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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

Pam Rehabilitation Hospital Of Corpus Christi

Corpus Christi, TX · CCN 673067 · Rates published

5,940 distinct procedures filed
28 distinct payers
158,970 rate rows
2025-09-11 last MRF observed
Data quality

151,252 of 158,970 rate rows are consumer-grade (95.1%)

7,718 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 7,140
per-diem day rate — not a per-procedure price 534
exceeds 10× this hospital's gross charge — excluded from medians 44
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11006/371795725_post-acute-medical-rehabilitation-hospital-of-corpus-christi-llc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/PAMRehabHospitalCorpusChristi/11006
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 6e78a37a057e0098… · 30,466,691 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
B0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 18 $80,811.59 $121,217.39 $80,811.59 nat. median
$79,920
1.0× median
C0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 18 $71,864.17 $107,796.26 $71,864.17 nat. median
$70,083
1.0× median
B1904
LOCAL 		Guillain-barré M <38.50 18 $69,925.98 $104,888.97 $69,925.98 nat. median
$68,345
1.0× median
D0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 18 $69,761.59 $104,642.39 $69,761.59 nat. median
$67,662
1.0× median
B1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 18 $65,776.25 $98,664.38 $65,776.25 nat. median
$64,290
1.0× median
A0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 18 $63,388.87 $95,083.31 $63,388.87 nat. median
$61,956
1.0× median
B0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 18 $59,111.08 $88,666.62 $59,111.08 nat. median
$59,111
1.0× median
B0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 18 $58,252.85 $87,379.28 $58,252.85 nat. median
$57,695
1.0× median
B0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50 18 $57,654.57 $86,481.86 $57,654.57 nat. median
$56,226
1.0× median
B0106
LOCAL 		Stroke M <41.50 And A <84.50 18 $55,553.91 $83,330.87 $55,553.91 nat. median
$53,762
1.0× median
C1904
LOCAL 		Guillain-barré M <38.50 18 $53,759.07 $80,638.61 $53,759.07 nat. median
$52,544
1.0× median
C0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 18 $52,566.34 $78,849.51 $52,566.34 nat. median
$52,063
1.0× median
C1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 18 $52,472.68 $78,709.02 $52,472.68 nat. median
$51,172
1.0× median
C0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 18 $51,803.67 $77,705.51 $51,803.67 nat. median
$50,633
1.0× median
D0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 18 $51,027.63 $76,541.45 $51,027.63 nat. median
$49,763
1.0× median
B0205
LOCAL 		Traumatic Brain Injury M <35.50 18 $50,433.18 $75,649.77 $50,433.18 nat. median
$49,196
1.0× median
D0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 18 $50,287.91 $75,431.87 $50,287.91 nat. median
$49,042
1.0× median
D1904
LOCAL 		Guillain-barré M <38.50 18 $50,163.66 $75,245.49 $50,163.66 nat. median
$49,620
1.0× median
B1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 18 $50,117.79 $75,176.69 $50,117.79 nat. median
$48,876
1.0× median
D1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 18 $49,815.78 $74,723.67 $49,815.78 nat. median
$48,581
1.0× median
A1904
LOCAL 		Guillain-barré M <38.50 18 $49,295.87 $73,943.81 $49,295.87 nat. median
$48,824
1.0× median
B0105
LOCAL 		Stroke M <41.50 And A >=84.50 18 $48,842.86 $73,264.29 $48,842.86 nat. median
$48,375
1.0× median
C0106
LOCAL 		Stroke M <41.50 And A <84.50 18 $48,179.60 $72,269.40 $48,179.60 nat. median
$46,986
1.0× median
B1903
LOCAL 		Guillain-barré M >=38.50 And M <51.50 18 $48,003.74 $72,005.61 $48,003.74 nat. median
$46,919
1.0× median
B0604
LOCAL 		Neurological M <43.50 18 $47,602.34 $71,403.51 $47,602.34 nat. median
$46,423
1.0× median
A0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 18 $46,367.56 $69,551.34 $46,367.56 nat. median
$45,230
1.0× median
B0405
LOCAL 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50 18 $46,325.50 $69,488.25 $46,325.50 nat. median
$46,326
1.0× median
B1805
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 18 $46,315.95 $69,473.93 $46,315.95 nat. median
$45,253
1.0× median
A1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 18 $46,187.88 $69,281.82 $46,187.88 nat. median
$45,144
1.0× median
A0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 18 $45,694.73 $68,542.10 $45,694.73 nat. median
$44,562
1.0× median
B0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50 18 $45,578.13 $68,367.20 $45,578.13 nat. median
$44,232
1.0× median
A5104
LOCAL 		Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More 18 $45,557.11 $68,335.67 $45,557.11 nat. median
$44,527
1.0× median
B1604
LOCAL 		Pain Syndrome M <43.50 18 $44,870.90 $67,306.35 $44,870.90 nat. median
$43,857
1.0× median
C0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50 18 $44,853.70 $67,280.55 $44,853.70 nat. median
$43,704
1.0× median
B0704
LOCAL 		Fracture Of Lower Extremity M <41.50 18 $44,484.79 $66,727.19 $44,484.79 nat. median
$43,383
1.0× median
B2102
LOCAL 		Burns M <52.50 18 $44,299.39 $66,449.09 $44,299.39 nat. median
$43,298
1.0× median
D0106
LOCAL 		Stroke M <41.50 And A <84.50 18 $44,027.96 $66,041.94 $44,027.96 nat. median
$42,703
1.0× median
B1004
LOCAL 		Amputation Lower Extremity M <47.50 18 $43,984.00 $65,976.00 $43,984.00 nat. median
$42,470
1.0× median
B1504
LOCAL 		Pulmonary M <45.50 18 $43,473.65 $65,210.48 $43,473.65 nat. median
$43,057
1.0× median
B1704
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 18 $42,707.16 $64,060.74 $42,707.16 nat. median
$41,742
1.0× median
B2005
LOCAL 		Miscellaneous M <46.50 And A <77.50 18 $42,456.76 $63,685.14 $42,456.76 nat. median
$40,995
1.0× median
D0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50 18 $42,374.57 $63,561.86 $42,374.57 nat. median
$41,099
1.0× median
C0105
LOCAL 		Stroke M <41.50 And A >=84.50 18 $42,359.28 $63,538.92 $42,359.28 nat. median
$41,402
1.0× median
A0106
LOCAL 		Stroke M <41.50 And A <84.50 18 $41,957.88 $62,936.82 $41,957.88 nat. median
$39,573
1.1× median
B1204
LOCAL 		Osteoarthritis M <49.50 And A <74.50 18 $41,739.98 $62,609.97 $41,739.98 nat. median
$40,797
1.0× median
C0205
LOCAL 		Traumatic Brain Injury M <35.50 18 $41,537.36 $62,306.04 $41,537.36 nat. median
$40,508
1.0× median
B0504
LOCAL 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 18 $41,491.49 $62,237.24 $41,491.49 nat. median
$41,330
1.0× median
B0304
LOCAL 		Non-traumatic Brain Injury M <42.50 And A >=78.50 18 $41,327.11 $61,990.67 $41,327.11 nat. median
$41,166
1.0× median
C0405
LOCAL 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50 18 $41,197.13 $61,795.70 $41,197.13 nat. median
$40,176
1.0× median
B1404
LOCAL 		Cardiac M <45.50 18 $41,015.54 $61,523.31 $41,015.54 nat. median
$39,603
1.0× median

Other procedures at this hospital

Browse this hospital's 5,940 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
             
33231 CPT Insrt Pulse Gen W/mult Leads 4 2 — — $21,864.90 $21,864.90 $21,864.90 2025-09-11
33249 CPT Insj/rplcmt Defib W/lead(s) 4 2 — — $21,852.74 $21,852.74 $21,852.74 2025-09-11
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 4 2 — — $21,766.45 $21,766.45 $21,766.45 2025-09-11
33270 CPT Ins/rep Subq Defibrillator 4 2 — — $21,943.90 $21,943.90 $21,943.90 2025-09-11
33276 CPT Insj Phrnc Nrv Stim Sys 4 2 — — $32,454.62 $32,454.62 $32,454.62 2025-09-11
69930 CPT Implant Cochlear Device 4 2 — — $25,960.08 $25,960.08 $25,960.08 2025-09-11
A0103 LOCAL Stroke M >=50.50 And M <63.50 40 18 — — $23,114.97 $34,672.46 $23,114.97 2025-09-11
A0104 LOCAL Stroke M >=41.50 And M <50.50 40 18 — — $29,501.07 $44,251.61 $29,501.07 2025-09-11
A0105 LOCAL Stroke M <41.50 And A >=84.50 40 18 — — $36,890.67 $55,336.01 $36,890.67 2025-09-11
A0106 LOCAL Stroke M <41.50 And A <84.50 40 18 — — $41,957.88 $62,936.82 $41,957.88 2025-09-11
A0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 40 18 — — $22,358.04 $33,537.06 $22,358.04 2025-09-11
A0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 40 18 — — $27,731.08 $41,596.62 $27,731.08 2025-09-11
A0205 LOCAL Traumatic Brain Injury M <35.50 40 18 — — $35,520.17 $53,280.26 $35,520.17 2025-09-11
A0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 40 18 — — $24,689.99 $37,034.99 $24,689.99 2025-09-11
A0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 40 18 — — $28,627.54 $42,941.31 $28,627.54 2025-09-11
A0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 40 18 — — $31,571.15 $47,356.73 $31,571.15 2025-09-11
A0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 40 18 — — $23,321.40 $34,982.10 $23,321.40 2025-09-11
A0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 40 18 — — $29,265.96 $43,898.94 $29,265.96 2025-09-11
A0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 40 18 — — $45,694.73 $68,542.10 $45,694.73 2025-09-11
A0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 40 18 — — $36,338.26 $54,507.39 $36,338.26 2025-09-11
A0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 40 18 — — $46,367.56 $69,551.34 $46,367.56 2025-09-11
A0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 40 18 — — $63,388.87 $95,083.31 $63,388.87 2025-09-11
A0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 40 18 — — $23,640.61 $35,460.92 $23,640.61 2025-09-11
A0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 40 18 — — $28,101.90 $42,152.85 $28,101.90 2025-09-11
A0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 40 18 — — $39,048.68 $58,573.02 $39,048.68 2025-09-11
A0603 LOCAL Neurological M >=43.50 And M <52.50 40 18 — — $23,925.41 $35,888.12 $23,925.41 2025-09-11
A0604 LOCAL Neurological M <43.50 40 18 — — $30,005.68 $45,008.52 $30,005.68 2025-09-11
A0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 40 18 — — $24,653.67 $36,980.51 $24,653.67 2025-09-11
A0704 LOCAL Fracture Of Lower Extremity M <41.50 40 18 — — $30,116.55 $45,174.83 $30,116.55 2025-09-11
A0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 40 18 — — $22,415.38 $33,623.07 $22,415.38 2025-09-11
A0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 40 18 — — $26,884.31 $40,326.47 $26,884.31 2025-09-11
A0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 40 18 — — $23,334.78 $35,002.17 $23,334.78 2025-09-11
A0904 LOCAL Other Orthopedic M <44.5 40 18 — — $27,960.45 $41,940.68 $27,960.45 2025-09-11
A1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 40 18 — — $23,254.50 $34,881.75 $23,254.50 2025-09-11
A1004 LOCAL Amputation Lower Extremity M <47.50 40 18 — — $29,770.58 $44,655.87 $29,770.58 2025-09-11
A1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 40 18 — — $24,212.13 $36,318.20 $24,212.13 2025-09-11
A1103 LOCAL Amputation Non-lower Extremity M <52.50 40 18 — — $30,193.01 $45,289.52 $30,193.01 2025-09-11
A1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 40 18 — — $25,938.15 $38,907.23 $25,938.15 2025-09-11
A1204 LOCAL Osteoarthritis M <49.50 And A <74.50 40 18 — — $27,201.61 $40,802.42 $27,201.61 2025-09-11
A1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 40 18 — — $20,918.73 $31,378.10 $20,918.73 2025-09-11
A1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 40 18 — — $23,799.26 $35,698.89 $23,799.26 2025-09-11
A1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 40 18 — — $30,055.38 $45,083.07 $30,055.38 2025-09-11
A1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 40 18 — — $28,782.37 $43,173.56 $28,782.37 2025-09-11
A1403 LOCAL Cardiac M >=45.50 And M <55.50 40 18 — — $22,560.65 $33,840.98 $22,560.65 2025-09-11
A1404 LOCAL Cardiac M <45.50 40 18 — — $27,643.15 $41,464.73 $27,643.15 2025-09-11
A1502 LOCAL Pulmonary M >=56.50 And M <68.50 40 18 — — $22,056.03 $33,084.05 $22,056.03 2025-09-11
A1503 LOCAL Pulmonary M >=45.50 And M <56.50 40 18 — — $25,066.54 $37,599.81 $25,066.54 2025-09-11
A1504 LOCAL Pulmonary M <45.50 40 18 — — $31,041.68 $46,562.52 $31,041.68 2025-09-11
A1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 40 18 — — $22,507.13 $33,760.70 $22,507.13 2025-09-11
A1604 LOCAL Pain Syndrome M <43.50 40 18 — — $27,885.90 $41,828.85 $27,885.90 2025-09-11
A1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 40 18 — — $24,644.11 $36,966.17 $24,644.11 2025-09-11
A1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 40 18 — — $27,891.64 $41,837.46 $27,891.64 2025-09-11
A1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 40 18 — — $32,731.39 $49,097.09 $32,731.39 2025-09-11
A1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 40 18 — — $24,531.34 $36,797.01 $24,531.34 2025-09-11
A1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 40 18 — — $26,825.06 $40,237.59 $26,825.06 2025-09-11
A1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 40 18 — — $32,523.04 $48,784.56 $32,523.04 2025-09-11
A1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 40 18 — — $46,187.88 $69,281.82 $46,187.88 2025-09-11
A1902 LOCAL Guillain-barré M >=51.50 And M <66.50 40 18 — — $22,428.76 $33,643.14 $22,428.76 2025-09-11
A1903 LOCAL Guillain-barré M >=38.50 And M <51.50 40 18 — — $33,840.02 $50,760.03 $33,840.02 2025-09-11
A1904 LOCAL Guillain-barré M <38.50 40 18 — — $49,295.87 $73,943.81 $49,295.87 2025-09-11
A2003 LOCAL Miscellaneous M >=46.50 And M <55.50 40 18 — — $22,879.86 $34,319.79 $22,879.86 2025-09-11
A2004 LOCAL Miscellaneous M <46.50 And A >=77.50 40 18 — — $27,356.44 $41,034.66 $27,356.44 2025-09-11
A2005 LOCAL Miscellaneous M <46.50 And A <77.50 40 18 — — $28,835.89 $43,253.84 $28,835.89 2025-09-11
A2102 LOCAL Burns M <52.50 40 18 — — $28,747.96 $43,121.94 $28,747.96 2025-09-11
A5102 LOCAL Expired, Orthopedic, Length Of Stay Is 14 Days Or More 40 18 — — $34,264.36 $51,396.54 $34,264.36 2025-09-11
A5104 LOCAL Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More 40 18 — — $45,557.11 $68,335.67 $45,557.11 2025-09-11
B0102 LOCAL Stroke M >=63.50 And M <72.50 40 18 — — $23,745.74 $35,618.61 $23,745.74 2025-09-11
B0103 LOCAL Stroke M >=50.50 And M <63.50 40 18 — — $30,605.87 $45,908.81 $30,605.87 2025-09-11
B0104 LOCAL Stroke M >=41.50 And M <50.50 40 18 — — $39,060.15 $58,590.23 $39,060.15 2025-09-11
B0105 LOCAL Stroke M <41.50 And A >=84.50 40 18 — — $48,842.86 $73,264.29 $48,842.86 2025-09-11
B0106 LOCAL Stroke M <41.50 And A <84.50 40 18 — — $55,553.91 $83,330.87 $55,553.91 2025-09-11
B0202 LOCAL Traumatic Brain Injury M >=61.50 And M <73.50 40 18 — — $25,490.88 $38,236.32 $25,490.88 2025-09-11
B0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 40 18 — — $31,745.09 $47,617.64 $31,745.09 2025-09-11
B0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 40 18 — — $39,371.71 $59,057.57 $39,371.71 2025-09-11
B0205 LOCAL Traumatic Brain Injury M <35.50 40 18 — — $50,433.18 $75,649.77 $50,433.18 2025-09-11
B0301 LOCAL Non-traumatic Brain Injury M >=65.50 40 18 — — $22,912.35 $34,368.53 $22,912.35 2025-09-11
B0302 LOCAL Non-traumatic Brain Injury M >=52.50 And M <65.50 40 18 — — $29,623.40 $44,435.10 $29,623.40 2025-09-11
B0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 40 18 — — $35,644.41 $53,466.62 $35,644.41 2025-09-11
B0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 40 18 — — $41,327.11 $61,990.67 $41,327.11 2025-09-11
B0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 40 18 — — $45,578.13 $68,367.20 $45,578.13 2025-09-11
B0401 LOCAL Traumatic Spinal Cord Injury M >=56.50 40 18 — — $23,051.89 $34,577.84 $23,051.89 2025-09-11
B0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 40 18 — — $29,730.44 $44,595.66 $29,730.44 2025-09-11
B0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 40 18 — — $37,309.27 $55,963.91 $37,309.27 2025-09-11
B0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 40 18 — — $58,252.85 $87,379.28 $58,252.85 2025-09-11
B0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 40 18 — — $46,325.50 $69,488.25 $46,325.50 2025-09-11
B0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 40 18 — — $59,111.08 $88,666.62 $59,111.08 2025-09-11
B0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 40 18 — — $80,811.59 $121,217.39 $80,811.59 2025-09-11
B0501 LOCAL Non-traumatic Spinal Cord Injury M >=60.50 40 18 — — $24,273.30 $36,409.95 $24,273.30 2025-09-11
B0502 LOCAL Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 40 18 — — $30,451.05 $45,676.58 $30,451.05 2025-09-11
B0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 40 18 — — $34,904.69 $52,357.04 $34,904.69 2025-09-11
B0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 40 18 — — $41,491.49 $62,237.24 $41,491.49 2025-09-11
B0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 40 18 — — $57,654.57 $86,481.86 $57,654.57 2025-09-11
B0601 LOCAL Neurological M >=64.50 40 18 — — $25,397.22 $38,095.83 $25,397.22 2025-09-11
B0602 LOCAL Neurological M >=52.50 And M <64.50 40 18 — — $32,213.39 $48,320.09 $32,213.39 2025-09-11
B0603 LOCAL Neurological M >=43.50 And M <52.50 40 18 — — $37,957.25 $56,935.88 $37,957.25 2025-09-11
B0604 LOCAL Neurological M <43.50 40 18 — — $47,602.34 $71,403.51 $47,602.34 2025-09-11
B0701 LOCAL Fracture Of Lower Extremity M >=61.50 40 18 — — $23,973.20 $35,959.80 $23,973.20 2025-09-11
B0702 LOCAL Fracture Of Lower Extremity M >=52.50 And M <61.50 40 18 — — $29,611.93 $44,417.90 $29,611.93 2025-09-11
B0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 40 18 — — $36,414.72 $54,622.08 $36,414.72 2025-09-11
B0704 LOCAL Fracture Of Lower Extremity M <41.50 40 18 — — $44,484.79 $66,727.19 $44,484.79 2025-09-11
B0801 LOCAL Replacement Of Lower-extremity Joint M >=63.50 40 18 — — $23,237.30 $34,855.95 $23,237.30 2025-09-11
B0802 LOCAL Replacement Of Lower-extremity Joint M >=57.50 And M <63.50 40 18 — — $26,345.29 $39,517.94 $26,345.29 2025-09-11
B0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 40 18 — — $29,323.30 $43,984.95 $29,323.30 2025-09-11
B0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 40 18 — — $32,851.81 $49,277.72 $32,851.81 2025-09-11
B0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 40 18 — — $39,400.38 $59,100.57 $39,400.38 2025-09-11
B0901 LOCAL Other Orthopedic M >=63.50 40 18 — — $22,969.70 $34,454.55 $22,969.70 2025-09-11
B0902 LOCAL Other Orthopedic M >=51.50 And M <63.50 40 18 — — $28,608.43 $42,912.65 $28,608.43 2025-09-11
B0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 40 18 — — $34,163.05 $51,244.58 $34,163.05 2025-09-11
B0904 LOCAL Other Orthopedic M <44.5 40 18 — — $40,935.26 $61,402.89 $40,935.26 2025-09-11
B1001 LOCAL Amputation Lower Extremity M >=64.50 40 18 — — $23,147.46 $34,721.19 $23,147.46 2025-09-11
B1002 LOCAL Amputation Lower Extremity M >=55.50 And M <64.50 40 18 — — $29,323.30 $43,984.95 $29,323.30 2025-09-11
B1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 40 18 — — $34,356.11 $51,534.17 $34,356.11 2025-09-11
B1004 LOCAL Amputation Lower Extremity M <47.50 40 18 — — $43,984.00 $65,976.00 $43,984.00 2025-09-11
B1101 LOCAL Amputation Non-lower Extremity M >=58.50 40 18 — — $24,179.64 $36,269.46 $24,179.64 2025-09-11
B1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 40 18 — — $30,741.59 $46,112.39 $30,741.59 2025-09-11
B1103 LOCAL Amputation Non-lower Extremity M <52.50 40 18 — — $38,335.71 $57,503.57 $38,335.71 2025-09-11
B1201 LOCAL Osteoarthritis M >=61.50 40 18 — — $25,378.10 $38,067.15 $25,378.10 2025-09-11
B1202 LOCAL Osteoarthritis M >=49.50 And M <61.50 40 18 — — $30,724.38 $46,086.57 $30,724.38 2025-09-11
B1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 40 18 — — $39,803.69 $59,705.54 $39,803.69 2025-09-11
B1204 LOCAL Osteoarthritis M <49.50 And A <74.50 40 18 — — $41,739.98 $62,609.97 $41,739.98 2025-09-11
B1301 LOCAL Rheumatoid Other Arthritis M >=62.50 40 18 — — $20,844.18 $31,266.27 $20,844.18 2025-09-11
B1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 40 18 — — $28,491.83 $42,737.75 $28,491.83 2025-09-11
B1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 40 18 — — $32,414.09 $48,621.14 $32,414.09 2025-09-11
B1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 40 18 — — $40,935.26 $61,402.89 $40,935.26 2025-09-11
B1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 40 18 — — $39,201.59 $58,802.39 $39,201.59 2025-09-11
B1401 LOCAL Cardiac M >=68.50 40 18 — — $21,570.53 $32,355.80 $21,570.53 2025-09-11
B1402 LOCAL Cardiac M >=55.50 And M <68.50 40 18 — — $27,356.44 $41,034.66 $27,356.44 2025-09-11
B1403 LOCAL Cardiac M >=45.50 And M <55.50 40 18 — — $33,473.03 $50,209.55 $33,473.03 2025-09-11
B1404 LOCAL Cardiac M <45.50 40 18 — — $41,015.54 $61,523.31 $41,015.54 2025-09-11
B1501 LOCAL Pulmonary M >=68.50 40 18 — — $24,349.75 $36,524.63 $24,349.75 2025-09-11
B1502 LOCAL Pulmonary M >=56.50 And M <68.50 40 18 — — $30,888.77 $46,333.16 $30,888.77 2025-09-11
B1503 LOCAL Pulmonary M >=45.50 And M <56.50 40 18 — — $35,105.39 $52,658.09 $35,105.39 2025-09-11
B1504 LOCAL Pulmonary M <45.50 40 18 — — $43,473.65 $65,210.48 $43,473.65 2025-09-11
B1601 LOCAL Pain Syndrome M >=65.50 40 18 — — $25,024.49 $37,536.74 $25,024.49 2025-09-11
B1602 LOCAL Pain Syndrome M >=58.50 And M <65.50 40 18 — — $28,677.24 $43,015.86 $28,677.24 2025-09-11
B1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 40 18 — — $36,215.93 $54,323.90 $36,215.93 2025-09-11
B1604 LOCAL Pain Syndrome M <43.50 40 18 — — $44,870.90 $67,306.35 $44,870.90 2025-09-11
B1701 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50 40 18 — — $25,557.78 $38,336.67 $25,557.78 2025-09-11
B1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 40 18 — — $31,752.73 $47,629.10 $31,752.73 2025-09-11
B1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 40 18 — — $37,731.70 $56,597.55 $37,731.70 2025-09-11
B1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 40 18 — — $42,707.16 $64,060.74 $42,707.16 2025-09-11
B1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 40 18 — — $50,117.79 $75,176.69 $50,117.79 2025-09-11
B1802 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50 40 18 — — $27,190.14 $40,785.21 $27,190.14 2025-09-11
B1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 40 18 — — $34,933.36 $52,400.04 $34,933.36 2025-09-11
B1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 40 18 — — $38,201.91 $57,302.87 $38,201.91 2025-09-11
B1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 40 18 — — $46,315.95 $69,473.93 $46,315.95 2025-09-11
B1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 40 18 — — $65,776.25 $98,664.38 $65,776.25 2025-09-11
B1902 LOCAL Guillain-barré M >=51.50 And M <66.50 40 18 — — $31,815.81 $47,723.72 $31,815.81 2025-09-11
B1903 LOCAL Guillain-barré M >=38.50 And M <51.50 40 18 — — $48,003.74 $72,005.61 $48,003.74 2025-09-11
B1904 LOCAL Guillain-barré M <38.50 40 18 — — $69,925.98 $104,888.97 $69,925.98 2025-09-11
B2001 LOCAL Miscellaneous M >=66.50 40 18 — — $22,562.56 $33,843.84 $22,562.56 2025-09-11
B2002 LOCAL Miscellaneous M >=55.50 And M <66.50 40 18 — — $28,132.48 $42,198.72 $28,132.48 2025-09-11
B2003 LOCAL Miscellaneous M >=46.50 And M <55.50 40 18 — — $33,689.02 $50,533.53 $33,689.02 2025-09-11
B2004 LOCAL Miscellaneous M <46.50 And A >=77.50 40 18 — — $40,279.64 $60,419.46 $40,279.64 2025-09-11
B2005 LOCAL Miscellaneous M <46.50 And A <77.50 40 18 — — $42,456.76 $63,685.14 $42,456.76 2025-09-11
B2101 LOCAL Burns M >=52.50 40 18 — — $28,765.16 $43,147.74 $28,765.16 2025-09-11
B2102 LOCAL Burns M <52.50 40 18 — — $44,299.39 $66,449.09 $44,299.39 2025-09-11
C0103 LOCAL Stroke M >=50.50 And M <63.50 40 18 — — $26,544.08 $39,816.12 $26,544.08 2025-09-11
C0104 LOCAL Stroke M >=41.50 And M <50.50 40 18 — — $33,874.43 $50,811.65 $33,874.43 2025-09-11
C0105 LOCAL Stroke M <41.50 And A >=84.50 40 18 — — $42,359.28 $63,538.92 $42,359.28 2025-09-11
C0106 LOCAL Stroke M <41.50 And A <84.50 40 18 — — $48,179.60 $72,269.40 $48,179.60 2025-09-11
C0202 LOCAL Traumatic Brain Injury M >=61.50 And M <73.50 40 18 — — $20,995.19 $31,492.79 $20,995.19 2025-09-11
C0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 40 18 — — $26,146.50 $39,219.75 $26,146.50 2025-09-11
C0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 40 18 — — $32,429.38 $48,644.07 $32,429.38 2025-09-11
C0205 LOCAL Traumatic Brain Injury M <35.50 40 18 — — $41,537.36 $62,306.04 $41,537.36 2025-09-11
C0302 LOCAL Non-traumatic Brain Injury M >=52.50 And M <65.50 40 18 — — $23,701.78 $35,552.67 $23,701.78 2025-09-11
C0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 40 18 — — $28,516.68 $42,775.02 $28,516.68 2025-09-11
C0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 40 18 — — $33,063.98 $49,595.97 $33,063.98 2025-09-11
C0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 40 18 — — $36,464.42 $54,696.63 $36,464.42 2025-09-11
C0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 40 18 — — $26,438.95 $39,658.43 $26,438.95 2025-09-11
C0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 40 18 — — $33,178.66 $49,767.99 $33,178.66 2025-09-11
C0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 40 18 — — $51,803.67 $77,705.51 $51,803.67 2025-09-11
C0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 40 18 — — $41,197.13 $61,795.70 $41,197.13 2025-09-11
C0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 40 18 — — $52,566.34 $78,849.51 $52,566.34 2025-09-11
C0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 40 18 — — $71,864.17 $107,796.26 $71,864.17 2025-09-11
C0502 LOCAL Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 40 18 — — $23,688.40 $35,532.60 $23,688.40 2025-09-11
C0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 40 18 — — $27,153.83 $40,730.75 $27,153.83 2025-09-11
C0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 40 18 — — $32,278.38 $48,417.57 $32,278.38 2025-09-11
C0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 40 18 — — $44,853.70 $67,280.55 $44,853.70 2025-09-11
C0602 LOCAL Neurological M >=52.50 And M <64.50 40 18 — — $24,118.47 $36,177.71 $24,118.47 2025-09-11
C0603 LOCAL Neurological M >=43.50 And M <52.50 40 18 — — $28,417.28 $42,625.92 $28,417.28 2025-09-11
C0604 LOCAL Neurological M <43.50 40 18 — — $35,638.68 $53,458.02 $35,638.68 2025-09-11
C0702 LOCAL Fracture Of Lower Extremity M >=52.50 And M <61.50 40 18 — — $22,906.62 $34,359.93 $22,906.62 2025-09-11
C0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 40 18 — — $28,168.80 $42,253.20 $28,168.80 2025-09-11
C0704 LOCAL Fracture Of Lower Extremity M <41.50 40 18 — — $34,411.54 $51,617.31 $34,411.54 2025-09-11
C0802 LOCAL Replacement Of Lower-extremity Joint M >=57.50 And M <63.50 40 18 — — $21,140.46 $31,710.69 $21,140.46 2025-09-11
C0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 40 18 — — $23,529.75 $35,294.63 $23,529.75 2025-09-11
C0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 40 18 — — $26,360.58 $39,540.87 $26,360.58 2025-09-11
C0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 40 18 — — $31,615.11 $47,422.67 $31,615.11 2025-09-11
C0902 LOCAL Other Orthopedic M >=51.50 And M <63.50 40 18 — — $22,914.27 $34,371.41 $22,914.27 2025-09-11
C0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 40 18 — — $27,362.17 $41,043.26 $27,362.17 2025-09-11
C0904 LOCAL Other Orthopedic M <44.5 40 18 — — $32,786.82 $49,180.23 $32,786.82 2025-09-11
C1002 LOCAL Amputation Lower Extremity M >=55.50 And M <64.50 40 18 — — $24,250.36 $36,375.54 $24,250.36 2025-09-11
C1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 40 18 — — $28,413.46 $42,620.19 $28,413.46 2025-09-11
C1004 LOCAL Amputation Lower Extremity M <47.50 40 18 — — $36,376.49 $54,564.74 $36,376.49 2025-09-11
C1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 40 18 — — $24,711.01 $37,066.52 $24,711.01 2025-09-11
C1103 LOCAL Amputation Non-lower Extremity M <52.50 40 18 — — $30,816.13 $46,224.20 $30,816.13 2025-09-11
C1202 LOCAL Osteoarthritis M >=49.50 And M <61.50 40 18 — — $23,357.72 $35,036.58 $23,357.72 2025-09-11
C1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 40 18 — — $30,259.91 $45,389.87 $30,259.91 2025-09-11
C1204 LOCAL Osteoarthritis M <49.50 And A <74.50 40 18 — — $31,733.62 $47,600.43 $31,733.62 2025-09-11
C1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 40 18 — — $23,558.42 $35,337.63 $23,558.42 2025-09-11
C1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 40 18 — — $26,802.12 $40,203.18 $26,802.12 2025-09-11
C1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 40 18 — — $33,845.75 $50,768.63 $33,845.75 2025-09-11
C1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 40 18 — — $32,412.18 $48,618.27 $32,412.18 2025-09-11
C1402 LOCAL Cardiac M >=55.50 And M <68.50 40 18 — — $21,551.41 $32,327.12 $21,551.41 2025-09-11
C1403 LOCAL Cardiac M >=45.50 And M <55.50 40 18 — — $26,370.14 $39,555.21 $26,370.14 2025-09-11
C1404 LOCAL Cardiac M <45.50 40 18 — — $32,310.87 $48,466.31 $32,310.87 2025-09-11
C1502 LOCAL Pulmonary M >=56.50 And M <68.50 40 18 — — $25,070.36 $37,605.54 $25,070.36 2025-09-11
C1503 LOCAL Pulmonary M >=45.50 And M <56.50 40 18 — — $28,491.83 $42,737.75 $28,491.83 2025-09-11
C1504 LOCAL Pulmonary M <45.50 40 18 — — $35,285.06 $52,927.59 $35,285.06 2025-09-11
C1602 LOCAL Pain Syndrome M >=58.50 And M <65.50 40 18 — — $21,301.02 $31,951.53 $21,301.02 2025-09-11
C1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 40 18 — — $26,899.61 $40,349.42 $26,899.61 2025-09-11
C1604 LOCAL Pain Syndrome M <43.50 40 18 — — $33,327.76 $49,991.64 $33,327.76 2025-09-11
C1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 40 18 — — $24,682.34 $37,023.51 $24,682.34 2025-09-11
C1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 40 18 — — $29,329.04 $43,993.56 $29,329.04 2025-09-11
C1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 40 18 — — $33,195.87 $49,793.81 $33,195.87 2025-09-11
C1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 40 18 — — $38,956.93 $58,435.40 $38,956.93 2025-09-11
C1802 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50 40 18 — — $21,690.95 $32,536.43 $21,690.95 2025-09-11
C1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 40 18 — — $27,868.70 $41,803.05 $27,868.70 2025-09-11
C1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 40 18 — — $30,475.90 $45,713.85 $30,475.90 2025-09-11
C1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 40 18 — — $36,948.01 $55,422.02 $36,948.01 2025-09-11
C1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 40 18 — — $52,472.68 $78,709.02 $52,472.68 2025-09-11
C1902 LOCAL Guillain-barré M >=51.50 And M <66.50 40 18 — — $24,460.62 $36,690.93 $24,460.62 2025-09-11
C1903 LOCAL Guillain-barré M >=38.50 And M <51.50 40 18 — — $36,904.05 $55,356.08 $36,904.05 2025-09-11
C1904 LOCAL Guillain-barré M <38.50 40 18 — — $53,759.07 $80,638.61 $53,759.07 2025-09-11
C2002 LOCAL Miscellaneous M >=55.50 And M <66.50 40 18 — — $22,470.81 $33,706.22 $22,470.81 2025-09-11
C2003 LOCAL Miscellaneous M >=46.50 And M <55.50 40 18 — — $26,909.16 $40,363.74 $26,909.16 2025-09-11
C2004 LOCAL Miscellaneous M <46.50 And A >=77.50 40 18 — — $32,173.25 $48,259.88 $32,173.25 2025-09-11
C2005 LOCAL Miscellaneous M <46.50 And A <77.50 40 18 — — $33,912.65 $50,868.98 $33,912.65 2025-09-11
C2101 LOCAL Burns M >=52.50 40 18 — — $21,857.24 $32,785.86 $21,857.24 2025-09-11
C2102 LOCAL Burns M <52.50 40 18 — — $33,662.26 $50,493.39 $33,662.26 2025-09-11
D0103 LOCAL Stroke M >=50.50 And M <63.50 40 18 — — $24,256.09 $36,384.14 $24,256.09 2025-09-11
D0104 LOCAL Stroke M >=41.50 And M <50.50 40 18 — — $30,955.67 $46,433.51 $30,955.67 2025-09-11
D0105 LOCAL Stroke M <41.50 And A >=84.50 40 18 — — $38,708.44 $58,062.66 $38,708.44 2025-09-11
D0106 LOCAL Stroke M <41.50 And A <84.50 40 18 — — $44,027.96 $66,041.94 $44,027.96 2025-09-11
D0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 40 18 — — $23,747.65 $35,621.48 $23,747.65 2025-09-11
D0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 40 18 — — $29,453.28 $44,179.92 $29,453.28 2025-09-11
D0205 LOCAL Traumatic Brain Injury M <35.50 40 18 — — $37,727.88 $56,591.82 $37,727.88 2025-09-11
D0302 LOCAL Non-traumatic Brain Injury M >=52.50 And M <65.50 40 18 — — $21,771.23 $32,656.85 $21,771.23 2025-09-11
D0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 40 18 — — $26,196.20 $39,294.30 $26,196.20 2025-09-11
D0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 40 18 — — $30,372.68 $45,559.02 $30,372.68 2025-09-11
D0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 40 18 — — $33,495.96 $50,243.94 $33,495.96 2025-09-11
D0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 40 18 — — $25,664.82 $38,497.23 $25,664.82 2025-09-11
D0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 40 18 — — $32,207.66 $48,311.49 $32,207.66 2025-09-11
D0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 40 18 — — $50,287.91 $75,431.87 $50,287.91 2025-09-11
D0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 40 18 — — $39,991.01 $59,986.52 $39,991.01 2025-09-11
D0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 40 18 — — $51,027.63 $76,541.45 $51,027.63 2025-09-11
D0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 40 18 — — $69,761.59 $104,642.39 $69,761.59 2025-09-11
D0502 LOCAL Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 40 18 — — $22,380.98 $33,571.47 $22,380.98 2025-09-11
D0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 40 18 — — $25,653.35 $38,480.03 $25,653.35 2025-09-11
D0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 40 18 — — $30,495.01 $45,742.52 $30,495.01 2025-09-11
D0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 40 18 — — $42,374.57 $63,561.86 $42,374.57 2025-09-11
D0602 LOCAL Neurological M >=52.50 And M <64.50 40 18 — — $22,514.78 $33,772.17 $22,514.78 2025-09-11
D0603 LOCAL Neurological M >=43.50 And M <52.50 40 18 — — $26,528.79 $39,793.19 $26,528.79 2025-09-11
D0604 LOCAL Neurological M <43.50 40 18 — — $33,270.41 $49,905.62 $33,270.41 2025-09-11
D0702 LOCAL Fracture Of Lower Extremity M >=52.50 And M <61.50 40 18 — — $21,698.59 $32,547.89 $21,698.59 2025-09-11
D0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 40 18 — — $26,683.61 $40,025.42 $26,683.61 2025-09-11
D0704 LOCAL Fracture Of Lower Extremity M <41.50 40 18 — — $32,597.59 $48,896.39 $32,597.59 2025-09-11
D0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 40 18 — — $21,452.02 $32,178.03 $21,452.02 2025-09-11
D0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 40 18 — — $24,034.37 $36,051.56 $24,034.37 2025-09-11
D0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 40 18 — — $28,824.42 $43,236.63 $28,824.42 2025-09-11
D0902 LOCAL Other Orthopedic M >=51.50 And M <63.50 40 18 — — $21,356.45 $32,034.68 $21,356.45 2025-09-11
D0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 40 18 — — $25,504.26 $38,256.39 $25,504.26 2025-09-11
D0904 LOCAL Other Orthopedic M <44.5 40 18 — — $30,560.00 $45,840.00 $30,560.00 2025-09-11
D1002 LOCAL Amputation Lower Extremity M >=55.50 And M <64.50 40 18 — — $22,153.52 $33,230.28 $22,153.52 2025-09-11
D1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 40 18 — — $25,955.36 $38,933.04 $25,955.36 2025-09-11
D1004 LOCAL Amputation Lower Extremity M <47.50 40 18 — — $33,228.36 $49,842.54 $33,228.36 2025-09-11
D1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 40 18 — — $24,711.01 $37,066.52 $24,711.01 2025-09-11
D1103 LOCAL Amputation Non-lower Extremity M <52.50 40 18 — — $30,816.13 $46,224.20 $30,816.13 2025-09-11
D1202 LOCAL Osteoarthritis M >=49.50 And M <61.50 40 18 — — $21,901.21 $32,851.82 $21,901.21 2025-09-11
D1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 40 18 — — $28,373.32 $42,559.98 $28,373.32 2025-09-11
D1204 LOCAL Osteoarthritis M <49.50 And A <74.50 40 18 — — $29,753.38 $44,630.07 $29,753.38 2025-09-11
D1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 40 18 — — $22,488.02 $33,732.03 $22,488.02 2025-09-11
D1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 40 18 — — $25,582.63 $38,373.95 $25,582.63 2025-09-11
D1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 40 18 — — $32,307.05 $48,460.58 $32,307.05 2025-09-11
D1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 40 18 — — $30,938.46 $46,407.69 $30,938.46 2025-09-11
D1403 LOCAL Cardiac M >=45.50 And M <55.50 40 18 — — $24,517.96 $36,776.94 $24,517.96 2025-09-11
D1404 LOCAL Cardiac M <45.50 40 18 — — $30,042.00 $45,063.00 $30,042.00 2025-09-11
D1502 LOCAL Pulmonary M >=56.50 And M <68.50 40 18 — — $23,577.53 $35,366.30 $23,577.53 2025-09-11
D1503 LOCAL Pulmonary M >=45.50 And M <56.50 40 18 — — $26,796.39 $40,194.59 $26,796.39 2025-09-11
D1504 LOCAL Pulmonary M <45.50 40 18 — — $33,184.40 $49,776.60 $33,184.40 2025-09-11
D1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 40 18 — — $24,313.44 $36,470.16 $24,313.44 2025-09-11
D1604 LOCAL Pain Syndrome M <43.50 40 18 — — $30,124.19 $45,186.29 $30,124.19 2025-09-11
D1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 40 18 — — $22,858.83 $34,288.25 $22,858.83 2025-09-11
D1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 40 18 — — $27,163.38 $40,745.07 $27,163.38 2025-09-11
D1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 40 18 — — $30,743.50 $46,115.25 $30,743.50 2025-09-11
D1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 40 18 — — $36,078.31 $54,117.47 $36,078.31 2025-09-11
D1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 40 18 — — $26,458.06 $39,687.09 $26,458.06 2025-09-11
D1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 40 18 — — $28,931.46 $43,397.19 $28,931.46 2025-09-11
D1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 40 18 — — $35,076.72 $52,615.08 $35,076.72 2025-09-11
D1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 40 18 — — $49,815.78 $74,723.67 $49,815.78 2025-09-11
D1902 LOCAL Guillain-barré M >=51.50 And M <66.50 40 18 — — $22,824.43 $34,236.65 $22,824.43 2025-09-11
D1903 LOCAL Guillain-barré M >=38.50 And M <51.50 40 18 — — $34,436.39 $51,654.59 $34,436.39 2025-09-11
D1904 LOCAL Guillain-barré M <38.50 40 18 — — $50,163.66 $75,245.49 $50,163.66 2025-09-11
D2002 LOCAL Miscellaneous M >=55.50 And M <66.50 40 18 — — $20,991.36 $31,487.04 $20,991.36 2025-09-11
D2003 LOCAL Miscellaneous M >=46.50 And M <55.50 40 18 — — $25,137.26 $37,705.89 $25,137.26 2025-09-11
D2004 LOCAL Miscellaneous M <46.50 And A >=77.50 40 18 — — $30,055.38 $45,083.07 $30,055.38 2025-09-11
D2005 LOCAL Miscellaneous M <46.50 And A <77.50 40 18 — — $31,680.10 $47,520.15 $31,680.10 2025-09-11
D2101 LOCAL Burns M >=52.50 40 18 — — $21,857.24 $32,785.86 $21,857.24 2025-09-11
D2102 LOCAL Burns M <52.50 40 18 — — $33,662.26 $50,493.39 $33,662.26 2025-09-11
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