0747T	OTHER	Car Ablt Rad Arrhyt Dlvr Rad	10	9	—	—	$15,643.75	$16,425.94	$15,643.75	2026-06-27
33216	HCPCS	Hchg 33216 Insert Sngl Transven Elect	44	28	$32,379.00	$14,991.48 54% off	$1,359.71	$29,141.10	$15,404.56	2026-06-27
J9266	HCPCS	Pegaspargase Injection	15	12	—	—	$14,915.24	$51,731.79	$15,362.70	2026-06-27
L5987	HCPCS	Shank Ft W Vert Load Pylon	4	2	—	—	$13,287.15	$17,431.00	$15,352.03	2026-06-27
L8627	HCPCS	Cid Ext Speech Process Repl	4	2	—	—	$13,177.37	$17,287.10	$15,225.29	2026-06-27
J3399	HCPCS	Inj Onase Abepar-xioi Treat	14	11	—	—	$14,915.24	$2,588,981.23	$15,138.97	2026-06-27
90288	HCPCS	Botulism Ig IV	10	9	—	—	$14,915.24	$15,773.49	$14,915.24	2026-06-27
J3397	HCPCS	Inj., Vestronidase Alfa-vjbk	14	11	—	—	$280.09	$15,773.49	$14,915.24	2026-06-27
J9281	HCPCS	Mitomycin Instillation	15	12	—	—	$323.90	$15,773.49	$14,915.24	2026-06-27
J9274	HCPCS	Inj, Tebentafusp-tebn, 1 Mcg	15	12	—	—	$222.21	$15,773.49	$14,915.24	2026-06-27
J3398	HCPCS	Inj Luxturna 1 Billion Vec G	14	11	—	—	$3,026.79	$15,773.49	$14,915.24	2026-06-27
J9348	HCPCS	Inj. Naxitamab-gqgk, 1 Mg	15	12	—	—	$686.08	$15,773.49	$14,915.24	2026-06-27
J9273	HCPCS	Inj Tisotu Vedotin-tftv, 1mg	15	12	—	—	$196.06	$15,773.49	$14,915.24	2026-06-27
J9359	HCPCS	Inj Lon Tesirin-lpyl 0.075mg	15	12	—	—	$221.22	$15,773.49	$14,915.24	2026-06-27
J3241	HCPCS	Inj. Teprotumumab-trbw 10 Mg	15	12	—	—	$369.31	$15,773.49	$14,915.24	2026-06-27
J1823	HCPCS	Inj. Inebilizumab-cdon, 1 Mg	15	12	—	—	$495.54	$15,773.49	$14,915.24	2026-06-27
J1429	HCPCS	Inj Golodirsen 10 Mg	10	9	—	—	$14,915.24	$15,773.49	$14,915.24	2026-06-27
J1458	HCPCS	Galsulfase Injection	15	12	—	—	$513.86	$15,773.49	$14,915.24	2026-06-27
J2507	HCPCS	Pegloticase Injection	15	12	—	—	$3,768.80	$15,773.49	$14,915.24	2026-06-27
J1743	HCPCS	Idursulfase Injection	15	12	—	—	$558.10	$15,773.49	$14,915.24	2026-06-27
C9061	HCPCS	Injection, Teprotumumab-trbw	10	9	—	—	$14,915.24	$15,773.49	$14,915.24	2026-06-27
J1426	HCPCS	Injection, Casimersen, 10 Mg	14	11	—	—	$166.19	$15,773.49	$14,915.24	2026-06-27
J7352	HCPCS	Afamelanotide Implant, 1 Mg	14	11	—	—	$2,943.42	$15,773.49	$14,915.24	2026-06-27
J1427	HCPCS	Inj. Viltolarsen	10	9	—	—	$14,915.24	$15,773.49	$14,915.24	2026-06-27
J7169	HCPCS	Inj Andexxa, 10 Mg	14	11	—	—	$131.37	$15,773.49	$14,915.24	2026-06-27
J9019	HCPCS	Erwinaze Injection	10	9	—	—	$14,915.24	$15,773.49	$14,915.24	2026-06-27
J9021	HCPCS	Inj, Aspara, Rylaze, 0.1 Mg	15	12	—	—	$56.17	$15,773.49	$14,915.24	2026-06-27
J1428	HCPCS	Inj, Eteplirsen, 10 Mg	14	11	—	—	$167.35	$15,773.49	$14,915.24	2026-06-27

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