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

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Hospital

ALTUS BAYTOWN HOSPITAL

Baytown, TX · CCN 670109 · Rates published

3,517 distinct procedures filed
3 distinct payers
24,568 rate rows
2026-04-01 last MRF observed
Data quality

24,558 of 24,568 rate rows are consumer-grade (100.0%)

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

Excluded — reasonRows
exceeds 10× this hospital's gross charge — excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/VXMZ-1739314201791/machine-readable/832329088_baytown-medical-center_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/baytown-medical-center-tx
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-06-16
Content fingerprint ed54414eaaa1783e… · 6,665,513 bytes · first seen 2026-06-16

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
CP17428476722283252
CDM 		Spinal Fusion Except Cervical Without Mcc 1 $98,535.00 $98,535.00 $98,535.00 nat. median
$98,535
1.0× median
CP17428476722286257
CDM 		Cervical Spinal Fusion Without Cc Or Mcc 1 $91,972.00 $91,972.00 $91,972.00 nat. median
$91,972
1.0× median
36593
CPT 		Declotting By Thrombolytic Agent Of Impl 2 $924.00 $177,250.00 $89,087.00 nat. median
$423
outlier · 210.7×
CP17428476722284545
CDM 		Cardiac Valve Or Cardiothoracic Procedure With Cardiac Catheterization With Mcc 1 $79,558.00 $79,558.00 $79,558.00 nat. median
$79,558
1.0× median
C1822
HCPCS 		Nevro Blue Lead Kit 1 $4,000.00 $94,300.00 $79,000.00 nat. median
$31,540
outlier · 2.5×
CP17428476722285366
CDM 		Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 1 $78,554.00 $78,554.00 $78,554.00 nat. median
$78,554
1.0× median
C1816
HCPCS 		Receiver And/or Transmitter, Neurostimul 1 $76,000.00 $76,000.00 $76,000.00 nat. median
$13,332
outlier · 5.7×
C1820
HCPCS 		B.s Spectra Wavewrtier Generator 1 $6,800.00 $82,000.00 $76,000.00 nat. median
$22,013
outlier · 3.5×
74246
CPT 		Xr Gastrointestinal Tract 1 $56,295.00 $56,295.00 $56,295.00 nat. median
$319
outlier · 176.5×
12202992
CDM 		New Or Level 6 1st 30 Mins 1 $54,450.00 $54,450.00 $54,450.00 nat. median
$54,450
1.0× median
0505T
CPT 		Endovenous Femoral-popliteal Arterial Re 1 $52,000.00 $52,000.00 $52,000.00 nat. median
$13,140
outlier · 4.0×
12202990
CDM 		New Or Level 5 1st 30 Mins 1 $49,502.00 $49,502.00 $49,502.00 nat. median
$49,502
1.0× median
12202984
CDM 		New Or Level 4 1st 30 Mins 1 $45,861.00 $45,861.00 $45,861.00 nat. median
$45,861
1.0× median
75743
CPT 		Angiography Pulm Bil Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,174
outlier · 13.7×
75810
CPT 		Splenoportography Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,146
outlier · 13.8×
75842
CPT 		Venography Adrenal Bilateral 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,845
outlier · 11.3×
75733
CPT 		Angiography Adrenal Bil Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,156
outlier · 13.8×
75600
CPT 		Aorto Thor Without Serialography Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,062
outlier · 14.2×
75658
CPT 		Angiography Brach Retrograde Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$637
outlier · 68.3×
75741
CPT 		Angiography Pulm Uni Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,082
outlier · 14.1×
75840
CPT 		Veno Adrenal Uni Selective 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$2,978
outlier · 14.6×
75731
CPT 		Angiography Adrenal Uni Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$2,932
outlier · 14.8×
75833
CPT 		Veno Renal Bil Selective 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,177
outlier · 13.7×
75885
CPT 		Percutaneous Transhepatic Portography 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,065
outlier · 14.2×
C1772
HCPCS 		Infusion Pump, Programmable (Implantable 1 $40,400.00 $40,400.00 $40,400.00 nat. median
$8,320
outlier · 4.9×
12202982
CDM 		New Or Level 3 1st 30 Mins 1 $37,015.00 $37,015.00 $37,015.00 nat. median
$37,015
1.0× median
75891
CPT 		Hepatic Venography Wedged 1 $35,416.00 $35,416.00 $35,416.00 nat. median
$3,038
outlier · 11.7×
75831
CPT 		Venography Renal Unilateral 1 $33,358.00 $33,358.00 $33,358.00 nat. median
$3,076
outlier · 10.8×
36903
CPT 		Introduction Of Needle(s) And/or Cathete 2 $2,196.00 $63,714.00 $32,955.00 nat. median
$12,627
outlier · 2.6×
77372
CPT 		Srs Linear Based 1 $32,032.00 $32,032.00 $32,032.00 nat. median
$9,062
outlier · 3.5×
63052
CPT 		Laminectomy, Facetectomy, Or Foraminotom 2 $924.00 $60,000.00 $30,462.00 nat. median
$2,572
outlier · 11.8×
75889
CPT 		Hepatic Venography Wedged 1 $29,532.00 $29,532.00 $29,532.00 nat. median
$3,148
outlier · 9.4×
75630
CPT 		Aorto Abd+bil Iliofemoral Serialography 1 $29,532.00 $29,532.00 $29,532.00 nat. median
$3,277
outlier · 9.0×
77371
CPT 		Srs Multisource 1 $28,834.00 $28,834.00 $28,834.00 nat. median
$9,046
outlier · 3.2×
C1874
HCPCS 		Stent, Coated/covered, With Delivery Sys 1 $28,000.00 $28,000.00 $28,000.00 nat. median
$4,694
outlier · 6.0×
37607
CPT 		Ligation Or Banding Of Angioaccess Arter 2 $1,232.00 $54,450.00 $27,841.00 nat. median
$3,725
outlier · 7.5×
75726
CPT 		Angio Visc Selective Or Supra Selective 1 $25,810.00 $25,810.00 $25,810.00 nat. median
$5,021
outlier · 5.1×
36821
CPT 		Arteriovenous Anastomosis, Open; Direct, 2 $1,232.00 $49,722.00 $25,477.00 nat. median
$3,652
outlier · 7.0×
75605
CPT 		Aorto/ Serialography Thor Rad Sup&int 1 $25,352.00 $25,352.00 $25,352.00 nat. median
$4,985
outlier · 5.1×
50593
CPT 		Ablation, Renal Tumor(s), Unilateral, Pe 2 $2,948.00 $47,078.00 $25,013.00 nat. median
$10,316
outlier · 2.4×
2202994
CDM 		Or Level 7 1st 15min 1 $24,862.00 $24,862.00 $24,862.00 nat. median
$24,862
1.0× median
27769
CPT 		Optx Post Ankle Fx 2 $1,232.00 $45,861.00 $23,546.50 nat. median
$6,945
outlier · 3.4×
75705
CPT 		Angiography Spinal Slct Rad Sup&int 1 $23,153.00 $23,153.00 $23,153.00 nat. median
$5,049
outlier · 4.6×
78816
CPT 		PET Body Skull To Feet 1 $21,866.00 $21,866.00 $21,866.00 nat. median
$2,707
outlier · 8.1×
78815
CPT 		PET Body Skull To Thigh 2 $950.00 $21,866.00 $21,866.00 nat. median
$2,794
outlier · 7.8×
36906
CPT 		Thrombolysis With Stent 2 $2,196.00 $41,225.00 $21,710.50 nat. median
$18,386
1.2× median
CP17428476722288338
CDM 		Uterine And Adnexa Procedures For Non-malignancy Without Cc Or Mcc 1 $21,337.00 $21,337.00 $21,337.00 nat. median
$21,337
1.0× median
37228
CPT 		Revascularization, Endovascular, Open Or 2 $1,508.00 $40,386.00 $20,947.00 nat. median
$10,888
1.9× median
35011
CPT 		Direct Repair Of Aneurysm, Pseudoaneurys 1 $20,944.00 $20,944.00 $20,944.00 nat. median
$5,963
outlier · 3.5×
74485
CPT 		Dilation Nephrostomy Ureters Or Urethra 1 $20,858.00 $20,858.00 $20,858.00 nat. median
$1,933
outlier · 10.8×

Other procedures at this hospital

Browse this hospital's 3,517 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
CP17428476722283252 CDM Spinal Fusion Except Cervical Without Mcc 3 1 $123,169.00 $123,169.00 $98,535.00 $98,535.00 $98,535.00 2026-04-01
CP17428476722286257 CDM Cervical Spinal Fusion Without Cc Or Mcc 3 1 $114,965.00 $114,965.00 $91,972.00 $91,972.00 $91,972.00 2026-04-01
36593 CPT Declotting By Thrombolytic Agent Of Impl 6 2 $221,562.00 $221,562.00 $924.00 $177,250.00 $89,087.00 2026-04-01
CP17428476722284545 CDM Cardiac Valve Or Cardiothoracic Procedure With Cardiac Catheterization With Mcc 3 1 $99,448.00 $99,448.00 $79,558.00 $79,558.00 $79,558.00 2026-04-01
C1822 HCPCS Nevro Blue Lead Kit 15 1 $98,750.00 $98,750.00 $4,000.00 $94,300.00 $79,000.00 2026-04-01
CP17428476722285366 CDM Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 3 1 $98,193.00 $98,193.00 $78,554.00 $78,554.00 $78,554.00 2026-04-01
C1820 HCPCS B.s Spectra Wavewrtier Generator 9 1 $95,000.00 $95,000.00 $6,800.00 $82,000.00 $76,000.00 2026-04-01
C1816 HCPCS Receiver And/or Transmitter, Neurostimul 3 1 $95,000.00 $95,000.00 $76,000.00 $76,000.00 $76,000.00 2026-04-01
74246 CPT Xr Gastrointestinal Tract 3 1 $70,369.00 $70,369.00 $56,295.00 $56,295.00 $56,295.00 2026-04-01
12202992 CDM New Or Level 6 1st 30 Mins 3 1 $68,063.00 $68,063.00 $54,450.00 $54,450.00 $54,450.00 2026-04-01
0505T CPT Endovenous Femoral-popliteal Arterial Re 3 1 $65,000.00 $65,000.00 $52,000.00 $52,000.00 $52,000.00 2026-04-01
12202990 CDM New Or Level 5 1st 30 Mins 3 1 $61,878.00 $61,878.00 $49,502.00 $49,502.00 $49,502.00 2026-04-01
12202984 CDM New Or Level 4 1st 30 Mins 3 1 $57,326.00 $57,326.00 $45,861.00 $45,861.00 $45,861.00 2026-04-01
75600 CPT Aorto Thor Without Serialography Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75842 CPT Venography Adrenal Bilateral 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75741 CPT Angiography Pulm Uni Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75743 CPT Angiography Pulm Bil Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75810 CPT Splenoportography Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75840 CPT Veno Adrenal Uni Selective 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75733 CPT Angiography Adrenal Bil Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75885 CPT Percutaneous Transhepatic Portography 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75731 CPT Angiography Adrenal Uni Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75658 CPT Angiography Brach Retrograde Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
75833 CPT Veno Renal Bil Selective 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-04-01
C1772 HCPCS Infusion Pump, Programmable (Implantable 3 1 $50,500.00 $50,500.00 $40,400.00 $40,400.00 $40,400.00 2026-04-01
12202982 CDM New Or Level 3 1st 30 Mins 3 1 $46,269.00 $46,269.00 $37,015.00 $37,015.00 $37,015.00 2026-04-01
75891 CPT Hepatic Venography Wedged 3 1 $44,270.00 $44,270.00 $35,416.00 $35,416.00 $35,416.00 2026-04-01
75831 CPT Venography Renal Unilateral 3 1 $41,698.00 $41,698.00 $33,358.00 $33,358.00 $33,358.00 2026-04-01
36903 CPT Introduction Of Needle(s) And/or Cathete 6 2 $79,642.00 $79,642.00 $2,196.00 $63,714.00 $32,955.00 2026-04-01
77372 CPT Srs Linear Based 3 1 $40,040.00 $40,040.00 $32,032.00 $32,032.00 $32,032.00 2026-04-01
63052 CPT Laminectomy, Facetectomy, Or Foraminotom 6 2 $75,000.00 $75,000.00 $924.00 $60,000.00 $30,462.00 2026-04-01
75889 CPT Hepatic Venography Wedged 3 1 $36,915.00 $36,915.00 $29,532.00 $29,532.00 $29,532.00 2026-04-01
75630 CPT Aorto Abd+bil Iliofemoral Serialography 3 1 $36,915.00 $36,915.00 $29,532.00 $29,532.00 $29,532.00 2026-04-01
77371 CPT Srs Multisource 3 1 $36,043.00 $36,043.00 $28,834.00 $28,834.00 $28,834.00 2026-04-01
C1874 HCPCS Stent, Coated/covered, With Delivery Sys 3 1 $35,000.00 $35,000.00 $28,000.00 $28,000.00 $28,000.00 2026-04-01
37607 CPT Ligation Or Banding Of Angioaccess Arter 6 2 $68,063.00 $68,063.00 $1,232.00 $54,450.00 $27,841.00 2026-04-01
75726 CPT Angio Visc Selective Or Supra Selective 3 1 $32,262.00 $32,262.00 $25,810.00 $25,810.00 $25,810.00 2026-04-01
36821 CPT Arteriovenous Anastomosis, Open; Direct, 6 2 $62,153.00 $62,153.00 $1,232.00 $49,722.00 $25,477.00 2026-04-01
75605 CPT Aorto/ Serialography Thor Rad Sup&int 3 1 $31,690.00 $31,690.00 $25,352.00 $25,352.00 $25,352.00 2026-04-01
50593 CPT Ablation, Renal Tumor(s), Unilateral, Pe 6 2 $58,847.00 $58,847.00 $2,948.00 $47,078.00 $25,013.00 2026-04-01
2202994 CDM Or Level 7 1st 15min 3 1 $31,077.00 $31,077.00 $24,862.00 $24,862.00 $24,862.00 2026-04-01
27769 CPT Optx Post Ankle Fx 6 2 $57,326.00 $57,326.00 $1,232.00 $45,861.00 $23,546.50 2026-04-01
75705 CPT Angiography Spinal Slct Rad Sup&int 3 1 $28,941.00 $28,941.00 $23,153.00 $23,153.00 $23,153.00 2026-04-01
78815 CPT PET Body Skull To Thigh 4 2 $27,332.00 $27,332.00 $950.00 $21,866.00 $21,866.00 2026-04-01
78816 CPT PET Body Skull To Feet 3 1 $27,332.00 $27,332.00 $21,866.00 $21,866.00 $21,866.00 2026-04-01
36906 CPT Thrombolysis With Stent 6 2 $51,531.00 $51,531.00 $2,196.00 $41,225.00 $21,710.50 2026-04-01
CP17428476722288338 CDM Uterine And Adnexa Procedures For Non-malignancy Without Cc Or Mcc 3 1 $26,671.00 $26,671.00 $21,337.00 $21,337.00 $21,337.00 2026-04-01
37228 CPT Revascularization, Endovascular, Open Or 6 2 $50,482.00 $50,482.00 $1,508.00 $40,386.00 $20,947.00 2026-04-01
35011 CPT Direct Repair Of Aneurysm, Pseudoaneurys 3 1 $26,180.00 $26,180.00 $20,944.00 $20,944.00 $20,944.00 2026-04-01
74480 CPT Intro Ureteral Cath Or Stent Into Ureter 3 1 $26,073.00 $26,073.00 $20,858.00 $20,858.00 $20,858.00 2026-04-01
74485 CPT Dilation Nephrostomy Ureters Or Urethra 3 1 $26,073.00 $26,073.00 $20,858.00 $20,858.00 $20,858.00 2026-04-01
74475 CPT Intro Cath Into Renal Pelvis For Drainag 3 1 $26,073.00 $26,073.00 $20,858.00 $20,858.00 $20,858.00 2026-04-01
2202992 CDM Or Level 6 1st 15min 3 1 $25,897.00 $25,897.00 $20,718.00 $20,718.00 $20,718.00 2026-04-01
37242 CPT Vascular Embolization Or Occlusion, Incl 6 2 $50,122.00 $50,122.00 $1,232.00 $40,098.00 $20,665.00 2026-04-01
36830 CPT Creation Of Arteriovenous Fistula By Oth 6 2 $47,123.00 $47,123.00 $1,508.00 $37,698.00 $19,603.00 2026-04-01
77373 CPT Sbrt Delivery 3 1 $24,376.00 $24,376.00 $19,501.00 $19,501.00 $19,501.00 2026-04-01
36819 CPT Arteriovenous Anastomosis, Open; By Uppe 6 2 $47,123.00 $47,123.00 $1,232.00 $37,698.00 $19,465.00 2026-04-01
75563 CPT Card MRI W/stress Img & Dye 3 1 $24,236.00 $24,236.00 $19,389.00 $19,389.00 $19,389.00 2026-04-01
36571 CPT Insert Picvad Cath 6 2 $46,269.00 $46,269.00 $1,232.00 $37,015.00 $19,123.50 2026-04-01
25290 CPT Incise Wrist/forearm Tendon 6 2 $46,269.00 $46,269.00 $1,232.00 $37,015.00 $19,123.50 2026-04-01
2202990 CDM Or Level 5 1st 15min 3 1 $23,544.00 $23,544.00 $18,835.00 $18,835.00 $18,835.00 2026-04-01
75710 CPT Angiography Ext Uni Rad Sup&int 3 1 $23,495.00 $23,495.00 $18,796.00 $18,796.00 $18,796.00 2026-04-01
75893 CPT Venous Sampling Throu Cath W/wo Angio 3 1 $23,005.00 $23,005.00 $18,404.00 $18,404.00 $18,404.00 2026-04-01
2202984 CDM Or Level 4 1st 15min 3 1 $21,812.00 $21,812.00 $17,450.00 $17,450.00 $17,450.00 2026-04-01
75716 CPT Angiography Ext Bil Rad Sup&int 3 1 $19,648.00 $19,648.00 $15,718.00 $15,718.00 $15,718.00 2026-04-01
12202986 CDM New Or Level 2 1st 30 Mins 3 1 $18,846.00 $18,846.00 $15,077.00 $15,077.00 $15,077.00 2026-04-01
75825 CPT Venography Caval Infer W/serialography 3 1 $18,770.00 $18,770.00 $15,016.00 $15,016.00 $15,016.00 2026-04-01
75736 CPT Angio Pelvic Slct/supraslct Rad Sup&int 3 1 $18,426.00 $18,426.00 $14,741.00 $14,741.00 $14,741.00 2026-04-01
35903 CPT Excision Of Infected Graft; Extremity 3 1 $18,222.00 $18,222.00 $14,578.00 $14,578.00 $14,578.00 2026-04-01
C1604 HCPCS Graft, Transmural Transvenous Arterial B 3 1 $18,000.00 $18,000.00 $14,400.00 $14,400.00 $14,400.00 2026-04-01
2202982 CDM Or Level 3 1st 15 Min 3 1 $17,605.00 $17,605.00 $14,084.00 $14,084.00 $14,084.00 2026-04-01
75887 CPT Percutaneous Transhepatic Portography 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-04-01
75827 CPT Venography Caval Sup With Serialography 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-04-01
75746 CPT Angio Pulm Nonslct Cath/ven Inj Rad 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-04-01
75872 CPT Venography Epidural 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-04-01
75860 CPT Venography Venous Sinus 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-04-01
75756 CPT Angiography Int Mammary Rad Sup&int 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-04-01
75880 CPT Venography Orbital 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-04-01
37187 CPT Percutaneous Transluminal Mechanical Thr 6 2 $31,445.00 $31,445.00 $2,948.00 $25,156.00 $14,052.00 2026-04-01
49325 CPT Laparoscopy, Surgical; With Revision Of 6 2 $32,986.00 $32,986.00 $1,508.00 $26,389.00 $13,948.50 2026-04-01
75805 CPT Lymphangiography Pel/abd Unilateral Rad 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-04-01
75803 CPT Lymphangiography Extremity Only Bil Rad 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-04-01
75822 CPT Venography Extremity B/l 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-04-01
75807 CPT Lymphangiography Pelvic/abd Bilat Rad 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-04-01
36905 CPT Thrmbc/nfs Dialysis Circuit 6 2 $31,445.00 $31,445.00 $2,196.00 $25,156.00 $13,676.00 2026-04-01
36902 CPT Dialysis Of Av Fistula 6 2 $30,630.00 $30,630.00 $2,196.00 $24,504.00 $13,350.00 2026-04-01
36833 CPT Revision, Open, Arteriovenous Fistula; W 6 2 $31,416.00 $31,416.00 $1,508.00 $25,133.00 $13,320.50 2026-04-01
12202988 CDM New Or Level 1 1st 30 Mins 3 1 $16,197.00 $16,197.00 $12,958.00 $12,958.00 $12,958.00 2026-04-01
78452 CPT Mycardiol Perfusion Imaging Tomographic 4 2 $15,927.00 $15,927.00 $950.00 $12,742.00 $12,742.00 2026-04-01
78814 CPT PET Limited Study 3 1 $15,819.00 $15,819.00 $12,655.00 $12,655.00 $12,655.00 2026-04-01
78608 CPT PET Brain Imaging 3 1 $15,671.00 $15,671.00 $12,537.00 $12,537.00 $12,537.00 2026-04-01
93452 CPT Insertion Of Catheter Into Left Heart For Diagnosis 6 2 $28,105.00 $28,105.00 $2,196.00 $22,484.00 $12,340.00 2026-04-01
C1889 HCPCS 8mm Barricaid (Annular Closure Device) 9 1 $15,000.00 $15,000.00 $11,980.00 $24,600.00 $12,000.00 2026-04-01
C1760 HCPCS Closure Device, Vascular (Implantable/in 3 1 $15,000.00 $15,000.00 $12,000.00 $12,000.00 $12,000.00 2026-04-01
50592 CPT Ablation, 1 Or More Renal Tumor(s), Perc 6 2 $27,488.00 $27,488.00 $1,508.00 $21,990.00 $11,749.00 2026-04-01
62380 CPT Endoscopic Decompression Of Spinal Cord, 6 2 $27,265.00 $27,265.00 $1,665.00 $21,812.00 $11,738.50 2026-04-01
36904 CPT Percutaneous Transluminal Mechanical Thr 6 2 $27,229.00 $27,229.00 $1,665.00 $21,783.00 $11,724.00 2026-04-01
77424 CPT Io Rad Tx Delivery By Xr 3 1 $14,591.00 $14,591.00 $11,673.00 $11,673.00 $11,673.00 2026-04-01
2202986 CDM Or Level 2 1st 15min 3 1 $14,342.00 $14,342.00 $11,474.00 $11,474.00 $11,474.00 2026-04-01
78492 CPT Myocrd Img PET Mlt Rst&strs 3 1 $13,726.00 $13,726.00 $10,981.00 $10,981.00 $10,981.00 2026-04-01
22585 CPT Arthrodesis Anterior Interbody Tech 1st 6 1 $13,167.50 $13,167.50 $350.00 $20,718.00 $10,534.00 2026-04-01
63051 CPT C-laminoplasty W/graft/plate 6 1 $13,167.50 $13,167.50 $350.00 $20,718.00 $10,534.00 2026-04-01
0275T CPT Perq Lamot/lam Lumbar 6 1 $13,167.50 $13,167.50 $350.00 $20,718.00 $10,534.00 2026-04-01
70010 CPT Myelography Posterior Fossa Rad Sup&int 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-04-01
70015 CPT Cistern Positive Contrast Rad Sup&int 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-04-01
72270 CPT Myelography Two Or More Regions 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-04-01
72240 CPT Myelography Cervical Rad Sup&int 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-04-01
78491 CPT Myocrd Img PET 1std Rst/strs 3 1 $12,581.00 $12,581.00 $10,065.00 $10,065.00 $10,065.00 2026-04-01
45391 CPT Ultrasound Examination Of Lower Large Bowel Using An Endoscope 6 2 $23,345.00 $23,345.00 $1,058.00 $18,676.00 $9,867.00 2026-04-01
2202988 CDM Or Level 1 1st 15min 3 1 $12,326.00 $12,326.00 $9,861.00 $9,861.00 $9,861.00 2026-04-01
37248 CPT Transluminal Balloon Angioplasty (Except 6 2 $21,784.00 $21,784.00 $2,196.00 $17,427.00 $9,811.50 2026-04-01
C1776 HCPCS Attune Tibial Insert Rotating Platform 1 36 1 $12,246.00 $12,246.00 $231.00 $36,616.00 $9,797.00 2026-04-01
72158 CPT Mr Lumbar Spine Wwo 3 1 $12,204.00 $12,204.00 $9,763.00 $9,763.00 $9,763.00 2026-04-01
75894 CPT Transcath Ther Embolization Any Method 3 1 $12,123.00 $12,123.00 $9,698.00 $9,698.00 $9,698.00 2026-04-01
66984 CPT Removal Of Cataract With Insertion Of Lens 12 2 $27,312.00 $27,312.00 $208.00 $26,250.00 $9,557.50 2026-04-01
63090 CPT Remove Vert Body Dcmprn Lmbr 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63103 CPT Vertebral Corpectomy Vertebral Body Rese 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
48550 CPT Donor Pancreatectomy Inc Cold Preserv 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
22523 CPT Perq Vertebral Augmentation Th 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63277 CPT Bx/exc Xdrl Spine Lesn Lmbr 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63101 CPT Remove Vert Body Dcmprn Thrc 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63082 CPT Vertebral Corpectomy Vertebral Body Res 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63081 CPT Remove Vert Body Dcmprn Crvl 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63088 CPT Vertebr Corpectomy Vertebral Body Resect 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63050 CPT Cervical Laminoplsty 2/> Seg 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
49566 CPT Rerepair Ventrl Hern Block 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
63087 CPT Remov Vertbr Dcmprn Thrclmbr 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
0163T CPT Total Disc Arthroplasty Anterior Approac 6 1 $11,940.50 $11,940.50 $270.00 $18,835.00 $9,552.50 2026-04-01
29826 CPT Shaving Of Shoulder Bone Using Endoscope 12 2 $25,312.00 $25,312.00 $208.00 $23,050.00 $9,341.00 2026-04-01
C9362 HCPCS Stryke Bone Matrix 5cc 6 1 $11,531.50 $11,531.50 $7,650.00 $10,800.00 $9,225.00 2026-04-01
12202993 CDM New Or Level 6 Addl 15 Mins 3 1 $11,519.00 $11,519.00 $9,215.00 $9,215.00 $9,215.00 2026-04-01
75820 CPT Veno Extremity Unilateral 3 1 $11,282.00 $11,282.00 $9,026.00 $9,026.00 $9,026.00 2026-04-01
C1763 HCPCS Mimedx Amniofix 4.0x10 Cm 12 1 $11,237.50 $11,237.50 $2,184.00 $17,580.00 $8,990.00 2026-04-01
49568 CPT Mesh Implant Incis/ventral Hernia Rep 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
34718 CPT Endovascular Repair The Iliac Artery 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
63709 CPT Repair Spinal Fluid Leakage 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
49654 CPT Lap Inc Hernia Repair 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
49653 CPT Lap Vent/abd Hern Proc Comp 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
43633 CPT Removal Of Stomach Partial 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
43775 CPT Lap Sleeve Gastrectomy 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
43621 CPT Removal Of Stomach 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
43632 CPT Removal Of Stomach Partial 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
61615 CPT Resect/excise Lesion Skull 6 1 $11,036.00 $11,036.00 $208.00 $17,450.00 $8,829.00 2026-04-01
49615 CPT Rpr Aa Hrn Rcr 3-10 Rdc 6 2 $19,778.00 $19,778.00 $1,508.00 $15,822.00 $8,665.00 2026-04-01
C1778 HCPCS Medtronic Electronic For Spinal Stimulat 9 1 $10,735.00 $10,735.00 $6,000.00 $8,600.00 $8,588.00 2026-04-01
49402 CPT Removal Of Peritoneal Foreign Body From 6 2 $19,778.00 $19,778.00 $1,058.00 $15,822.00 $8,440.00 2026-04-01
71552 CPT Mr Chest Wwo 3 1 $10,383.00 $10,383.00 $8,306.00 $8,306.00 $8,306.00 2026-04-01
74174 CPT CT Angio Abd/pel With And Without IV 3 1 $10,369.00 $10,369.00 $8,295.00 $8,295.00 $8,295.00 2026-04-01
28055 CPT Neurectomy Foot 6 2 $18,846.00 $18,846.00 $1,508.00 $15,077.00 $8,292.50 2026-04-01
73220 CPT Mr Non-joint Upper Extr Wwo Lt 6 1 $10,265.50 $10,265.50 $8,212.00 $8,213.00 $8,212.50 2026-04-01
73223 CPT Mr Joint Upper Extr Wwo Lt 6 1 $10,265.50 $10,265.50 $8,212.00 $8,213.00 $8,212.50 2026-04-01
73720 CPT Mr Non-joint Low Extr Wwo Lt 6 1 $10,265.50 $10,265.50 $8,212.00 $8,213.00 $8,212.50 2026-04-01
73723 CPT Mr Joint Low Extr Wwo Lt 6 1 $10,265.50 $10,265.50 $8,212.00 $8,213.00 $8,212.50 2026-04-01
70543 CPT Mr Orbs/face/neck Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
75561 CPT Cardiac MRI For Morph With Contrast 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
70559 CPT MRI Open Intracranial Proc W/wo Dye 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
70553 CPT MRI Scan 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
74183 CPT Mr Abd Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
70549 CPT Mr Angiograph Neck W/wo Dye 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
72197 CPT Mr Pelvis Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
70546 CPT Mr Angiograph Head W/wo Dye 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
72156 CPT Mr Cervical Spine Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
72157 CPT MRI Thoracic Spine Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-04-01
27047 CPT Exc Hip/pelvis Les Sc < 3 Cm 6 2 $18,846.00 $18,846.00 $1,058.00 $15,077.00 $8,067.50 2026-04-01
45398 CPT Colonoscopy Flexible W/band Ligations 6 2 $18,564.00 $18,564.00 $1,058.00 $14,851.00 $7,954.50 2026-04-01
36582 CPT Replacement, Complete, Of A Tunneled Cen 6 2 $18,222.00 $18,222.00 $1,232.00 $14,578.00 $7,905.00 2026-04-01
47562 CPT Removal Of Gallbladder Using An Endoscope 12 2 $52,605.00 $52,605.00 $176.00 $70,084.00 $7,874.50 2026-04-01
36475 CPT Endovenous Rf 1st Vein 6 2 $18,140.00 $18,140.00 $1,232.00 $14,512.00 $7,872.00 2026-04-01
49505 CPT Repair Of Groin Hernia Patient Age 5 Years Or Older 12 2 $37,605.00 $37,605.00 $176.00 $46,084.00 $7,796.00 2026-04-01
29881 CPT Removal Of One Knee Cartilage Using An Endoscope 12 2 $22,605.00 $22,605.00 $176.00 $22,084.00 $7,796.00 2026-04-01
77022 CPT Magnetic Resonance Guidance 3 1 $9,652.00 $9,652.00 $7,722.00 $7,722.00 $7,722.00 2026-04-01
42820 CPT Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12 12 2 $27,605.00 $27,605.00 $176.00 $30,084.00 $7,658.00 2026-04-01
74178 CPT CT Abdomen And Pelvis Without Contrast 6 1 $9,536.50 $9,536.50 $5,214.00 $10,044.00 $7,629.00 2026-04-01
74176 CPT CT Abdomen And Pelvis Without Contrast 6 1 $9,428.00 $9,428.00 $6,527.00 $8,558.00 $7,542.50 2026-04-01
77048 CPT MRI Breast C-+ W/cad Uni 3 1 $9,328.00 $9,328.00 $7,462.00 $7,462.00 $7,462.00 2026-04-01
C8905 HCPCS MRI Without Fol W/cont Brst Unilat 3 1 $9,328.00 $9,328.00 $7,462.00 $7,462.00 $7,462.00 2026-04-01
73219 CPT Mr Non-joint Upper Extr W Lt 3 1 $9,188.00 $9,188.00 $7,350.00 $7,350.00 $7,350.00 2026-04-01
37220 CPT Revascularization, Endovascular, Open Or 6 2 $16,338.00 $16,338.00 $1,508.00 $13,070.00 $7,289.00 2026-04-01
73222 CPT Mr Joint Upper Extr W Lt 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
71551 CPT Mr Chest W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
74182 CPT Mr Abd W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
70558 CPT MRI Open Intracranial Proc With Contrast 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
70548 CPT Mr Angiography Neck With Contrast 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
72147 CPT MRI Thoracic Spine W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
72196 CPT Mr Pelvis W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
70545 CPT Mr Angiography Head With Contrast 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
72149 CPT Mr Lumbar Spine W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
70542 CPT Mr Orbs/face/neck W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
72142 CPT Mr Cervical Spine W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
70552 CPT Mr Brain W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
73719 CPT Mr Non-joint Low Extr W Lt 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
73722 CPT Mr Joint Low Extr W Lt 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-04-01
76825 CPT Echo Exam Of Fetal Heart 4 2 $8,983.00 $8,983.00 $950.00 $7,186.00 $7,186.00 2026-04-01
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 6 1 $8,965.00 $8,965.00 $4,882.00 $9,462.00 $7,172.00 2026-04-01
49585 CPT Rpr Umbil Hern Reduc > 5 Yr 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49572 CPT Rpr Epigastric Hern Blocked 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49587 CPT Rpr Umbil Hern Block > 5 Yr 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
20102 CPT Explore Wound Abdomen 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49565 CPT Rerepair Ventrl Hern Reduce 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49561 CPT Rpr Ventral Hern Init Block 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49560 CPT Rpr Ventral Hern Init Reduc 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
0249T CPT Liga Hemorrhoid Vas Bund Inc US Guid 1st 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
19324 CPT Enlarge Breast 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49060 CPT Drainage Retroperitoneal Abscess Open 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
31040 CPT Pterygomaxillary Fossa Any Approach 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
C9749 HCPCS Repair Nasal Stenosis With Implant 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
63706 CPT Repair Of Spinal Herniation 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49657 CPT Lap Inc Hern Recur Comp 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49655 CPT Lap Inc Hern Repair Comp 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
0232T CPT Inj Platelet Rich Plasma Any Site 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44238 CPT Laparoscope Proc Intestine 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44205 CPT Lap Colectomy Part W/ileum 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44207 CPT L Colectomy/coloproctostomy 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44143 CPT Partial Removal Of Colon 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44146 CPT Partial Removal Of Colon 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44620 CPT Closure Enterostomy Lg/sm Intest 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44160 CPT Removal Of Colon 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44140 CPT Colectomy Partial With Anastomosis 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44955 CPT Appendectomy 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44120 CPT Removal Of Small Intestine 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
43843 CPT Gastroplasty Without V-band 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
27886 CPT Amp Leg Through Tibia&fibula Re-amp 1st 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
43644 CPT Lap Gastric Bypass/roux-en-y 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
44139 CPT Takedown Splenic Flexure W Colectomy 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
27880 CPT Amputation Leg Through Tibia & Fibula 1 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
43279 CPT Lap Myotomy Heller 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
27694 CPT Decompression Fasciotomy W/debridement 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49652 CPT Lap Vent/abd Hernia Repair 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
43122 CPT Partial Removal Of Esophagus 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
27598 CPT Disarticulation At Knee 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
58950 CPT Resect Ovarian Malignancy 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
49656 CPT Lap Inc Hernia Repair Recur 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
0627T CPT Perc Lumbar Intravertebral Disc Inj Proc 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
58146 CPT Myomectomy Abdom Complex 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
22522 CPT Percutaneous Vertebroplasty 1st 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
54430 CPT Revision Of Penis 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
51530 CPT Cystotomy For Excision Bladder Tumor 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
11005 CPT Debride Abdom Wall 6 1 $8,912.50 $8,912.50 $176.00 $14,084.00 $7,130.00 2026-04-01
93458 CPT Catheter Placement In Coronary Artery(s) 9 2 $27,943.00 $27,943.00 $2,196.00 $22,354.00 $7,100.00 2026-04-01
12202991 CDM New Or Level 5 Addl 15 Mins 3 1 $8,862.00 $8,862.00 $7,090.00 $7,090.00 $7,090.00 2026-04-01
49326 CPT Laparoscopy, Surgical; With Omentopexy ( 6 2 $16,493.00 $16,493.00 $924.00 $13,194.00 $7,059.00 2026-04-01
72141 CPT Mr Cervical Spine Wo 3 1 $8,786.00 $8,786.00 $7,029.00 $7,029.00 $7,029.00 2026-04-01
49594 CPT Repair Of Anterior Abdominal Hernia(s) ( 6 2 $15,636.00 $15,636.00 $1,508.00 $12,509.00 $7,008.50 2026-04-01
36907 CPT Transluminal Balloon Angioplasty, Centra 6 2 $16,338.00 $16,338.00 $924.00 $13,070.00 $6,997.00 2026-04-01
75896 CPT Transcatheter Therapy Infusion 3 1 $8,680.00 $8,680.00 $6,944.00 $6,944.00 $6,944.00 2026-04-01
87633 CPT Respiratory Pathogen Panel 3 1 $8,576.00 $8,576.00 $6,861.00 $6,861.00 $6,861.00 2026-04-01
35860 CPT Exploration For Postoperative Hemorrhage 6 2 $15,185.00 $15,185.00 $1,508.00 $12,148.00 $6,828.00 2026-04-01
49617 CPT Repair Of Anterior Abdominal Hernia(s) ( 6 2 $15,000.00 $15,000.00 $1,508.00 $12,000.00 $6,754.00 2026-04-01
72148 CPT MRI Scan Of Lower Spinal Canal 3 1 $8,385.00 $8,385.00 $6,708.00 $6,708.00 $6,708.00 2026-04-01
36223 CPT Selective Catheter Placement, Common Car 6 2 $15,419.00 $15,419.00 $1,058.00 $12,335.00 $6,696.50 2026-04-01
72195 CPT Mr Pelvis Wo 3 1 $8,080.00 $8,080.00 $6,464.00 $6,464.00 $6,464.00 2026-04-01
19120 CPT Removal Of One Or More Breast Growth, Open Procedure 12 2 $19,342.00 $19,342.00 $138.00 $19,474.00 $6,353.00 2026-04-01
75970 CPT Transcatheter Biopsy Rad Sup&int 3 1 $7,844.00 $7,844.00 $6,275.00 $6,275.00 $6,275.00 2026-04-01
19083 CPT Biopsy Breast W Plcmnt Brst Local Dvc 1s 12 2 $14,342.00 $14,342.00 $138.00 $14,396.00 $6,266.00 2026-04-01
38525 CPT Biopsy/removal Lymph Nodes 12 2 $17,669.00 $17,669.00 $138.00 $16,797.00 $6,266.00 2026-04-01
75625 CPT Aorto/serialography Abd Rad Sup&int 3 1 $7,812.00 $7,812.00 $6,250.00 $6,250.00 $6,250.00 2026-04-01
73225 CPT Mr Angio Upr Extr W/o&with Contrast 3 1 $7,709.00 $7,709.00 $6,167.00 $6,167.00 $6,167.00 2026-04-01
70555 CPT MRI Brain By Phys/psych 3 1 $7,549.00 $7,549.00 $6,039.00 $6,039.00 $6,039.00 2026-04-01
C1726 HCPCS Catheter, Balloon Dilatation, Non-vascul 3 1 $7,500.00 $7,500.00 $6,000.00 $6,000.00 $6,000.00 2026-04-01
73218 CPT Mr Non-joint Upper Extr Wo Lt 3 1 $7,490.00 $7,490.00 $5,992.00 $5,992.00 $5,992.00 2026-04-01
23076 CPT Excision, Tumor, Soft Tissue Of Shoulder 6 2 $13,500.00 $13,500.00 $1,058.00 $10,800.00 $5,929.00 2026-04-01
72133 CPT CT Lumbar Spine Wwo 3 1 $7,366.00 $7,366.00 $5,893.00 $5,893.00 $5,893.00 2026-04-01
19361 CPT Breast Reconstr W/lat Flap 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
19305 CPT Mast Radical 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
49203 CPT Exc Abd Tum 5 Cm Or Less 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
69105 CPT Biopsy External Auditory Canal 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
19260 CPT Exc Chest Wall Tumor Including Ribs 1st 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
49020 CPT Drainage Abdom Abscess Open 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
31299 CPT Procedure Accessory Sinuses 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
47122 CPT Extensive Removal Of Liver 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
63707 CPT Repair Spinal Fluid Leakage 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
45562 CPT Exploration/repair Of Rectum 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
11310 CPT Shave Skin Lesion 0.5 Cm/< 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
44322 CPT Colostomy With Biopsies 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
44604 CPT Suture Large Intestine 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
44204 CPT Laparo Partial Colectomy 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
44960 CPT Appendectomy 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
15420 CPT Xenograft Skin Dermal/temp Wound Close 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
S2068 HCPCS Breast Diep Or Siea Flap 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
42971 CPT Control Nose/throat Bleeding 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
20974 CPT Electrical Bone Stimulation 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
C9728 HCPCS Place Device/marker Non Pro 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
20926 CPT Tiss Grafts Oth Eg Paratenon Fat Dermis 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
51585 CPT Removal Of Bladder & Nodes 6 1 $7,257.00 $7,257.00 $138.00 $11,474.00 $5,806.00 2026-04-01
C1821 HCPCS Interspinous Process Distraction Device 3 1 $7,253.00 $7,253.00 $5,802.00 $5,802.00 $5,802.00 2026-04-01
72285 CPT Discography Cerv Or Thoracic Rad Sup&int 3 1 $7,212.00 $7,212.00 $5,770.00 $5,770.00 $5,770.00 2026-04-01
72295 CPT Discography Lumbar Rad Sup&int 3 1 $7,212.00 $7,212.00 $5,770.00 $5,770.00 $5,770.00 2026-04-01
70332 CPT Temporomandibular Jt Arthro Rad Sup&int 3 1 $7,196.00 $7,196.00 $5,757.00 $5,757.00 $5,757.00 2026-04-01
70170 CPT Dacryocysto Nasolac Duct Rad Sup&int 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
74740 CPT Hysterosalpingography Rad Sup&int 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
70390 CPT Sialography Rad Sup&int 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
77054 CPT Mammary Ductogram/galactogram Mult Ducts 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
74190 CPT Peritoneogram 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
75870 CPT Venography Sup Sag Sinus 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
74305 CPT Cholangio/ Pancreatography With Cath 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
75801 CPT Lymphangiography Extremity Uni Rad 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
76098 CPT Xrination Specimen 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
77053 CPT Mammary Ductogram Or Galactogram 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-04-01
C1771 HCPCS Advantage Fit Urethral Sling System 6 1 $7,120.00 $7,120.00 $4,180.00 $7,212.00 $5,696.00 2026-04-01
73206 CPT CT Angio Upr Extrm W/o&with Contrast 3 1 $7,115.00 $7,115.00 $5,692.00 $5,692.00 $5,692.00 2026-04-01
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