Price Transparencybeta 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

342 distinct procedures filed
23 distinct payers
23,359 rate rows
2026-03-17 last MRF observed
Data quality

5,872 of 23,359 rate rows are consumer-grade (25.1%)

17,487 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 16,828
per-diem day rate — not a per-procedure price 659
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mri.ernesthealth.com/wp-content/uploads/sites/13/2025/07/271140632_Mesquite-Rehabilitation-Institute_standard-charges.csv
Found on page https://mri.ernesthealth.com/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint da5cd6bee7536311… · 1,887,115 bytes · first seen 2026-05-08

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
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 1 12 — — $53,762.08 nat. median
$54,601
1.0× median
B0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 1 12 — — $48,661.32 nat. median
$52,525
0.9× median
C0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 2 12 — — $46,122.43 nat. median
$48,486
1.0× median
B0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 12 — — $43,976.85 nat. median
$47,151
0.9× median
C0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 12 — — $43,277.86 nat. median
$46,281
0.9× median
B1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 1 12 — — $42,438.72 nat. median
$45,558
0.9× median
B0604
HCPCS 		Neurological M <43.50- Tier Tier 1 12 — — $41,455.82 nat. median
$47,224
0.9× median
B0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 1 12 — — $41,084.45 nat. median
$43,337
0.9× median
B2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 1 12 — — $40,965.14 nat. median
$42,636
1.0× median
D0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 12 — — $40,885.83 nat. median
$43,056
0.9× median
D0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 3 12 — — $40,787.03 nat. median
$43,929
0.9× median
B1404
HCPCS 		Cardiac M <45.50- Tier Tier 1 12 — — $39,574.55 nat. median
$41,383
1.0× median
C0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 2 12 — — $38,881.69 nat. median
$41,763
0.9× median
C1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 12 — — $38,429.69 nat. median
$39,029
1.0× median
D0405
HCPCS 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier Tier 3 12 — — $38,297.17 nat. median
$38,814
1.0× median
A0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 12 — — $37,676.79 nat. median
$39,679
0.9× median
C1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 2 12 — — $37,273.78 nat. median
$37,855
1.0× median
A0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier None 12 — — $36,494.14 nat. median
$41,668
0.9× median
D0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier Tier 3 12 — — $36,444.07 nat. median
$38,998
0.9× median
C0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 12 — — $35,183.32 nat. median
$36,207
1.0× median
A0405
HCPCS 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 12 — — $35,061.60 nat. median
$35,266
1.0× median
D1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 12 — — $34,810.78 nat. median
$33,589
1.0× median
D1805
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 12 — — $34,629.03 nat. median
$37,121
0.9× median
B0303
HCPCS 		Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 1 12 — — $34,392.12 nat. median
$35,203
1.0× median
C0604
HCPCS 		Neurological M <43.50- Tier Tier 2 12 — — $34,386.59 nat. median
$35,764
1.0× median
C1504
HCPCS 		Pulmonary M <45.50- Tier Tier 2 12 — — $34,045.40 nat. median
$36,307
0.9× median
D1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 3 12 — — $33,830.73 nat. median
$34,358
1.0× median
C0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 12 — — $33,202.56 nat. median
$34,816
1.0× median
B2003
HCPCS 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 12 — — $32,505.43 nat. median
$33,399
1.0× median
C2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 2 12 — — $32,446.91 nat. median
$34,324
0.9× median
D0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 12 — — $32,319.15 nat. median
$33,755
1.0× median
D0604
HCPCS 		Neurological M <43.50- Tier Tier 3 12 — — $32,101.53 nat. median
$30,918
1.0× median
C0204
HCPCS 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 12 — — $32,052.26 nat. median
$32,552
1.0× median
D1504
HCPCS 		Pulmonary M <45.50- Tier Tier 3 12 — — $32,018.54 nat. median
$34,002
0.9× median
C0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 12 — — $31,902.35 nat. median
$33,053
1.0× median
A1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 12 — — $31,581.44 nat. median
$33,508
0.9× median
C0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 2 12 — — $31,213.13 nat. median
$32,826
1.0× median
C1404
HCPCS 		Cardiac M <45.50- Tier Tier 2 12 — — $31,175.70 nat. median
$33,337
0.9× median
D0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 12 — — $31,032.97 nat. median
$31,214
1.0× median
C2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 12 — — $31,031.67 nat. median
$32,666
0.9× median
C0805
HCPCS 		Replacement Of Lower-extremity Joint M <42.50- Tier Tier 2 12 — — $30,504.38 nat. median
$33,948
0.9× median
A0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 12 — — $30,461.97 nat. median
$31,600
1.0× median
D0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 12 — — $29,305.60 nat. median
$30,932
0.9× median
D0104
HCPCS 		Stroke M >=41.50 And M <50.50- Tier Tier 3 12 — — $29,091.75 nat. median
$31,294
0.9× median
A0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier None 12 — — $29,058.47 nat. median
$30,471
1.0× median
D2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 12 — — $28,999.45 nat. median
$30,380
1.0× median
A0604
HCPCS 		Neurological M <43.50- Tier None 12 — — $28,951.50 nat. median
$30,256
1.0× median
A0406
HCPCS 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier None 12 — — $28,727.66 nat. median
$47,427
0.6× median
D0204
HCPCS 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 12 — — $28,418.50 nat. median
$29,740
1.0× median
A0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 12 — — $28,404.22 nat. median
$28,847
1.0× median

Other procedures at this hospital

Browse this hospital's 342 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
             
0125 RC Room & Board - Semi-private (Two Beds) - Hospice 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0156 RC Room & Board - Ward - Detoxification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0155 RC Room & Board - Ward - Hospice 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0154 RC Room & Board - Ward - Psychiatric 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0208 RC Intensive Care Unit - Trauma 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0146 RC Room & Board - Deluxe Private - Detoxification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0219 RC Coronary Care Unit - Other 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0214 RC Coronary Care Unit - Intermediate Ccu 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0144 RC Room & Board - Deluxe Private - Psychiatric 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0213 RC Coronary Care Unit - Heart Transplant 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0212 RC Coronary Care Unit - Pulmonary Care 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0145 RC Room & Board - Deluxe Private - Hospice 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0211 RC Coronary Care Unit - Myocardial Infarction 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0167 RC Room & Board - Other - Self Care 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0210 RC Coronary Care Unit - General Classification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0209 RC Intensive Care Unit - Other 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0161 RC Room & Board - Hospital At Home 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0207 RC Intensive Care Unit - Burn Care 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0206 RC Intensive Care Unit - Intermediate ICU 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0204 RC Intensive Care Unit - Psychiatric 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0203 RC Intensive Care Unit - Pediatric 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0116 RC Room & Board - Private (One Bed) - Detoxification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0202 RC Intensive Care Unit - Medical 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0201 RC Intensive Care Unit - Surgical 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0200 RC Intensive Care Unit - General Classification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0199 RC Subacute Care - Other 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0115 RC Room & Board - Private (One Bed) - Hospice 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0136 RC Room & Board - Three And Four Beds - Detoxification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0135 RC Room & Board - Three And Four Beds - Hospice 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0190 RC Subacute Care - General Classification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0189 RC Leave Of Absence - Other 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0134 RC Room & Board - Three And Four Beds - Psychiatric 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0185 RC Leave Of Absence - Nursing Home (for Hospitalization) 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0183 RC Leave Of Absence - Therapeutic Leave 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0182 RC Leave Of Absence - Patient Convenience 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0180 RC Leave Of Absence - General Classification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0124 RC Room & Board - Semi-private (Two Beds) - Psychiatric 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0114 RC Room & Board - Private (One Bed) - Psychiatric 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0126 RC Room & Board - Semi-private (Two Beds) - Detoxification 3 1 — — $1,100.00 $1,100.00 $1,100.00 2026-03-17
0118 RC Room & Board - Private (One Bed) - Rehabilitation 50 14 — — $875.98 $2,450.00 $1,334.30 2026-03-17
0148 RC Room & Board - Deluxe Private - Rehabilitation 39 12 — — $875.98 $2,450.00 $1,316.86 2026-03-17
0138 RC Room & Board - Three And Four Beds - Rehabilitation 47 14 — — $875.98 $2,450.00 $1,300.61 2026-03-17
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 47 14 — — $875.98 $2,450.00 $1,254.78 2026-03-17
0194 RC Subacute Care - Level IV 5 2 — — $781.81 $1,100.00 $972.72 2026-03-17
0158 RC Room & Board - Ward - Rehabilitation 42 13 — — $775.00 $2,450.00 $1,264.42 2026-03-17
0111 RC Room & Board - Private (One Bed) - Medical/Surgical/GYN 7 3 — — $775.00 $1,100.00 $939.29 2026-03-17
0129 RC Room & Board - Semi-private (Two Beds) - Other 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0150 RC Room & Board - Ward - General Classification 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0149 RC Room & Board - Deluxe Private - Other 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0120 RC Room & Board - Semi-private (Two Beds) - General Classification 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0119 RC Room & Board - Private (One Bed) - Other 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0140 RC Room & Board - Deluxe Private - General Classification 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0139 RC Room & Board - Three And Four Beds - Other 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0130 RC Room & Board - Three And Four Beds - General Classification 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0159 RC Room & Board - Ward - Other 14 3 — — $775.00 $1,100.00 $938.93 2026-03-17
0157 RC Room & Board - Ward - Oncology 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0101 RC All Inclusive Rate - Room And Board 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0153 RC Room & Board - Ward - Pediatrics 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0123 RC Room & Board - Semi-private (Two Beds) - Pediatric 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0152 RC Room & Board - Ward - Obstetrics (ob) 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0170 RC Nursery - General Classification 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0151 RC Room & Board - Ward - Medical/Surgical/GYN 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0122 RC Room & Board - Semi-private (Two Beds) - Obstetrics (ob) 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0100 RC All Inclusive Rate - Room And Board Plus Ancillary 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0164 RC Room & Board - Other - Sterile Environment 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0121 RC Room & Board - Semi-private (Two Beds) - Medical/Surgical/GYN 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0147 RC Room & Board - Deluxe Private - Oncology 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0143 RC Room & Board - Deluxe Private - Pediatric 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0142 RC Room & Board - Deluxe Private - Obstetrics (ob) 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0169 RC Room & Board - Other - Other 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0141 RC Room & Board - Deluxe Private - Medical/Surgical/GYN 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0117 RC Room & Board - Private (One Bed) - Oncology 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0127 RC Room & Board - Semi-private (Two Beds) - Oncology 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0171 RC Nursery - Newborn - Level I 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0137 RC Room & Board - Three And Four Beds - Oncology 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0133 RC Room & Board - Three And Four Beds - Pediatric 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0132 RC Room & Board - Three And Four Beds - Obstetrics (ob) 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0179 RC Nursery - Other 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0113 RC Room & Board - Private (One Bed) - Pediatric 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0174 RC Nursery - Newborn - Level IV 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0131 RC Room & Board - Three And Four Beds - Medical/Surgical/GYN 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0173 RC Nursery - Newborn - Level Iii 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0172 RC Nursery - Newborn - Level Ii 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0160 RC Room & Board - Other - General Classification 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0112 RC Room & Board - Private (One Bed) - Obstetrics (ob) 6 2 — — $775.00 $1,100.00 $937.50 2026-03-17
0110 RC Room & Board - Private (One Bed) - General Classification 15 4 — — $775.00 $1,100.00 $936.33 2026-03-17
946 MS_DRG Rehabilitation Without Cc/mcc 3 1 — — $775.00 $775.00 $775.00 2026-03-17
945 MS_DRG Rehabilitation With Cc/mcc 3 1 — — $775.00 $775.00 $775.00 2026-03-17
0193 RC Subacute Care - Level Iii 5 2 — — $744.58 $1,100.00 $957.83 2026-03-17
0413 RC Respiratory Services - Hyperbaric Oxygen Therapy 4 2 — — $600.00 $600.00 $600.00 2026-03-17
0192 RC Subacute Care - Level Ii 5 2 — — $446.75 $1,100.00 $838.70 2026-03-17
0807 RC Inpatient Renal Dialysis - Observation/Hourly 11 3 — — $400.00 $600.00 $527.27 2026-03-17
0805 RC Inpatient Renal Dialysis - Treatment 11 3 — — $400.00 $600.00 $527.27 2026-03-17
0808 RC Inpatient Renal Dialysis - Other 11 3 — — $400.00 $600.00 $527.27 2026-03-17
0806 RC Inpatient Renal Dialysis - Continuation 11 3 — — $400.00 $600.00 $527.27 2026-03-17
0800 RC Inpatient Renal Dialysis - General Classification 19 6 — — $300.00 $600.00 $472.22 2026-03-17
0801 RC Inpatient Renal Dialysis - Hemodialysis 20 7 — — $300.00 $600.00 $472.22 2026-03-17
0809 RC Inpatient Renal Dialysis - Other 19 6 — — $300.00 $600.00 $472.22 2026-03-17
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 20 7 — — $300.00 $600.00 $472.22 2026-03-17
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 19 6 — — $300.00 $600.00 $472.22 2026-03-17
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 19 6 — — $300.00 $600.00 $472.22 2026-03-17
0822 RC Hemodialysis - Outpatient Or Home - Home Supplies 3 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
729 MS_DRG Other Male Reproductive System Diagnoses With Cc/mcc 4 1 — — $300.00 $300.00 $300.00 2026-03-17
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 4 1 — — $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
91 MS_DRG Other Disorders Of Nervous System With Mcc 4 1 — — $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
0820 RC Hemodialysis - Outpatient Or Home - General Classification 4 2 — — $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
0825 RC Hemodialysis - Outpatient Or Home - Support Services 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
0191 RC Subacute Care - Level I 5 2 — — $297.83 $1,100.00 $779.13 2026-03-17
0832 RC Peritoneal Dialysis - Outpatient Or Home - Home Supplies 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
0835 RC Peritoneal Dialysis - Outpatient Or Home - Support Services 3 1 — — $129.00 $129.00 $129.00 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
0859 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Other 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
0855 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Support Ser… 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
0854 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Maintenance… 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
0845 RC Continuous Ambulatory Peritoneal Dialysis (capd) - Outpatient Or Home - Support … 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
0852 RC Continuous Cycling Peritoneal Dialysis (ccpd) - Outpatient Or Home - Home Suppli… 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
0833 RC Peritoneal Dialysis - Outpatient Or Home - Home Equipment 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
0834 RC Peritoneal Dialysis - Outpatient Or Home - Maintenance 100% 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
0830 RC Peritoneal Dialysis - Outpatient Or Home - General Classification 3 1 — — $129.00 $129.00 $129.00 2026-03-17
92522 HCPCS Evaluate Speech Production 52 15 — — $120.00 $150.00 $135.00 2026-03-17
96105 HCPCS Assessment Of Aphasia 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
92524 HCPCS Behavral Qualit Analys Voice 52 15 — — $120.00 $150.00 $118.52 2026-03-17
0448 RC Speech-language Pathology - Other 4 2 — — $110.00 $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
0445 RC Speech-language Pathology - Treatment 4 2 — — $110.00 $110.00 $110.00 2026-03-17
0438 RC Occupational Therapy - Other 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
0437 RC Occupational Therapy - Observation/Hourly 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
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
0426 RC Physical Therapy - Continuation 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
97166 HCPCS Ot Eval Mod Complex 45 Min 58 18 — — $90.00 $150.00 $126.52 2026-03-17
97162 HCPCS Pt Eval Mod Complex 30 Min 58 18 — — $90.00 $150.00 $116.79 2026-03-17
97161 HCPCS Pt Eval Low Complex 20 Min 58 18 — — $90.00 $150.00 $115.78 2026-03-17
97167 HCPCS Ot Eval High Complex 60 Min 57 17 — — $90.00 $150.00 $105.00 2026-03-17
97165 HCPCS Ot Eval Low Complex 30 Min 58 18 — — $90.00 $150.00 $105.00 2026-03-17
97168 HCPCS Ot Re-eval Est Plan Care 57 17 — — $90.00 $150.00 $105.00 2026-03-17
97163 HCPCS Pt Eval High Complex 45 Min 58 18 — — $90.00 $150.00 $105.00 2026-03-17
97164 HCPCS Pt Re-eval Est Plan Care 58 18 — — $90.00 $150.00 $105.00 2026-03-17
92607 HCPCS Ex For Speech Device Rx 1hr 52 15 — — $90.00 $120.00 $105.00 2026-03-17
0410 RC Respiratory Services - General Classification 56 16 — — $90.00 $120.00 $96.00 2026-03-17
97535 HCPCS Self Care Mngment Training 58 18 — — $90.00 $120.00 $95.00 2026-03-17
97537 HCPCS Community/work Reintegration 57 17 — — $90.00 $120.00 $95.00 2026-03-17
97129 HCPCS Ther Ivntj 1st 15 Min 57 17 — — $90.00 $120.00 $95.00 2026-03-17
97113 HCPCS Aquatic Therapy/exercises 57 17 — — $90.00 $120.00 $95.00 2026-03-17
97799 HCPCS Unlisted Physcl Med/rehab Px 5 2 — — $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
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
97761 HCPCS Prosthetic Traing 1st Enc 55 15 — — $90.00 $90.00 $90.00 2026-03-17
97533 HCPCS Sensory Integration 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
97170 HCPCS Athletic Trn Eval Mod Cmplx 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
97172 HCPCS Athletic Trn Re-eval Plan Cr 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
97169 HCPCS Athletic Trn Eval Low Cmplx 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
97156 HCPCS Fam Adapt Bhv Tx Gdn Phy/qhp 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
97157 HCPCS Mult Fam Adapt Bhv Tx Gdn 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
97152 HCPCS Bhv Id Suprt Assmt By 1 Tech 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
97158 HCPCS Grp Adapt Bhv Tx By Phy/qhp 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
97139 HCPCS Unlisted Therapeutic Px 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
97546 HCPCS Work Hardening Add-on 5 2 — — $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
97036 HCPCS App Mdlty 1+hubbrd Tnk Ea 15 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
97037 HCPCS Appl Modality 1+lllt Po Pain 5 2 — — $90.00 $90.00 $90.00 2026-03-17
0449 RC Speech Therapy - Language Pathology - Other 10 4 — — $80.00 $110.00 $100.00 2026-03-17
0439 RC Occupational Therapy - Other 10 4 — — $80.00 $110.00 $100.00 2026-03-17
0429 RC Physical Therapy - Other 10 4 — — $80.00 $110.00 $100.00 2026-03-17
0430 RC Occupational Therapy - General Classification 63 20 — — $80.00 $120.00 $98.00 2026-03-17
0420 RC Physical Therapy - General Classification 63 20 — — $80.00 $120.00 $98.00 2026-03-17
0443 RC Speech Therapy - Language Pathology - Group Rate 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0442 RC Speech Therapy - Language Pathology - Hourly Charge 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0441 RC Speech Therapy - Language Pathology - Visit Charge 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0433 RC Occupational Therapy - Group Rate 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0432 RC Occupational Therapy - Hourly Charge 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0431 RC Occupational Therapy - Visit Charge 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0423 RC Physical Therapy - Group Rate 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0422 RC Physical Therapy - Hourly Charge 15 6 — — $80.00 $110.00 $96.92 2026-03-17
0421 RC Physical Therapy - Visit Charge 62 18 — — $80.00 $110.00 $96.92 2026-03-17
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 68 19 — — $80.00 $150.00 $94.35 2026-03-17
0434 RC Occupational Therapy - Evaluation Or Reevaluation 72 20 — — $80.00 $150.00 $94.35 2026-03-17
0424 RC Physical Therapy - Evaluation Or Re-evaluation 72 20 — — $80.00 $150.00 $94.35 2026-03-17
0440 RC Speech Therapy - Language Pathology - General Classification 71 20 — — $80.00 $120.00 $91.74 2026-03-17
92521 HCPCS Evaluation Of Speech Fluency 10 3 — — $80.00 $150.00 $91.00 2026-03-17
92526 HCPCS Oral Function Therapy 58 18 — — $77.88 $120.00 $107.18 2026-03-17
92507 HCPCS Speech/hearing Therapy 61 16 — — $68.42 $120.00 $99.94 2026-03-17
97110 HCPCS Therapeutic Exercises 66 18 — — $20.51 $120.00 $91.31 2026-03-17
B0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 1 26 12 — — — — $53,762.08 2026-03-17
B0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 1 26 12 — — — — $48,661.32 2026-03-17
C0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 2 26 12 — — — — $46,122.43 2026-03-17
B0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 26 12 — — — — $43,976.85 2026-03-17
C0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 26 12 — — — — $43,277.86 2026-03-17
B1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 1 26 12 — — — — $42,438.72 2026-03-17
B0604 HCPCS Neurological M <43.50- Tier Tier 1 26 12 — — — — $41,455.82 2026-03-17
B0904 HCPCS Other Orthopedic M <44.5- Tier Tier 1 26 12 — — — — $41,084.45 2026-03-17
B2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 1 26 12 — — — — $40,965.14 2026-03-17
D0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 26 12 — — — — $40,885.83 2026-03-17
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 26 12 — — — — $40,787.03 2026-03-17
B1404 HCPCS Cardiac M <45.50- Tier Tier 1 26 12 — — — — $39,574.55 2026-03-17
C0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 2 26 12 — — — — $38,881.69 2026-03-17
C1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 26 12 — — — — $38,429.69 2026-03-17
D0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier Tier 3 26 12 — — — — $38,297.17 2026-03-17
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier None 26 12 — — — — $37,676.79 2026-03-17
C1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 2 26 12 — — — — $37,273.78 2026-03-17
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 26 12 — — — — $36,494.14 2026-03-17
D0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 3 26 12 — — — — $36,444.07 2026-03-17
C0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 26 12 — — — — $35,183.32 2026-03-17
A0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 26 12 — — — — $35,061.60 2026-03-17
D1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 26 12 — — — — $34,810.78 2026-03-17
D1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 26 12 — — — — $34,629.03 2026-03-17
B0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 1 26 12 — — — — $34,392.12 2026-03-17
C0604 HCPCS Neurological M <43.50- Tier Tier 2 26 12 — — — — $34,386.59 2026-03-17
C1504 HCPCS Pulmonary M <45.50- Tier Tier 2 26 12 — — — — $34,045.40 2026-03-17
D1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 3 26 12 — — — — $33,830.73 2026-03-17
C0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 2 26 12 — — — — $33,202.56 2026-03-17
B2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 26 12 — — — — $32,505.43 2026-03-17
C2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 2 26 12 — — — — $32,446.91 2026-03-17
D0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 26 12 — — — — $32,319.15 2026-03-17
D0604 HCPCS Neurological M <43.50- Tier Tier 3 27 12 — — — — $32,101.53 2026-03-17
C0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 26 12 — — — — $32,052.26 2026-03-17
D1504 HCPCS Pulmonary M <45.50- Tier Tier 3 26 12 — — — — $32,018.54 2026-03-17
C0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 26 12 — — — — $31,902.35 2026-03-17
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 26 12 — — — — $31,581.44 2026-03-17
C0904 HCPCS Other Orthopedic M <44.5- Tier Tier 2 26 12 — — — — $31,213.13 2026-03-17
C1404 HCPCS Cardiac M <45.50- Tier Tier 2 26 12 — — — — $31,175.70 2026-03-17
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 26 12 — — — — $31,032.97 2026-03-17
C2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 26 12 — — — — $31,031.67 2026-03-17
C0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 2 26 12 — — — — $30,504.38 2026-03-17
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 26 12 — — — — $30,461.97 2026-03-17
D0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 26 12 — — — — $29,305.60 2026-03-17
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 26 12 — — — — $29,091.75 2026-03-17
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 26 12 — — — — $29,058.47 2026-03-17
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 26 12 — — — — $28,999.45 2026-03-17
A0604 HCPCS Neurological M <43.50- Tier None 26 12 — — — — $28,951.50 2026-03-17
A0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier None 26 12 — — — — $28,727.66 2026-03-17
D0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 26 12 — — — — $28,418.50 2026-03-17
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 26 12 — — — — $28,404.22 2026-03-17
D1404 HCPCS Cardiac M <45.50- Tier Tier 3 26 12 — — — — $27,889.29 2026-03-17
C0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 2 26 12 — — — — $27,844.30 2026-03-17
A2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier None 26 12 — — — — $27,822.80 2026-03-17
D0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 26 12 — — — — $27,811.74 2026-03-17
C0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 2 26 12 — — — — $27,514.81 2026-03-17
D0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 26 12 — — — — $27,052.24 2026-03-17
A0904 HCPCS Other Orthopedic M <44.5- Tier None 26 12 — — — — $26,978.12 2026-03-17
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 26 12 — — — — $26,756.81 2026-03-17
A1404 HCPCS Cardiac M <45.50- Tier None 26 12 — — — — $26,671.97 2026-03-17
A2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier None 26 12 — — — — $26,395.33 2026-03-17
D2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 3 26 12 — — — — $26,271.67 2026-03-17
A0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier None 26 12 — — — — $25,939.79 2026-03-17
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 27 12 — — — — $25,746.14 2026-03-17
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 27 12 — — — — $25,596.76 2026-03-17
A1503 HCPCS Pulmonary M >=45.50 And M <56.50- Tier None 26 12 — — — — $25,521.09 2026-03-17
C1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 2 26 12 — — — — $25,443.68 2026-03-17
D0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 26 12 — — — — $24,608.22 2026-03-17
A0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 26 12 — — — — $24,469.58 2026-03-17
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 26 12 — — — — $24,254.12 2026-03-17
A0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 26 12 — — — — $23,822.56 2026-03-17
A1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 26 12 — — — — $23,778.30 2026-03-17
D1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 3 26 12 — — — — $23,656.57 2026-03-17
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 26 12 — — — — $23,403.91 2026-03-17
D0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 26 12 — — — — $23,189.97 2026-03-17
A0603 HCPCS Neurological M >=43.50 And M <52.50- Tier None 26 12 — — — — $23,084.85 2026-03-17
A0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier None 26 12 — — — — $22,514.96 2026-03-17
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 26 12 — — — — $22,076.03 2026-03-17
A0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 26 12 — — — — $21,627.87 2026-03-17
D0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 3 26 12 — — — — $21,056.74 2026-03-17
D0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 26 12 — — — — $21,006.34 2026-03-17
A0104 HCPCS Stroke M >=41.50 And M <50.50- Tier None 26 12 — — — — $20,981.21 2026-03-17
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 26 12 — — — — $20,844.42 2026-03-17
A0602 HCPCS Neurological M >=52.50 And M <64.50- Tier None 26 12 — — — — $19,591.78 2026-03-17
A0205 HCPCS Traumatic Brain Injury M <35.50- Tier None 26 12 — — — — $18,359.81 2026-03-17
D2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 26 12 — — — — $12,047.49 2026-03-17
92610 HCPCS Evaluate Swallowing Function 51 14 — — — — $351.00 2026-03-17
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