Price Transparency Hospital negotiated rates

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

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Hospital

Mesquite Rehabilitation Institute

Mesquite, TX · CCN 673045 · Rates published

2,673 distinct procedures filed
43 distinct payers
27,656 rate rows
2026-05-08 last MRF observed
Data quality

5,847 of 27,656 rate rows are consumer-grade (21.1%)

21,809 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 21,105
per-diem day rate — not a per-procedure price 704
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ernesthealth.com/pricing/2026/271140632_mesquite-rehabilitation-institute_standard-charges.json
Found on page https://mri.ernesthealth.com/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint de2324bbbadec72a… · 8,749,724 bytes · first seen 2026-05-09

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
B0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 1 12 $53,762.08 $53,762.08 $53,762.08 nat. median
$53,762
1.0× median
B0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier Tier 1 12 $48,661.32 $48,661.32 $48,661.32 nat. median
$49,196
1.0× median
C0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 2 12 $45,028.97 $46,486.91 $45,757.94 nat. median
$46,986
1.0× median
B0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 12 $43,976.85 $43,976.85 $43,976.85 nat. median
$44,232
1.0× median
C0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 12 $43,277.86 $43,277.86 $43,277.86 nat. median
$43,704
1.0× median
B1004
LOCAL 		Amputation Lower Extremity M <47.50- Tier Tier 1 12 $42,438.72 $42,438.72 $42,438.72 nat. median
$42,470
1.0× median
B0604
LOCAL 		Neurological M <43.50- Tier Tier 1 12 $37,253.44 $45,929.94 $41,591.69 nat. median
$46,423
0.9× median
B0904
LOCAL 		Other Orthopedic M <44.5- Tier Tier 1 12 $39,497.09 $42,671.81 $41,084.45 nat. median
$40,010
1.0× median
B2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 1 12 $40,965.14 $40,965.14 $40,965.14 nat. median
$40,995
1.0× median
D0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 12 $40,885.83 $40,885.83 $40,885.83 nat. median
$41,099
1.0× median
B1404
LOCAL 		Cardiac M <45.50- Tier Tier 1 12 $39,574.55 $39,574.55 $39,574.55 nat. median
$39,603
1.0× median
D0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 3 12 $35,704.71 $42,481.13 $39,092.92 nat. median
$42,703
0.9× median
C1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 12 $38,429.69 $38,429.69 $38,429.69 nat. median
$37,992
1.0× median
D0405
LOCAL 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier Tier 3 12 $38,008.32 $38,586.02 $38,297.17 nat. median
$38,816
1.0× median
C0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier Tier 2 12 $36,296.69 $39,743.36 $38,020.03 nat. median
$40,508
0.9× median
A0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 12 $37,676.79 $37,676.79 $37,676.79 nat. median
$37,907
1.0× median
C1004
LOCAL 		Amputation Lower Extremity M <47.50- Tier Tier 2 12 $37,273.78 $37,273.78 $37,273.78 nat. median
$35,393
1.1× median
D0105
LOCAL 		Stroke M <41.50 And A >=84.50- Tier Tier 3 12 $35,539.63 $37,348.50 $36,444.07 nat. median
$37,662
1.0× median
A0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier None 12 $30,509.67 $40,483.78 $35,496.72 nat. median
$39,573
0.9× median
C0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 12 $35,183.32 $35,183.32 $35,183.32 nat. median
$35,561
1.0× median
A0405
LOCAL 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 12 $35,061.60 $35,061.60 $35,061.60 nat. median
$35,438
1.0× median
D1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 12 $34,810.78 $34,810.78 $34,810.78 nat. median
$34,992
1.0× median
D1805
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 12 $33,844.37 $35,413.69 $34,629.03 nat. median
$34,208
1.0× median
B0303
LOCAL 		Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 1 12 $34,392.12 $34,392.12 $34,392.12 nat. median
$34,839
1.0× median
C0604
LOCAL 		Neurological M <43.50- Tier Tier 2 12 $34,386.59 $34,386.59 $34,386.59 nat. median
$34,756
1.0× median
C1504
LOCAL 		Pulmonary M <45.50- Tier Tier 2 12 $34,045.40 $34,045.40 $34,045.40 nat. median
$34,243
1.0× median
D1004
LOCAL 		Amputation Lower Extremity M <47.50- Tier Tier 3 12 $33,830.73 $33,830.73 $33,830.73 nat. median
$32,228
1.0× median
C0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 12 $33,202.56 $33,202.56 $33,202.56 nat. median
$33,146
1.0× median
B2003
LOCAL 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 12 $32,505.43 $32,505.43 $32,505.43 nat. median
$32,854
1.0× median
C2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 2 12 $32,172.61 $32,721.21 $32,446.91 nat. median
$32,921
1.0× median
D0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 12 $32,319.15 $32,319.15 $32,319.15 nat. median
$32,319
1.0× median
D0604
LOCAL 		Neurological M <43.50- Tier Tier 3 12 $32,101.53 $32,101.53 $32,101.53 nat. median
$32,269
1.0× median
C0204
LOCAL 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 12 $32,052.26 $32,052.26 $32,052.26 nat. median
$31,314
1.0× median
D1504
LOCAL 		Pulmonary M <45.50- Tier Tier 3 12 $32,018.54 $32,018.54 $32,018.54 nat. median
$32,186
1.0× median
C0304
LOCAL 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 12 $31,902.35 $31,902.35 $31,902.35 nat. median
$32,043
1.0× median
A1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 12 $31,581.44 $31,581.44 $31,581.44 nat. median
$31,920
1.0× median
C0904
LOCAL 		Other Orthopedic M <44.5- Tier Tier 2 12 $31,002.23 $31,634.93 $31,318.58 nat. median
$31,818
1.0× median
C1404
LOCAL 		Cardiac M <45.50- Tier Tier 2 12 $31,175.70 $31,175.70 $31,175.70 nat. median
$30,962
1.0× median
D0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 12 $30,823.29 $31,452.34 $31,137.81 nat. median
$31,616
1.0× median
C2004
LOCAL 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 12 $31,020.44 $31,042.91 $31,031.67 nat. median
$31,232
1.0× median
C0805
LOCAL 		Replacement Of Lower-extremity Joint M <42.50- Tier Tier 2 12 $30,504.38 $30,504.38 $30,504.38 nat. median
$30,832
1.0× median
A0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 12 $30,461.97 $30,461.97 $30,461.97 nat. median
$30,648
1.0× median
D0304
LOCAL 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 12 $29,305.60 $29,305.60 $29,305.60 nat. median
$29,475
1.0× median
A0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier None 12 $29,058.47 $29,058.47 $29,058.47 nat. median
$29,236
1.0× median
D2004
LOCAL 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 12 $28,999.45 $28,999.45 $28,999.45 nat. median
$29,151
1.0× median
A0604
LOCAL 		Neurological M <43.50- Tier None 12 $28,951.50 $28,951.50 $28,951.50 nat. median
$28,952
1.0× median
A0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier None 12 $28,727.66 $28,727.66 $28,727.66 nat. median
$45,230
0.6× median
D0104
LOCAL 		Stroke M >=41.50 And M <50.50- Tier Tier 3 12 $27,539.04 $29,868.11 $28,703.58 nat. median
$30,024
1.0× median
D0204
LOCAL 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 12 $28,418.50 $28,418.50 $28,418.50 nat. median
$28,585
1.0× median
A0304
LOCAL 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 12 $28,404.22 $28,404.22 $28,404.22 nat. median
$27,918
1.0× median

Other procedures at this hospital

Browse this hospital's 2,673 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
B0106 LOCAL Stroke M <41.50 And A <84.50- Tier Tier 1 26 12 — — $53,762.08 $53,762.08 $53,762.08 2026-03-17
B0205 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 1 26 12 — — $48,661.32 $48,661.32 $48,661.32 2026-03-17
C0106 LOCAL Stroke M <41.50 And A <84.50- Tier Tier 2 26 12 — — $45,028.97 $46,486.91 $45,757.94 2026-03-17
B0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 26 12 — — $43,976.85 $43,976.85 $43,976.85 2026-03-17
C0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 26 12 — — $43,277.86 $43,277.86 $43,277.86 2026-03-17
B1004 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 1 26 12 — — $42,438.72 $42,438.72 $42,438.72 2026-03-17
B0604 LOCAL Neurological M <43.50- Tier Tier 1 26 12 — — $37,253.44 $45,929.94 $41,591.69 2026-03-17
B0904 LOCAL Other Orthopedic M <44.5- Tier Tier 1 26 12 — — $39,497.09 $42,671.81 $41,084.45 2026-03-17
B2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier Tier 1 26 12 — — $40,965.14 $40,965.14 $40,965.14 2026-03-17
D0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 26 12 — — $40,885.83 $40,885.83 $40,885.83 2026-03-17
B1404 LOCAL Cardiac M <45.50- Tier Tier 1 26 12 — — $39,574.55 $39,574.55 $39,574.55 2026-03-17
D0106 LOCAL Stroke M <41.50 And A <84.50- Tier Tier 3 26 12 — — $35,704.71 $42,481.13 $39,092.92 2026-03-17
C1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 26 12 — — $38,429.69 $38,429.69 $38,429.69 2026-03-17
D0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier Tier 3 26 12 — — $38,008.32 $38,586.02 $38,297.17 2026-03-17
C0205 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 2 26 12 — — $36,296.69 $39,743.36 $38,020.03 2026-03-17
A0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50- Tier None 26 12 — — $37,676.79 $37,676.79 $37,676.79 2026-03-17
C1004 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 2 26 12 — — $37,273.78 $37,273.78 $37,273.78 2026-03-17
D0105 LOCAL Stroke M <41.50 And A >=84.50- Tier Tier 3 26 12 — — $35,539.63 $37,348.50 $36,444.07 2026-03-17
A0106 LOCAL Stroke M <41.50 And A <84.50- Tier None 26 12 — — $30,509.67 $40,483.78 $35,496.72 2026-03-17
C0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 26 12 — — $35,183.32 $35,183.32 $35,183.32 2026-03-17
A0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 26 12 — — $35,061.60 $35,061.60 $35,061.60 2026-03-17
D1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 26 12 — — $34,810.78 $34,810.78 $34,810.78 2026-03-17
D1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 26 12 — — $33,844.37 $35,413.69 $34,629.03 2026-03-17
B0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 1 26 12 — — $34,392.12 $34,392.12 $34,392.12 2026-03-17
C0604 LOCAL Neurological M <43.50- Tier Tier 2 26 12 — — $34,386.59 $34,386.59 $34,386.59 2026-03-17
C1504 LOCAL Pulmonary M <45.50- Tier Tier 2 26 12 — — $34,045.40 $34,045.40 $34,045.40 2026-03-17
D1004 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 3 26 12 — — $33,830.73 $33,830.73 $33,830.73 2026-03-17
C0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier Tier 2 26 12 — — $33,202.56 $33,202.56 $33,202.56 2026-03-17
B2003 LOCAL Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 26 12 — — $32,505.43 $32,505.43 $32,505.43 2026-03-17
C2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier Tier 2 26 12 — — $32,172.61 $32,721.21 $32,446.91 2026-03-17
D0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 26 12 — — $32,319.15 $32,319.15 $32,319.15 2026-03-17
D0604 LOCAL Neurological M <43.50- Tier Tier 3 26 12 — — $32,101.53 $32,101.53 $32,101.53 2026-03-17
C0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 26 12 — — $32,052.26 $32,052.26 $32,052.26 2026-03-17
D1504 LOCAL Pulmonary M <45.50- Tier Tier 3 26 12 — — $32,018.54 $32,018.54 $32,018.54 2026-03-17
C0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 26 12 — — $31,902.35 $31,902.35 $31,902.35 2026-03-17
A1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 26 12 — — $31,581.44 $31,581.44 $31,581.44 2026-03-17
C0904 LOCAL Other Orthopedic M <44.5- Tier Tier 2 26 12 — — $31,002.23 $31,634.93 $31,318.58 2026-03-17
C1404 LOCAL Cardiac M <45.50- Tier Tier 2 26 12 — — $31,175.70 $31,175.70 $31,175.70 2026-03-17
D0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier Tier 3 26 12 — — $30,823.29 $31,452.34 $31,137.81 2026-03-17
C2004 LOCAL Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 26 12 — — $31,020.44 $31,042.91 $31,031.67 2026-03-17
C0805 LOCAL Replacement Of Lower-extremity Joint M <42.50- Tier Tier 2 26 12 — — $30,504.38 $30,504.38 $30,504.38 2026-03-17
A0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 26 12 — — $30,461.97 $30,461.97 $30,461.97 2026-03-17
D0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 26 12 — — $29,305.60 $29,305.60 $29,305.60 2026-03-17
A0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier None 26 12 — — $29,058.47 $29,058.47 $29,058.47 2026-03-17
D2004 LOCAL Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 26 12 — — $28,999.45 $28,999.45 $28,999.45 2026-03-17
A0604 LOCAL Neurological M <43.50- Tier None 26 12 — — $28,951.50 $28,951.50 $28,951.50 2026-03-17
A0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier None 26 12 — — $28,727.66 $28,727.66 $28,727.66 2026-03-17
D0104 LOCAL Stroke M >=41.50 And M <50.50- Tier Tier 3 26 12 — — $27,539.04 $29,868.11 $28,703.58 2026-03-17
D0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 26 12 — — $28,418.50 $28,418.50 $28,418.50 2026-03-17
A0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 26 12 — — $28,404.22 $28,404.22 $28,404.22 2026-03-17
D1404 LOCAL Cardiac M <45.50- Tier Tier 3 26 12 — — $26,792.05 $28,986.54 $27,889.29 2026-03-17
C0603 LOCAL Neurological M >=43.50 And M <52.50- Tier Tier 2 26 12 — — $27,844.30 $27,844.30 $27,844.30 2026-03-17
A2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier None 26 12 — — $27,822.80 $27,822.80 $27,822.80 2026-03-17
D0805 LOCAL Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 26 12 — — $27,811.74 $27,811.74 $27,811.74 2026-03-17
C0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 2 26 12 — — $27,514.81 $27,514.81 $27,514.81 2026-03-17
D0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 26 12 — — $24,680.85 $29,423.64 $27,052.24 2026-03-17
A0904 LOCAL Other Orthopedic M <44.5- Tier None 26 12 — — $26,978.12 $26,978.12 $26,978.12 2026-03-17
A0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 26 12 — — $26,756.81 $26,756.81 $26,756.81 2026-03-17
A1404 LOCAL Cardiac M <45.50- Tier None 26 12 — — $26,671.97 $26,671.97 $26,671.97 2026-03-17
A2004 LOCAL Miscellaneous M <46.50 And A >=77.50- Tier None 26 12 — — $26,395.33 $26,395.33 $26,395.33 2026-03-17
A0805 LOCAL Replacement Of Lower-extremity Joint M <42.50- Tier None 26 12 — — $25,939.79 $25,939.79 $25,939.79 2026-03-17
D0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 26 12 — — $25,746.14 $25,746.14 $25,746.14 2026-03-17
D0603 LOCAL Neurological M >=43.50 And M <52.50- Tier Tier 3 26 12 — — $25,596.76 $25,596.76 $25,596.76 2026-03-17
A1503 LOCAL Pulmonary M >=45.50 And M <56.50- Tier None 26 12 — — $25,521.09 $25,521.09 $25,521.09 2026-03-17
C1403 LOCAL Cardiac M >=45.50 And M <55.50- Tier Tier 2 26 12 — — $25,443.68 $25,443.68 $25,443.68 2026-03-17
D0903 LOCAL Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 26 12 — — $24,608.22 $24,608.22 $24,608.22 2026-03-17
A0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 26 12 — — $24,469.58 $24,469.58 $24,469.58 2026-03-17
D2003 LOCAL Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 26 12 — — $24,254.12 $24,254.12 $24,254.12 2026-03-17
A0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 26 12 — — $23,822.56 $23,822.56 $23,822.56 2026-03-17
A1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 26 12 — — $23,778.30 $23,778.30 $23,778.30 2026-03-17
D1403 LOCAL Cardiac M >=45.50 And M <55.50- Tier Tier 3 26 12 — — $23,656.57 $23,656.57 $23,656.57 2026-03-17
D0103 LOCAL Stroke M >=50.50 And M <63.50- Tier Tier 3 26 12 — — $23,403.91 $23,403.91 $23,403.91 2026-03-17
D0205 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 3 26 12 — — $9,116.38 $37,567.97 $23,342.17 2026-03-17
D0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 26 12 — — $23,189.97 $23,189.97 $23,189.97 2026-03-17
A0603 LOCAL Neurological M >=43.50 And M <52.50- Tier None 26 12 — — $23,084.85 $23,084.85 $23,084.85 2026-03-17
A0903 LOCAL Other Orthopedic M >=44.50 And M <51.50- Tier None 26 12 — — $22,514.96 $22,514.96 $22,514.96 2026-03-17
A2003 LOCAL Miscellaneous M >=46.50 And M <55.50- Tier None 26 12 — — $22,076.03 $22,076.03 $22,076.03 2026-03-17
A0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 26 12 — — $21,627.87 $21,627.87 $21,627.87 2026-03-17
D0302 LOCAL Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 26 12 — — $21,006.34 $21,006.34 $21,006.34 2026-03-17
A0104 LOCAL Stroke M >=41.50 And M <50.50- Tier None 26 12 — — $13,497.81 $28,464.61 $20,981.21 2026-03-17
D0904 LOCAL Other Orthopedic M <44.5- Tier Tier 3 26 12 — — $12,202.51 $29,486.34 $20,844.42 2026-03-17
D2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier Tier 3 26 12 — — $10,312.65 $30,567.09 $20,439.87 2026-03-17
A0602 LOCAL Neurological M >=52.50 And M <64.50- Tier None 26 12 — — $19,591.78 $19,591.78 $19,591.78 2026-03-17
A0205 LOCAL Traumatic Brain Injury M <35.50- Tier None 26 12 — — $2,447.37 $34,272.25 $18,359.81 2026-03-17
D2002 LOCAL Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 26 12 — — $12,047.49 $12,047.49 $12,047.49 2026-03-17
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 11 5 — — $1,662.99 $1,662.99 $1,662.99 2026-03-17
0138 RC Room & Board - Three And Four Beds - Rehabilitation 11 5 — — $1,662.99 $1,662.99 $1,662.99 2026-03-17
0148 RC Room & Board - Deluxe Private - Rehabilitation 11 5 — — $1,662.99 $1,662.99 $1,662.99 2026-03-17
0158 RC Room & Board - Ward - Rehabilitation 11 5 — — $1,612.50 $1,612.50 $1,612.50 2026-03-17
0118 RC Room & Board - Private (One Bed) - Rehabilitation 11 5 — — $500.00 $1,475.00 $1,475.00 2026-03-17
118 OTHER R&b - Private - Irf 4 4 $1,000.00 — $1,112.50 $1,112.50 $1,112.50 2026-05-08
128 OTHER R&b - Semi Pvt - Irf 4 4 $1,000.00 — $1,112.50 $1,112.50 $1,112.50 2026-05-08
0805 RC Inpatient Renal Dialysis - Treatment 11 3 — — $400.00 $600.00 $600.00 2026-03-17
0808 RC Inpatient Renal Dialysis - Other 11 3 — — $400.00 $600.00 $600.00 2026-03-17
0806 RC Inpatient Renal Dialysis - Continuation 11 3 — — $400.00 $600.00 $600.00 2026-03-17
0413 RC Respiratory Services - Hyperbaric Oxygen Therapy 4 2 — — $600.00 $600.00 $600.00 2026-03-17
0807 RC Inpatient Renal Dialysis - Observation/Hourly 11 3 — — $400.00 $600.00 $600.00 2026-03-17
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 17 6 — — $300.00 $600.00 $450.00 2026-03-17
0801 RC Inpatient Renal Dialysis - Hemodialysis 17 6 — — $300.00 $600.00 $450.00 2026-03-17
0800 RC Inpatient Renal Dialysis - General Classification 16 5 — — $300.00 $600.00 $425.00 2026-03-17
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 16 5 — — $300.00 $600.00 $425.00 2026-03-17
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 16 5 — — $300.00 $600.00 $425.00 2026-03-17
0809 RC Inpatient Renal Dialysis - Other 16 5 — — $300.00 $600.00 $425.00 2026-03-17
92610 HCPCS Evaluate Swallowing Function 51 14 — — $351.00 $351.00 $351.00 2026-03-17
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 4 1 — — $300.00 $300.00 $300.00 2026-03-17
0825 RC Hemodialysis - Outpatient Or Home - Support Services 3 1 — — $300.00 $300.00 $300.00 2026-03-17
0821 RC Hemodialysis - Outpatient Or Home - Hemodialysis Composite Or Other Rate 4 2 — — $300.00 $300.00 $300.00 2026-03-17
0822 RC Hemodialysis - Outpatient Or Home - Home Supplies 3 1 — — $300.00 $300.00 $300.00 2026-03-17
0820 RC Hemodialysis - Outpatient Or Home - General Classification 4 2 — — $300.00 $300.00 $300.00 2026-03-17
0824 RC Hemodialysis - Outpatient Or Home - Maintenance 100% 3 1 — — $300.00 $300.00 $300.00 2026-03-17
0829 RC Hemodialysis - Outpatient Or Home - Other Op Hemodialysis 4 2 — — $300.00 $300.00 $300.00 2026-03-17
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 4 1 — — $300.00 $300.00 $300.00 2026-03-17
729 MS_DRG Other Male Reproductive System Diagnoses With Cc/mcc 4 1 — — $300.00 $300.00 $300.00 2026-03-17
0823 RC Hemodialysis - Outpatient Or Home - Home Equipment 3 1 — — $300.00 $300.00 $300.00 2026-03-17
91 MS_DRG Other Disorders Of Nervous System With Mcc 4 1 — — $300.00 $300.00 $300.00 2026-03-17
97161 HCPCS Pt Eval Low Complex 20 Min 58 18 — — $90.00 $280.80 $185.40 2026-03-17
97162 HCPCS Pt Eval Mod Complex 30 Min 58 18 — — $90.00 $280.80 $185.40 2026-03-17
97166 HCPCS Ot Eval Mod Complex 45 Min 58 18 — — $90.00 $280.80 $185.40 2026-03-17
92526 HCPCS Oral Function Therapy 58 18 — — $77.88 $280.80 $179.34 2026-03-17
92507 HCPCS Speech/hearing Therapy 61 16 — — $68.42 $280.80 $174.61 2026-03-17
97110 HCPCS Therapeutic Exercises 66 18 — — $20.51 $280.80 $150.66 2026-03-17
96105 HCPCS Assessment Of Aphasia 52 15 — — $120.00 $150.00 $135.00 2026-03-17
92522 HCPCS Evaluate Speech Production 52 15 — — $120.00 $150.00 $135.00 2026-03-17
92523 HCPCS Speech Sound Lang Comprehen 53 16 — — $120.00 $150.00 $135.00 2026-03-17
0850 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - General Cla… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0851 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - CCPD/Compos… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0852 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Home Suppli… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0849 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - Other 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0853 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Home Equipm… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0842 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - Home Sup… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0839 RC Peritoneal Dialysis - Outpatient Or Home - Other 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0843 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - Home Equ… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0854 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Maintenance… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0831 RC Peritoneal Dialysis - Outpatient Or Home - Peritoneal/Composite Or Other Rate 4 2 — — $129.00 $129.00 $129.00 2026-03-17
0832 RC Peritoneal Dialysis - Outpatient Or Home - Home Supplies 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0833 RC Peritoneal Dialysis - Outpatient Or Home - Home Equipment 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0855 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Support Ser… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0834 RC Peritoneal Dialysis - Outpatient Or Home - Maintenance 100% 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0840 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - General … 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0841 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - CAPD/Com… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0830 RC Peritoneal Dialysis - Outpatient Or Home - General Classification 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0835 RC Peritoneal Dialysis - Outpatient Or Home - Support Services 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0859 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Other 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0845 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - Support … 3 1 — — $129.00 $129.00 $129.00 2026-03-17
0844 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - Maintena… 3 1 — — $129.00 $129.00 $129.00 2026-03-17
92524 HCPCS Behavral Qualit Analys Voice 52 15 — — $107.53 $150.00 $128.76 2026-03-17
97530 HCPCS Therapeutic Activities 66 18 — — $36.00 $210.60 $123.30 2026-03-17
97165 HCPCS Ot Eval Low Complex 30 Min 58 18 — — $90.00 $150.00 $120.00 2026-03-17
97168 HCPCS Ot Re-eval Est Plan Care 57 17 — — $90.00 $150.00 $120.00 2026-03-17
97164 HCPCS Pt Re-eval Est Plan Care 58 18 — — $90.00 $150.00 $120.00 2026-03-17
97163 HCPCS Pt Eval High Complex 45 Min 58 18 — — $90.00 $150.00 $120.00 2026-03-17
97167 HCPCS Ot Eval High Complex 60 Min 57 17 — — $90.00 $150.00 $120.00 2026-03-17
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 68 19 — — $80.00 $150.00 $115.00 2026-03-17
0434 RC Occupational Therapy - Evaluation Or Reevaluation 72 20 — — $80.00 $150.00 $115.00 2026-03-17
0424 RC Physical Therapy - Evaluation Or Re-evaluation 72 20 — — $80.00 $150.00 $115.00 2026-03-17
0449 RC Speech Therapy - Language Pathology - Other 10 4 — — $80.00 $110.00 $110.00 2026-03-17
0447 RC Speech-language Pathology - Observation/Hourly 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0446 RC Speech-language Pathology - Continuation 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0448 RC Speech-language Pathology - Other 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0439 RC Occupational Therapy - Other 10 4 — — $80.00 $110.00 $110.00 2026-03-17
0438 RC Occupational Therapy - Other 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0435 RC Occupational Therapy - Treatment 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0436 RC Occupational Therapy - Continuation 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0445 RC Speech-language Pathology - Treatment 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0437 RC Occupational Therapy - Observation/Hourly 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0425 RC Physical Therapy - Treatment 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0426 RC Physical Therapy - Continuation 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0428 RC Physical Therapy - Other 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0427 RC Physical Therapy - Observation/Hourly 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0429 RC Physical Therapy - Other 10 4 — — $80.00 $110.00 $110.00 2026-03-17
97129 HCPCS Ther Ivntj 1st 15 Min 57 17 — — $90.00 $120.00 $105.00 2026-03-17
97113 HCPCS Aquatic Therapy/exercises 57 17 — — $90.00 $120.00 $105.00 2026-03-17
0410 RC Respiratory Services - General Classification 56 16 — — $90.00 $120.00 $105.00 2026-03-17
97537 HCPCS Community/work Reintegration 57 17 — — $90.00 $120.00 $105.00 2026-03-17
97535 HCPCS Self Care Mngment Training 58 18 — — $90.00 $120.00 $105.00 2026-03-17
92607 HCPCS Ex For Speech Device Rx 1hr 52 15 — — $90.00 $120.00 $105.00 2026-03-17
0440 RC Speech Therapy - Language Pathology - General Classification 71 20 — — $80.00 $120.00 $100.00 2026-03-17
0420 RC Physical Therapy - General Classification 63 20 — — $80.00 $120.00 $100.00 2026-03-17
0430 RC Occupational Therapy - General Classification 63 20 — — $80.00 $120.00 $100.00 2026-03-17
0442 RC Speech Therapy - Language Pathology - Hourly Charge 15 6 — — $80.00 $110.00 $95.00 2026-03-17
0441 RC Speech Therapy - Language Pathology - Visit Charge 15 6 — — $80.00 $110.00 $95.00 2026-03-17
0443 RC Speech Therapy - Language Pathology - Group Rate 15 6 — — $80.00 $110.00 $95.00 2026-03-17
0432 RC Occupational Therapy - Hourly Charge 15 6 — — $80.00 $110.00 $95.00 2026-03-17
0431 RC Occupational Therapy - Visit Charge 15 6 — — $80.00 $110.00 $95.00 2026-03-17
0433 RC Occupational Therapy - Group Rate 15 6 — — $80.00 $110.00 $95.00 2026-03-17
0422 RC Physical Therapy - Hourly Charge 15 6 — — $80.00 $110.00 $95.00 2026-03-17
0421 RC Physical Therapy - Visit Charge 62 18 — — $80.00 $110.00 $95.00 2026-03-17
0423 RC Physical Therapy - Group Rate 15 6 — — $80.00 $110.00 $95.00 2026-03-17
434 OTHER Ot Eval High Complex 1unit 15 12 $260.00 — $80.00 $91.00 $91.00 2026-05-08
424 OTHER Pt Eval High Complex 1unit 15 12 $260.00 — $80.00 $91.00 $91.00 2026-05-08
444 OTHER St Aphasia Assessment 1unit 13 11 $260.00 — $80.00 $91.00 $91.00 2026-05-08
97037 HCPCS Appl Modality 1+lllt Po Pain 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97130 HCPCS Ther Ivntj Ea Addl 15 Min 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97036 HCPCS App Mdlty 1+hubbrd Tnk Ea 15 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97154 HCPCS Grp Adapt Bhv Tx By Tech 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97152 HCPCS Bhv Id Suprt Assmt By 1 Tech 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97034 HCPCS App Mdlty 1+cntrst Bth Ea 15 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97172 HCPCS Athletic Trn Re-eval Plan Cr 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97755 HCPCS Assistive Technology Assess 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97760 HCPCS Orthotic Mgmt&traing 1st Enc 55 15 — — $90.00 $90.00 $90.00 2026-03-17
S8940 HCPCS Hippotherapy Per Session 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9126 HCPCS Hospice Care, In The Home, P 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9128 HCPCS Speech Therapy, In The Home, 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97799 HCPCS Unlisted Physcl Med/rehab Px 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9129 HCPCS Occupational Therapy, In The 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97026 HCPCS Infrared Therapy 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97024 HCPCS Diathermy Eg Microwave 5 2 — — $90.00 $90.00 $90.00 2026-03-17
0561 RC Home Health (hh) - Medical Social Services - Visit Charge 4 1 — — $90.00 $90.00 $90.00 2026-03-17
97018 HCPCS Paraffin Bath Therapy 55 15 — — $90.00 $90.00 $90.00 2026-03-17
S9152 HCPCS Speech Therapy, Re-eval 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9131 HCPCS Pt In The Home Per Diem 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9125 HCPCS Respite Care, In The Home, P 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9127 HCPCS Social Work Visit, In The Ho 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9150 HCPCS Evaluation By Ocularist 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9122 HCPCS Home Health Aide Or Certifie 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S8948 HCPCS Low-level Laser Trmt 15 Min 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S9123 HCPCS Nursing Care In Home Rn 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97761 HCPCS Prosthetic Traing 1st Enc 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97546 HCPCS Work Hardening Add-on 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97545 HCPCS Work Hardening 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97750 HCPCS Physical Performance Test 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97763 HCPCS Orthc/prostc Mgmt Sbsq Enc 55 15 — — $90.00 $90.00 $90.00 2026-03-17
S9124 HCPCS Nursing Care, In The Home; B 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97171 HCPCS Athletic Trn Eval High Cmplx 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97169 HCPCS Athletic Trn Eval Low Cmplx 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97170 HCPCS Athletic Trn Eval Mod Cmplx 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97533 HCPCS Sensory Integration 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97156 HCPCS Fam Adapt Bhv Tx Gdn Phy/qhp 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97153 HCPCS Adaptive Behavior Tx By Tech 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97157 HCPCS Mult Fam Adapt Bhv Tx Gdn 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97158 HCPCS Grp Adapt Bhv Tx By Phy/qhp 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97150 HCPCS Group Therapeutic Procedures 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97012 HCPCS Mechanical Traction Therapy 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97039 HCPCS Unlisted Modality 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97033 HCPCS App Mdlty 1+iontphrsis Ea 15 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97035 HCPCS App Mdlty 1+ultrasound Ea 15 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97028 HCPCS Ultraviolet Therapy 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97016 HCPCS Vasopneumatic Device Therapy 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97022 HCPCS Whirlpool Therapy 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97010 HCPCS Hot Or Cold Packs Therapy 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S8990 HCPCS Pt Or Manip For Maint 5 2 — — $90.00 $90.00 $90.00 2026-03-17
S8950 HCPCS Complex Lymphedema Therapy, 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97014 HCPCS Electric Stimulation Therapy 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97542 HCPCS Wheelchair Mngment Training 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97139 HCPCS Unlisted Therapeutic Px 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97151 HCPCS Bhv Id Assmt By Phys/qhp 5 2 — — $90.00 $90.00 $90.00 2026-03-17
97155 HCPCS Adapt Behavior Tx Phys/qhp 5 2 — — $90.00 $90.00 $90.00 2026-03-17
0551 RC Skilled Nursing - Visit Charge 4 1 — — $82.00 $82.00 $82.00 2026-03-17
97112 HCPCS Neuromuscular Reeducation 58 18 — — $23.57 $140.40 $81.98 2026-03-17
92606 HCPCS Non-speech Device Service 10 3 — — $80.00 $120.00 $80.00 2026-03-17
92605 HCPCS Ex For Nonspeech Device Rx 10 3 — — $80.00 $120.00 $80.00 2026-03-17
92521 HCPCS Evaluation Of Speech Fluency 10 3 — — $80.00 $150.00 $80.00 2026-03-17
92597 HCPCS Oral Speech Device Eval 10 3 — — $80.00 $120.00 $80.00 2026-03-17
430 OTHER Ot Adl Slf Care Trn 15min 14 11 $100.00 — $32.00 $90.00 $76.00 2026-05-08
440 OTHER St Cog Tx Ea Addl 15min 15 12 $65.00 — $76.00 $90.00 $76.00 2026-05-08
420 OTHER Pt Adl Slf Care Trn 15min 15 12 $100.00 — $32.00 $90.00 $76.00 2026-05-08
97124 HCPCS Massage Therapy 65 17 — — $27.00 $120.00 $73.50 2026-03-17
97140 HCPCS Manual Therapy 1/> Regions 65 17 — — $23.26 $120.00 $71.63 2026-03-17
97116 HCPCS Gait Training Therapy 66 18 — — $22.04 $120.00 $71.02 2026-03-17
97032 HCPCS Appl Modality 1+estim Ea 15 65 17 — — $20.00 $120.00 $70.00 2026-03-17
0589 RC Home Health (hh) - Other Visits - Other 4 1 — — $68.00 $68.00 $68.00 2026-03-17
0552 RC Skilled Nursing - Hourly Charge 4 1 — — $41.00 $41.00 $41.00 2026-03-17
0571 RC Home Health (hh) Aide - Visit Charge 4 1 — — $37.00 $37.00 $37.00 2026-03-17
0572 RC Home Health (hh) Aide - Hourly Charge 4 1 — — $18.50 $18.50 $18.50 2026-03-17
66180 HCPCS Aqueous Shunt Eye W/graft 0 0 — — — — — 2026-03-17
66170 HCPCS Glaucoma Surgery 0 0 — — — — — 2026-03-17
36589 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-03-17
65820 HCPCS Relieve Inner Eye Pressure 0 0 — — — — — 2026-03-17
65756 HCPCS Corneal Trnspl Endothelial 0 0 — — — — — 2026-03-17
36573 HCPCS Insj Picc Rs&i 5 Yr+ 0 0 — — — — — 2026-03-17
24615 HCPCS Treat Elbow Dislocation 0 0 — — — — — 2026-03-17
65755 HCPCS Corneal Transplant 0 0 — — — — — 2026-03-17
65730 HCPCS Corneal Transplant 0 0 — — — — — 2026-03-17
36569 HCPCS Insj Picc 5 Yr+ Without Imaging 0 0 — — — — — 2026-03-17
65426 HCPCS Removal Of Eye Lesion 0 0 — — — — — 2026-03-17
64721 HCPCS Carpal Tunnel Surgery 0 0 — — — — — 2026-03-17
36561 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
24516 HCPCS Treat Humerus Fracture 0 0 — — — — — 2026-03-17
15853 HCPCS Removal Sutr/stapl Xreq Anes 0 0 — — — — — 2026-03-17
64718 HCPCS Revise Ulnar Nerve At Elbow 0 0 — — — — — 2026-03-17
64450 HCPCS Njx Aa&/strd Other Pn/branch 0 0 — — — — — 2026-03-17
36558 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
62328 HCPCS Dx Lmbr Spi Pnxr W/fluor/ct 0 0 — — — — — 2026-03-17
62270 HCPCS Dx Lmbr Spi Pnxr 0 0 — — — — — 2026-03-17
36556 HCPCS Insert Non-tunnel Cv Cath 0 0 — — — — — 2026-03-17
24430 HCPCS Repair Of Humerus 0 0 — — — — — 2026-03-17
61782 HCPCS Scan Proc Cranial Extra 0 0 — — — — — 2026-03-17
60220 HCPCS Partial Removal Of Thyroid 0 0 — — — — — 2026-03-17
36514 HCPCS Apheresis Plasma 0 0 — — — — — 2026-03-17
59897 HCPCS Unlisted Fetal Invas Px W/us 0 0 — — — — — 2026-03-17
59820 HCPCS Care Of Miscarriage 0 0 — — — — — 2026-03-17
36460 HCPCS Intrauterine Transfusion Ftl 0 0 — — — — — 2026-03-17
24344 HCPCS Reconstruct Elbow Lat Ligmnt 0 0 — — — — — 2026-03-17
15772 HCPCS Grfg Autol Fat Lipo Ea Addl 0 0 — — — — — 2026-03-17
10060 HCPCS I&d Abscess Simple/single 0 0 — — — — — 2026-03-17
59025 HCPCS Fetal Non-stress Test 0 0 — — — — — 2026-03-17
59012 HCPCS Fetal Cord Puncture Prenatal 0 0 — — — — — 2026-03-17
36430 HCPCS Transfusion Bld/bld Compnt 0 0 — — — — — 2026-03-17
58662 HCPCS Laparoscopy Excise Lesions 0 0 — — — — — 2026-03-17
58661 HCPCS Laparoscopy Remove Adnexa 0 0 — — — — — 2026-03-17
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