|
B1004
|
OTHER
|
Amputation Lower Extremity M <47.50
|
11
|
11
|
$44,606.81
|
$44,606.81
|
$42,376.47
|
$44,606.81
|
$44,606.81
|
2026-03-18
|
|
C1004
|
OTHER
|
Amputation Lower Extremity M <47.50
|
11
|
11
|
$37,064.76
|
$37,064.76
|
$35,211.52
|
$37,064.76
|
$37,064.76
|
2026-03-18
|
|
D1004
|
OTHER
|
Amputation Lower Extremity M <47.50
|
11
|
11
|
$33,641.02
|
$33,641.02
|
$31,958.97
|
$33,641.02
|
$33,641.02
|
2026-03-18
|
|
A1004
|
OTHER
|
Amputation Lower Extremity M <47.50
|
11
|
11
|
$31,236.47
|
$31,236.47
|
$29,674.65
|
$31,236.47
|
$31,236.47
|
2026-03-18
|
|
B1003
|
OTHER
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
11
|
11
|
$33,535.32
|
$33,535.32
|
$31,858.56
|
$33,535.32
|
$33,535.32
|
2026-03-18
|
|
C1003
|
OTHER
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
11
|
11
|
$27,865.57
|
$27,865.57
|
$26,472.29
|
$27,865.57
|
$27,865.57
|
2026-03-18
|
|
D1003
|
OTHER
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
11
|
11
|
$25,291.16
|
$25,291.16
|
$24,026.60
|
$25,291.16
|
$25,291.16
|
2026-03-18
|
|
A1003
|
OTHER
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
11
|
11
|
$23,483.03
|
$23,483.03
|
$22,308.88
|
$23,483.03
|
$23,483.03
|
2026-03-18
|
|
B1002
|
OTHER
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
11
|
11
|
$28,176.99
|
$28,176.99
|
$26,768.14
|
$28,176.99
|
$28,176.99
|
2026-03-18
|
|
C1002
|
OTHER
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
11
|
11
|
$23,413.20
|
$23,413.20
|
$22,242.54
|
$23,413.20
|
$23,413.20
|
2026-03-18
|
|
B1001
|
OTHER
|
Amputation Lower Extremity M >=64.50
|
11
|
11
|
$23,194.26
|
$23,194.26
|
$22,034.55
|
$23,194.26
|
$23,194.26
|
2026-03-18
|
|
B1103
|
OTHER
|
Amputation Non-lower Extremity M <52.50
|
11
|
11
|
$36,509.87
|
$36,509.87
|
$34,684.37
|
$36,509.87
|
$36,509.87
|
2026-03-18
|
|
C1103
|
OTHER
|
Amputation Non-lower Extremity M <52.50
|
11
|
11
|
$34,563.96
|
$34,563.96
|
$32,835.76
|
$34,563.96
|
$34,563.96
|
2026-03-18
|
|
D1103
|
OTHER
|
Amputation Non-lower Extremity M <52.50
|
11
|
11
|
$29,745.42
|
$29,745.42
|
$28,258.15
|
$29,745.42
|
$29,745.42
|
2026-03-18
|
|
A1103
|
OTHER
|
Amputation Non-lower Extremity M <52.50
|
11
|
11
|
$26,025.36
|
$26,025.36
|
$24,724.09
|
$26,025.36
|
$26,025.36
|
2026-03-18
|
|
B1102
|
OTHER
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
11
|
11
|
$29,149.01
|
$29,149.01
|
$27,691.56
|
$29,149.01
|
$29,149.01
|
2026-03-18
|
|
C1102
|
OTHER
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
11
|
11
|
$27,595.68
|
$27,595.68
|
$26,215.89
|
$27,595.68
|
$27,595.68
|
2026-03-18
|
|
D1102
|
OTHER
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
11
|
11
|
$23,747.27
|
$23,747.27
|
$22,559.90
|
$23,747.27
|
$23,747.27
|
2026-03-18
|
|
B1101
|
OTHER
|
Amputation Non-lower Extremity M >=58.50
|
11
|
11
|
$25,525.20
|
$25,525.20
|
$24,248.94
|
$25,525.20
|
$25,525.20
|
2026-03-18
|
|
C1101
|
OTHER
|
Amputation Non-lower Extremity M >=58.50
|
11
|
11
|
$24,166.27
|
$24,166.27
|
$22,957.96
|
$24,166.27
|
$24,166.27
|
2026-03-18
|
|
B2102
|
OTHER
|
Burns M <52.50
|
11
|
11
|
$48,036.22
|
$48,036.22
|
$45,634.41
|
$48,036.22
|
$48,036.22
|
2026-03-18
|
|
C2102
|
OTHER
|
Burns M <52.50
|
11
|
11
|
$40,384.70
|
$40,384.70
|
$38,365.46
|
$40,384.70
|
$40,384.70
|
2026-03-18
|
|
D2102
|
OTHER
|
Burns M <52.50
|
11
|
11
|
$30,455.09
|
$30,455.09
|
$28,932.33
|
$30,455.09
|
$30,455.09
|
2026-03-18
|
|
A2102
|
OTHER
|
Burns M <52.50
|
11
|
11
|
$29,205.63
|
$29,205.63
|
$27,745.35
|
$29,205.63
|
$29,205.63
|
2026-03-18
|
|
B2101
|
OTHER
|
Burns M >=52.50
|
11
|
11
|
$30,313.53
|
$30,313.53
|
$28,797.85
|
$30,313.53
|
$30,313.53
|
2026-03-18
|
|
C2101
|
OTHER
|
Burns M >=52.50
|
11
|
11
|
$25,485.56
|
$25,485.56
|
$24,211.28
|
$25,485.56
|
$25,485.56
|
2026-03-18
|
|
B1404
|
OTHER
|
Cardiac M <45.50
|
11
|
11
|
$40,518.70
|
$40,518.70
|
$38,492.77
|
$40,518.70
|
$40,518.70
|
2026-03-18
|
|
C1404
|
OTHER
|
Cardiac M <45.50
|
11
|
11
|
$32,640.70
|
$32,640.70
|
$31,008.66
|
$32,640.70
|
$32,640.70
|
2026-03-18
|
|
D1404
|
OTHER
|
Cardiac M <45.50
|
11
|
11
|
$30,181.41
|
$30,181.41
|
$28,672.34
|
$30,181.41
|
$30,181.41
|
2026-03-18
|
|
A1404
|
OTHER
|
Cardiac M <45.50
|
11
|
11
|
$27,754.22
|
$27,754.22
|
$26,366.51
|
$27,754.22
|
$27,754.22
|
2026-03-18
|
|
B1403
|
OTHER
|
Cardiac M >=45.50 And M <55.50
|
11
|
11
|
$32,476.49
|
$32,476.49
|
$30,852.67
|
$32,476.49
|
$32,476.49
|
2026-03-18
|
|
C1403
|
OTHER
|
Cardiac M >=45.50 And M <55.50
|
11
|
11
|
$26,161.25
|
$26,161.25
|
$24,853.19
|
$26,161.25
|
$26,161.25
|
2026-03-18
|
|
D1403
|
OTHER
|
Cardiac M >=45.50 And M <55.50
|
11
|
11
|
$24,188.92
|
$24,188.92
|
$22,979.47
|
$24,188.92
|
$24,188.92
|
2026-03-18
|
|
B1402
|
OTHER
|
Cardiac M >=55.50 And M <68.50
|
11
|
11
|
$26,869.03
|
$26,869.03
|
$25,525.58
|
$26,869.03
|
$26,869.03
|
2026-03-18
|
|
A5104
|
OTHER
|
Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More
|
11
|
11
|
$41,298.20
|
$41,298.20
|
$39,233.29
|
$41,298.20
|
$41,298.20
|
2026-03-18
|
|
A5102
|
OTHER
|
Expired, Orthopedic, Length Of Stay Is 14 Days Or More
|
11
|
11
|
$38,663.39
|
$38,663.39
|
$36,730.22
|
$38,663.39
|
$38,663.39
|
2026-03-18
|
|
B0704
|
OTHER
|
Fracture Of Lower Extremity M <41.50
|
11
|
11
|
$43,296.96
|
$43,296.96
|
$41,132.11
|
$43,296.96
|
$43,296.96
|
2026-03-18
|
|
C0704
|
OTHER
|
Fracture Of Lower Extremity M <41.50
|
11
|
11
|
$34,618.69
|
$34,618.69
|
$32,887.76
|
$34,618.69
|
$34,618.69
|
2026-03-18
|
|
D0704
|
OTHER
|
Fracture Of Lower Extremity M <41.50
|
11
|
11
|
$32,878.51
|
$32,878.51
|
$31,234.58
|
$32,878.51
|
$32,878.51
|
2026-03-18
|
|
A0704
|
OTHER
|
Fracture Of Lower Extremity M <41.50
|
11
|
11
|
$30,043.63
|
$30,043.63
|
$28,541.45
|
$30,043.63
|
$30,043.63
|
2026-03-18
|
|
B0703
|
OTHER
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
11
|
11
|
$35,064.12
|
$35,064.12
|
$33,310.91
|
$35,064.12
|
$35,064.12
|
2026-03-18
|
|
C0703
|
OTHER
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
11
|
11
|
$28,035.44
|
$28,035.44
|
$26,633.67
|
$28,035.44
|
$28,035.44
|
2026-03-18
|
|
D0703
|
OTHER
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
11
|
11
|
$26,627.44
|
$26,627.44
|
$25,296.07
|
$26,627.44
|
$26,627.44
|
2026-03-18
|
|
A0703
|
OTHER
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
11
|
11
|
$24,332.36
|
$24,332.36
|
$23,115.74
|
$24,332.36
|
$24,332.36
|
2026-03-18
|
|
B0702
|
OTHER
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
11
|
11
|
$28,622.42
|
$28,622.42
|
$27,191.30
|
$28,622.42
|
$28,622.42
|
2026-03-18
|
|
C0702
|
OTHER
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
11
|
11
|
$22,884.72
|
$22,884.72
|
$21,740.49
|
$22,884.72
|
$22,884.72
|
2026-03-18
|
|
B0701
|
OTHER
|
Fracture Of Lower Extremity M >=61.50
|
11
|
11
|
$23,156.51
|
$23,156.51
|
$21,998.69
|
$23,156.51
|
$23,156.51
|
2026-03-18
|
|
92218460
|
CDM
|
Gamunex-c 1 Gm/10 Ml Sol
|
11
|
11
|
$27,997.20
|
$27,997.20
|
$27,997.20
|
$27,997.20
|
$27,997.20
|
2026-03-18
|
|
B1904
|
OTHER
|
Guillain-barré M <38.50
|
11
|
11
|
$80,093.71
|
$80,093.71
|
$76,089.02
|
$80,093.71
|
$80,093.71
|
2026-03-18
|
|
C1904
|
OTHER
|
Guillain-barré M <38.50
|
11
|
11
|
$56,605.01
|
$56,605.01
|
$53,774.76
|
$56,605.01
|
$56,605.01
|
2026-03-18
|
|
A1904
|
OTHER
|
Guillain-barré M <38.50
|
11
|
11
|
$49,223.39
|
$49,223.39
|
$46,762.22
|
$49,223.39
|
$49,223.39
|
2026-03-18
|
|
D1904
|
OTHER
|
Guillain-barré M <38.50
|
11
|
11
|
$49,208.29
|
$49,208.29
|
$46,747.88
|
$49,208.29
|
$49,208.29
|
2026-03-18
|
|
B1903
|
OTHER
|
Guillain-barré M >=38.50 And M <51.50
|
11
|
11
|
$52,086.58
|
$52,086.58
|
$49,482.25
|
$52,086.58
|
$52,086.58
|
2026-03-18
|
|
C1903
|
OTHER
|
Guillain-barré M >=38.50 And M <51.50
|
11
|
11
|
$36,811.85
|
$36,811.85
|
$34,971.26
|
$36,811.85
|
$36,811.85
|
2026-03-18
|
|
A1903
|
OTHER
|
Guillain-barré M >=38.50 And M <51.50
|
11
|
11
|
$32,010.30
|
$32,010.30
|
$30,409.79
|
$32,010.30
|
$32,010.30
|
2026-03-18
|
|
D1903
|
OTHER
|
Guillain-barré M >=38.50 And M <51.50
|
11
|
11
|
$32,002.75
|
$32,002.75
|
$30,402.62
|
$32,002.75
|
$32,002.75
|
2026-03-18
|
|
B1902
|
OTHER
|
Guillain-barré M >=51.50 And M <66.50
|
11
|
11
|
$36,813.74
|
$36,813.74
|
$34,973.05
|
$36,813.74
|
$36,813.74
|
2026-03-18
|
|
C1902
|
OTHER
|
Guillain-barré M >=51.50 And M <66.50
|
11
|
11
|
$26,017.81
|
$26,017.81
|
$24,716.92
|
$26,017.81
|
$26,017.81
|
2026-03-18
|
|
A1902
|
OTHER
|
Guillain-barré M >=51.50 And M <66.50
|
11
|
11
|
$22,624.26
|
$22,624.26
|
$21,493.05
|
$22,624.26
|
$22,624.26
|
2026-03-18
|
|
D1902
|
OTHER
|
Guillain-barré M >=51.50 And M <66.50
|
11
|
11
|
$22,618.60
|
$22,618.60
|
$21,487.67
|
$22,618.60
|
$22,618.60
|
2026-03-18
|
|
B1901
|
OTHER
|
Guillain-barré M >=66.50
|
11
|
11
|
$25,304.37
|
$25,304.37
|
$24,039.15
|
$25,304.37
|
$25,304.37
|
2026-03-18
|
|
76085056
|
CDM
|
In-111 Pentetr Dx To 6mci
|
11
|
11
|
$23,220.35
|
$23,220.35
|
$23,220.35
|
$23,220.35
|
$23,220.35
|
2026-03-18
|
|
76085057
|
CDM
|
In111 Satumomab Dx To 6mc
|
11
|
11
|
$24,275.29
|
$24,275.29
|
$24,275.29
|
$24,275.29
|
$24,275.29
|
2026-03-18
|
|
74080268
|
CDM
|
Insert Tips
|
11
|
11
|
$48,288.18
|
$48,288.18
|
$48,288.18
|
$48,288.18
|
$48,288.18
|
2026-03-18
|
|
92220143
|
CDM
|
Interferon Beta-1a30mcg/0.5ml
|
11
|
11
|
$25,431.50
|
$25,431.50
|
$25,431.50
|
$25,431.50
|
$25,431.50
|
2026-03-18
|
|
36901
|
CPT
|
Intro Dial Graft
|
11
|
11
|
$28,319.15
|
$28,319.15
|
$28,319.15
|
$28,319.15
|
$28,319.15
|
2026-03-18
|
|
77020083
|
CDM
|
Liver Tumor Ablat Rf Perc
|
11
|
11
|
$25,297.02
|
$25,297.02
|
$25,297.02
|
$25,297.02
|
$25,297.02
|
2026-03-18
|
|
B1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
11
|
11
|
$67,793.52
|
$67,793.52
|
$64,403.84
|
$67,793.52
|
$67,793.52
|
2026-03-18
|
|
C1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
11
|
11
|
$55,461.25
|
$55,461.25
|
$52,688.19
|
$55,461.25
|
$55,461.25
|
2026-03-18
|
|
D1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
11
|
11
|
$51,020.20
|
$51,020.20
|
$48,469.19
|
$51,020.20
|
$51,020.20
|
2026-03-18
|
|
A1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
11
|
11
|
$47,887.11
|
$47,887.11
|
$45,492.76
|
$47,887.11
|
$47,887.11
|
2026-03-18
|
|
B1805
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
11
|
11
|
$46,792.42
|
$46,792.42
|
$44,452.80
|
$46,792.42
|
$46,792.42
|
2026-03-18
|
|
C1805
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
11
|
11
|
$38,280.25
|
$38,280.25
|
$36,366.23
|
$38,280.25
|
$38,280.25
|
2026-03-18
|
|
D1805
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
11
|
11
|
$35,215.11
|
$35,215.11
|
$33,454.35
|
$35,215.11
|
$35,215.11
|
2026-03-18
|
|
A1805
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
11
|
11
|
$33,052.15
|
$33,052.15
|
$31,399.54
|
$33,052.15
|
$33,052.15
|
2026-03-18
|
|
B1804
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
11
|
11
|
$39,003.12
|
$39,003.12
|
$37,052.96
|
$39,003.12
|
$39,003.12
|
2026-03-18
|
|
C1804
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
11
|
11
|
$31,908.38
|
$31,908.38
|
$30,312.97
|
$31,908.38
|
$31,908.38
|
2026-03-18
|
|
D1804
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
11
|
11
|
$29,352.84
|
$29,352.84
|
$27,885.20
|
$29,352.84
|
$29,352.84
|
2026-03-18
|
|
A1804
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
11
|
11
|
$27,550.38
|
$27,550.38
|
$26,172.86
|
$27,550.38
|
$27,550.38
|
2026-03-18
|
|
B1803
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
11
|
11
|
$33,395.66
|
$33,395.66
|
$31,725.87
|
$33,395.66
|
$33,395.66
|
2026-03-18
|
|
C1803
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
11
|
11
|
$27,320.12
|
$27,320.12
|
$25,954.11
|
$27,320.12
|
$27,320.12
|
2026-03-18
|
|
D1803
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
11
|
11
|
$25,132.62
|
$25,132.62
|
$23,875.99
|
$25,132.62
|
$25,132.62
|
2026-03-18
|
|
A1803
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
11
|
11
|
$23,588.73
|
$23,588.73
|
$22,409.29
|
$23,588.73
|
$23,588.73
|
2026-03-18
|
|
B1802
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
11
|
11
|
$26,844.49
|
$26,844.49
|
$25,502.27
|
$26,844.49
|
$26,844.49
|
2026-03-18
|
|
B1705
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
11
|
11
|
$48,236.28
|
$48,236.28
|
$45,824.47
|
$48,236.28
|
$48,236.28
|
2026-03-18
|
|
C1705
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
11
|
11
|
$38,214.19
|
$38,214.19
|
$36,303.48
|
$38,214.19
|
$38,214.19
|
2026-03-18
|
|
D1705
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
11
|
11
|
$35,481.23
|
$35,481.23
|
$33,707.17
|
$35,481.23
|
$35,481.23
|
2026-03-18
|
|
A1705
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
11
|
11
|
$32,663.34
|
$32,663.34
|
$31,030.18
|
$32,663.34
|
$32,663.34
|
2026-03-18
|
|
B1704
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
11
|
11
|
$41,434.09
|
$41,434.09
|
$39,362.39
|
$41,434.09
|
$41,434.09
|
2026-03-18
|
|
C1704
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
11
|
11
|
$32,825.66
|
$32,825.66
|
$31,184.38
|
$32,825.66
|
$32,825.66
|
2026-03-18
|
|
D1704
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
11
|
11
|
$30,477.74
|
$30,477.74
|
$28,953.85
|
$30,477.74
|
$30,477.74
|
2026-03-18
|
|
A1704
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
11
|
11
|
$28,058.09
|
$28,058.09
|
$26,655.18
|
$28,058.09
|
$28,058.09
|
2026-03-18
|
|
B1703
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
11
|
11
|
$36,007.82
|
$36,007.82
|
$34,207.43
|
$36,007.82
|
$36,007.82
|
2026-03-18
|
|
C1703
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
11
|
11
|
$28,526.16
|
$28,526.16
|
$27,099.86
|
$28,526.16
|
$28,526.16
|
2026-03-18
|
|
D1703
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
11
|
11
|
$26,485.88
|
$26,485.88
|
$25,161.59
|
$26,485.88
|
$26,485.88
|
2026-03-18
|
|
A1703
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
11
|
11
|
$24,383.32
|
$24,383.32
|
$23,164.15
|
$24,383.32
|
$24,383.32
|
2026-03-18
|
|
B1702
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
11
|
11
|
$30,689.12
|
$30,689.12
|
$29,154.67
|
$30,689.12
|
$30,689.12
|
2026-03-18
|
|
C1702
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
11
|
11
|
$24,311.60
|
$24,311.60
|
$23,096.02
|
$24,311.60
|
$24,311.60
|
2026-03-18
|
|
B1701
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50
|
11
|
11
|
$24,896.69
|
$24,896.69
|
$23,651.86
|
$24,896.69
|
$24,896.69
|
2026-03-18
|
|
B2005
|
OTHER
|
Miscellaneous M <46.50 And A <77.50
|
11
|
11
|
$41,745.51
|
$41,745.51
|
$39,658.24
|
$41,745.51
|
$41,745.51
|
2026-03-18
|
|
C2005
|
OTHER
|
Miscellaneous M <46.50 And A <77.50
|
11
|
11
|
$33,478.70
|
$33,478.70
|
$31,804.77
|
$33,478.70
|
$33,478.70
|
2026-03-18
|
|
D2005
|
OTHER
|
Miscellaneous M <46.50 And A <77.50
|
11
|
11
|
$31,134.55
|
$31,134.55
|
$29,577.82
|
$31,134.55
|
$31,134.55
|
2026-03-18
|
|
A2005
|
OTHER
|
Miscellaneous M <46.50 And A <77.50
|
11
|
11
|
$28,501.63
|
$28,501.63
|
$27,076.55
|
$28,501.63
|
$28,501.63
|
2026-03-18
|
|
B2004
|
OTHER
|
Miscellaneous M <46.50 And A >=77.50
|
11
|
11
|
$39,882.65
|
$39,882.65
|
$37,888.52
|
$39,882.65
|
$39,882.65
|
2026-03-18
|
|
C2004
|
OTHER
|
Miscellaneous M <46.50 And A >=77.50
|
11
|
11
|
$31,983.88
|
$31,983.88
|
$30,384.69
|
$31,983.88
|
$31,983.88
|
2026-03-18
|
|
D2004
|
OTHER
|
Miscellaneous M <46.50 And A >=77.50
|
11
|
11
|
$29,745.42
|
$29,745.42
|
$28,258.15
|
$29,745.42
|
$29,745.42
|
2026-03-18
|
|
A2004
|
OTHER
|
Miscellaneous M <46.50 And A >=77.50
|
11
|
11
|
$27,229.52
|
$27,229.52
|
$25,868.04
|
$27,229.52
|
$27,229.52
|
2026-03-18
|
|
B2003
|
OTHER
|
Miscellaneous M >=46.50 And M <55.50
|
11
|
11
|
$32,701.09
|
$32,701.09
|
$31,066.04
|
$32,701.09
|
$32,701.09
|
2026-03-18
|
|
C2003
|
OTHER
|
Miscellaneous M >=46.50 And M <55.50
|
11
|
11
|
$26,225.42
|
$26,225.42
|
$24,914.15
|
$26,225.42
|
$26,225.42
|
2026-03-18
|
|
D2003
|
OTHER
|
Miscellaneous M >=46.50 And M <55.50
|
11
|
11
|
$24,388.98
|
$24,388.98
|
$23,169.53
|
$24,388.98
|
$24,388.98
|
2026-03-18
|
|
B2002
|
OTHER
|
Miscellaneous M >=55.50 And M <66.50
|
11
|
11
|
$27,848.59
|
$27,848.59
|
$26,456.16
|
$27,848.59
|
$27,848.59
|
2026-03-18
|
|
74080421
|
CDM
|
Nephrostolithotm/pyel<2cm
|
11
|
11
|
$23,284.61
|
$23,284.61
|
$23,284.61
|
$23,284.61
|
$23,284.61
|
2026-03-18
|
|
B0604
|
OTHER
|
Neurological M <43.50
|
11
|
11
|
$46,237.53
|
$46,237.53
|
$43,925.65
|
$46,237.53
|
$46,237.53
|
2026-03-18
|
|
C0604
|
OTHER
|
Neurological M <43.50
|
11
|
11
|
$35,016.93
|
$35,016.93
|
$33,266.09
|
$35,016.93
|
$35,016.93
|
2026-03-18
|
|
D0604
|
OTHER
|
Neurological M <43.50
|
11
|
11
|
$32,982.32
|
$32,982.32
|
$31,333.20
|
$32,982.32
|
$32,982.32
|
2026-03-18
|
|
A0604
|
OTHER
|
Neurological M <43.50
|
11
|
11
|
$29,624.63
|
$29,624.63
|
$28,143.40
|
$29,624.63
|
$29,624.63
|
2026-03-18
|
|
B0603
|
OTHER
|
Neurological M >=43.50 And M <52.50
|
11
|
11
|
$36,558.94
|
$36,558.94
|
$34,730.99
|
$36,558.94
|
$36,558.94
|
2026-03-18
|
|
C0603
|
OTHER
|
Neurological M >=43.50 And M <52.50
|
11
|
11
|
$27,688.16
|
$27,688.16
|
$26,303.75
|
$27,688.16
|
$27,688.16
|
2026-03-18
|
|
D0603
|
OTHER
|
Neurological M >=43.50 And M <52.50
|
11
|
11
|
$26,078.21
|
$26,078.21
|
$24,774.30
|
$26,078.21
|
$26,078.21
|
2026-03-18
|
|
A0603
|
OTHER
|
Neurological M >=43.50 And M <52.50
|
11
|
11
|
$23,424.52
|
$23,424.52
|
$22,253.30
|
$23,424.52
|
$23,424.52
|
2026-03-18
|
|
B0602
|
OTHER
|
Neurological M >=52.50 And M <64.50
|
11
|
11
|
$30,743.86
|
$30,743.86
|
$29,206.67
|
$30,743.86
|
$30,743.86
|
2026-03-18
|
|
C0602
|
OTHER
|
Neurological M >=52.50 And M <64.50
|
11
|
11
|
$23,284.85
|
$23,284.85
|
$22,120.61
|
$23,284.85
|
$23,284.85
|
2026-03-18
|
|
B0601
|
OTHER
|
Neurological M >=64.50
|
11
|
11
|
$24,715.50
|
$24,715.50
|
$23,479.73
|
$24,715.50
|
$24,715.50
|
2026-03-18
|
|
B0305
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
11
|
11
|
$44,729.49
|
$44,729.49
|
$42,493.02
|
$44,729.49
|
$44,729.49
|
2026-03-18
|
|
C0305
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
11
|
11
|
$35,451.03
|
$35,451.03
|
$33,678.48
|
$35,451.03
|
$35,451.03
|
2026-03-18
|
|
D0305
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
11
|
11
|
$33,050.26
|
$33,050.26
|
$31,397.75
|
$33,050.26
|
$33,050.26
|
2026-03-18
|
|
A0305
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
11
|
11
|
$30,940.15
|
$30,940.15
|
$29,393.14
|
$30,940.15
|
$30,940.15
|
2026-03-18
|
|
B0304
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
11
|
11
|
$40,833.90
|
$40,833.90
|
$38,792.20
|
$40,833.90
|
$40,833.90
|
2026-03-18
|
|
C0304
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
11
|
11
|
$32,363.25
|
$32,363.25
|
$30,745.09
|
$32,363.25
|
$32,363.25
|
2026-03-18
|
|
D0304
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
11
|
11
|
$30,170.09
|
$30,170.09
|
$28,661.58
|
$30,170.09
|
$30,170.09
|
2026-03-18
|
|
A0304
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
11
|
11
|
$28,244.94
|
$28,244.94
|
$26,832.69
|
$28,244.94
|
$28,244.94
|
2026-03-18
|
|
B0303
|
OTHER
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
11
|
11
|
$34,467.70
|
$34,467.70
|
$32,744.31
|
$34,467.70
|
$34,467.70
|
2026-03-18
|
|
C0303
|
OTHER
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
11
|
11
|
$27,318.23
|
$27,318.23
|
$25,952.32
|
$27,318.23
|
$27,318.23
|
2026-03-18
|
|
D0303
|
OTHER
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
11
|
11
|
$25,468.58
|
$25,468.58
|
$24,195.15
|
$25,468.58
|
$25,468.58
|
2026-03-18
|
|
A0303
|
OTHER
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
11
|
11
|
$23,843.52
|
$23,843.52
|
$22,651.35
|
$23,843.52
|
$23,843.52
|
2026-03-18
|
|
B0302
|
OTHER
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
11
|
11
|
$29,150.89
|
$29,150.89
|
$27,693.35
|
$29,150.89
|
$29,150.89
|
2026-03-18
|
|
C0302
|
OTHER
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
11
|
11
|
$23,103.66
|
$23,103.66
|
$21,948.48
|
$23,103.66
|
$23,103.66
|
2026-03-18
|
|
B0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
11
|
11
|
$58,966.15
|
$58,966.15
|
$56,017.84
|
$58,966.15
|
$58,966.15
|
2026-03-18
|
|
C0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
11
|
11
|
$45,314.59
|
$45,314.59
|
$43,048.86
|
$45,314.59
|
$45,314.59
|
2026-03-18
|
|
D0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
11
|
11
|
$42,156.97
|
$42,156.97
|
$40,049.12
|
$42,156.97
|
$42,156.97
|
2026-03-18
|
|
A0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
11
|
11
|
$38,850.24
|
$38,850.24
|
$36,907.73
|
$38,850.24
|
$38,850.24
|
2026-03-18
|
|
B0504
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
11
|
11
|
$41,502.04
|
$41,502.04
|
$39,426.94
|
$41,502.04
|
$41,502.04
|
2026-03-18
|
|
C0504
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
11
|
11
|
$31,893.29
|
$31,893.29
|
$30,298.62
|
$31,893.29
|
$31,893.29
|
2026-03-18
|
|
D0504
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
11
|
11
|
$29,669.93
|
$29,669.93
|
$28,186.43
|
$29,669.93
|
$29,669.93
|
2026-03-18
|
|
A0504
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
11
|
11
|
$27,342.76
|
$27,342.76
|
$25,975.63
|
$27,342.76
|
$27,342.76
|
2026-03-18
|
|
B0503
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
11
|
11
|
$34,731.93
|
$34,731.93
|
$32,995.34
|
$34,731.93
|
$34,731.93
|
2026-03-18
|
|
C0503
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
11
|
11
|
$26,691.61
|
$26,691.61
|
$25,357.03
|
$26,691.61
|
$26,691.61
|
2026-03-18
|
|
D0503
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
11
|
11
|
$24,830.63
|
$24,830.63
|
$23,589.10
|
$24,830.63
|
$24,830.63
|
2026-03-18
|
|
A0503
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
11
|
11
|
$22,882.84
|
$22,882.84
|
$21,738.70
|
$22,882.84
|
$22,882.84
|
2026-03-18
|
|
B0502
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
11
|
11
|
$30,672.14
|
$30,672.14
|
$29,138.53
|
$30,672.14
|
$30,672.14
|
2026-03-18
|
|
C0502
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
11
|
11
|
$23,571.74
|
$23,571.74
|
$22,393.15
|
$23,571.74
|
$23,571.74
|
2026-03-18
|
|
B0501
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=60.50
|
11
|
11
|
$24,706.07
|
$24,706.07
|
$23,470.76
|
$24,706.07
|
$24,706.07
|
2026-03-18
|
|
74080532
|
CDM
|
Occ/emb Hemorrhag/lymph
|
11
|
11
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
2026-03-18
|
|
74080530
|
CDM
|
Occ/emb Non Hemorr Art
|
11
|
11
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
2026-03-18
|
|
74080529
|
CDM
|
Occ/emb Non Hemorr Venous
|
11
|
11
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
2026-03-18
|
|
74080531
|
CDM
|
Occ/emb Tumor/organ Infar
|
11
|
11
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
$56,399.93
|
2026-03-18
|
|
B1204
|
OTHER
|
Osteoarthritis M <49.50 And A <74.50
|
11
|
11
|
$40,513.04
|
$40,513.04
|
$38,487.39
|
$40,513.04
|
$40,513.04
|
2026-03-18
|
|
C1204
|
OTHER
|
Osteoarthritis M <49.50 And A <74.50
|
11
|
11
|
$32,155.63
|
$32,155.63
|
$30,547.85
|
$32,155.63
|
$32,155.63
|
2026-03-18
|
|
D1204
|
OTHER
|
Osteoarthritis M <49.50 And A <74.50
|
11
|
11
|
$28,735.67
|
$28,735.67
|
$27,298.88
|
$28,735.67
|
$28,735.67
|
2026-03-18
|
|
A1204
|
OTHER
|
Osteoarthritis M <49.50 And A <74.50
|
11
|
11
|
$26,612.34
|
$26,612.34
|
$25,281.72
|
$26,612.34
|
$26,612.34
|
2026-03-18
|
|
B1203
|
OTHER
|
Osteoarthritis M <49.50 And A >=74.50
|
11
|
11
|
$39,352.29
|
$39,352.29
|
$37,384.68
|
$39,352.29
|
$39,352.29
|
2026-03-18
|
|
C1203
|
OTHER
|
Osteoarthritis M <49.50 And A >=74.50
|
11
|
11
|
$31,232.70
|
$31,232.70
|
$29,671.06
|
$31,232.70
|
$31,232.70
|
2026-03-18
|
|
D1203
|
OTHER
|
Osteoarthritis M <49.50 And A >=74.50
|
11
|
11
|
$27,910.87
|
$27,910.87
|
$26,515.33
|
$27,910.87
|
$27,910.87
|
2026-03-18
|
|
A1203
|
OTHER
|
Osteoarthritis M <49.50 And A >=74.50
|
11
|
11
|
$25,849.83
|
$25,849.83
|
$24,557.34
|
$25,849.83
|
$25,849.83
|
2026-03-18
|
|
B1202
|
OTHER
|
Osteoarthritis M >=49.50 And M <61.50
|
11
|
11
|
$29,398.14
|
$29,398.14
|
$27,928.24
|
$29,398.14
|
$29,398.14
|
2026-03-18
|
|
C1202
|
OTHER
|
Osteoarthritis M >=49.50 And M <61.50
|
11
|
11
|
$23,332.04
|
$23,332.04
|
$22,165.44
|
$23,332.04
|
$23,332.04
|
2026-03-18
|
|
B1201
|
OTHER
|
Osteoarthritis M >=61.50
|
11
|
11
|
$25,002.39
|
$25,002.39
|
$23,752.27
|
$25,002.39
|
$25,002.39
|
2026-03-18
|
|
B0904
|
OTHER
|
Other Orthopedic M <44.5
|
11
|
11
|
$42,432.53
|
$42,432.53
|
$40,310.90
|
$42,432.53
|
$42,432.53
|
2026-03-18
|
|
C0904
|
OTHER
|
Other Orthopedic M <44.5
|
11
|
11
|
$32,140.53
|
$32,140.53
|
$30,533.51
|
$32,140.53
|
$32,140.53
|
2026-03-18
|
|
D0904
|
OTHER
|
Other Orthopedic M <44.5
|
11
|
11
|
$30,360.72
|
$30,360.72
|
$28,842.68
|
$30,360.72
|
$30,360.72
|
2026-03-18
|
|
A0904
|
OTHER
|
Other Orthopedic M <44.5
|
11
|
11
|
$27,697.60
|
$27,697.60
|
$26,312.72
|
$27,697.60
|
$27,697.60
|
2026-03-18
|
|
B0903
|
OTHER
|
Other Orthopedic M >=44.50 And M <51.50
|
11
|
11
|
$35,237.76
|
$35,237.76
|
$33,475.87
|
$35,237.76
|
$35,237.76
|
2026-03-18
|
|
C0903
|
OTHER
|
Other Orthopedic M >=44.50 And M <51.50
|
11
|
11
|
$26,689.72
|
$26,689.72
|
$25,355.24
|
$26,689.72
|
$26,689.72
|
2026-03-18
|
|
D0903
|
OTHER
|
Other Orthopedic M >=44.50 And M <51.50
|
11
|
11
|
$25,211.89
|
$25,211.89
|
$23,951.29
|
$25,211.89
|
$25,211.89
|
2026-03-18
|
|
A0903
|
OTHER
|
Other Orthopedic M >=44.50 And M <51.50
|
11
|
11
|
$23,001.74
|
$23,001.74
|
$21,851.66
|
$23,001.74
|
$23,001.74
|
2026-03-18
|
|
B0902
|
OTHER
|
Other Orthopedic M >=51.50 And M <63.50
|
11
|
11
|
$29,694.46
|
$29,694.46
|
$28,209.74
|
$29,694.46
|
$29,694.46
|
2026-03-18
|
|
B0901
|
OTHER
|
Other Orthopedic M >=63.50
|
11
|
11
|
$23,375.45
|
$23,375.45
|
$22,206.68
|
$23,375.45
|
$23,375.45
|
2026-03-18
|
|
B1604
|
OTHER
|
Pain Syndrome M <43.50
|
11
|
11
|
$37,840.48
|
$37,840.48
|
$35,948.46
|
$37,840.48
|
$37,840.48
|
2026-03-18
|
|
C1604
|
OTHER
|
Pain Syndrome M <43.50
|
11
|
11
|
$33,912.80
|
$33,912.80
|
$32,217.16
|
$33,912.80
|
$33,912.80
|
2026-03-18
|
|
D1604
|
OTHER
|
Pain Syndrome M <43.50
|
11
|
11
|
$31,021.31
|
$31,021.31
|
$29,470.24
|
$31,021.31
|
$31,021.31
|
2026-03-18
|
|
A1604
|
OTHER
|
Pain Syndrome M <43.50
|
11
|
11
|
$28,118.49
|
$28,118.49
|
$26,712.56
|
$28,118.49
|
$28,118.49
|
2026-03-18
|
|
B1603
|
OTHER
|
Pain Syndrome M >=43.50 And M <58.50
|
11
|
11
|
$28,909.31
|
$28,909.31
|
$27,463.84
|
$28,909.31
|
$28,909.31
|
2026-03-18
|
|
C1603
|
OTHER
|
Pain Syndrome M >=43.50 And M <58.50
|
11
|
11
|
$25,908.34
|
$25,908.34
|
$24,612.92
|
$25,908.34
|
$25,908.34
|
2026-03-18
|
|
D1603
|
OTHER
|
Pain Syndrome M >=43.50 And M <58.50
|
11
|
11
|
$23,700.08
|
$23,700.08
|
$22,515.08
|
$23,700.08
|
$23,700.08
|
2026-03-18
|
|
B1602
|
OTHER
|
Pain Syndrome M >=58.50 And M <65.50
|
11
|
11
|
$23,871.84
|
$23,871.84
|
$22,678.24
|
$23,871.84
|
$23,871.84
|
2026-03-18
|
|
74080582
|
CDM
|
Pl St Bile Duct Cth Nw Ea
|
11
|
11
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
2026-03-18
|
|
74080661
|
CDM
|
Pl St Bile Duct Cth Nw Ea
|
11
|
11
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
2026-03-18
|
|
36224
|
CPT
|
Place Cath Int Carotid Art Bi
|
11
|
11
|
$35,853.69
|
$35,853.69
|
$35,853.69
|
$35,853.69
|
$35,853.69
|
2026-03-18
|
|
36226
|
CPT
|
Place Cath Vertebral Art Bi
|
11
|
11
|
$29,036.88
|
$29,036.88
|
$29,036.88
|
$29,036.88
|
$29,036.88
|
2026-03-18
|
|
74080580
|
CDM
|
Plc Stent Bile Duct Ex Ea
|
11
|
11
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
2026-03-18
|
|
74080659
|
CDM
|
Plc Stent Bile Duct Ex Ea
|
11
|
11
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
2026-03-18
|
|
74080660
|
CDM
|
Plc Stnt Bile Duct New Ea
|
11
|
11
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
2026-03-18
|
|
74080581
|
CDM
|
Plc Stnt Bile Duct New Ea
|
11
|
11
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
$24,053.59
|
2026-03-18
|
|
36907
|
CPT
|
Pta Central Dial Seg Add On
|
11
|
11
|
$22,581.68
|
$22,581.68
|
$22,581.68
|
$22,581.68
|
$22,581.68
|
2026-03-18
|
|
B1504
|
OTHER
|
Pulmonary M <45.50
|
11
|
11
|
$44,212.35
|
$44,212.35
|
$42,001.73
|
$44,212.35
|
$44,212.35
|
2026-03-18
|
|
C1504
|
OTHER
|
Pulmonary M <45.50
|
11
|
11
|
$35,549.18
|
$35,549.18
|
$33,771.72
|
$35,549.18
|
$35,549.18
|
2026-03-18
|
|
D1504
|
OTHER
|
Pulmonary M <45.50
|
11
|
11
|
$33,291.85
|
$33,291.85
|
$31,627.26
|
$33,291.85
|
$33,291.85
|
2026-03-18
|
|
A1504
|
OTHER
|
Pulmonary M <45.50
|
11
|
11
|
$31,825.34
|
$31,825.34
|
$30,234.07
|
$31,825.34
|
$31,825.34
|
2026-03-18
|
|
B1503
|
OTHER
|
Pulmonary M >=45.50 And M <56.50
|
11
|
11
|
$35,256.63
|
$35,256.63
|
$33,493.80
|
$35,256.63
|
$35,256.63
|
2026-03-18
|
|
C1503
|
OTHER
|
Pulmonary M >=45.50 And M <56.50
|
11
|
11
|
$28,348.75
|
$28,348.75
|
$26,931.31
|
$28,348.75
|
$28,348.75
|
2026-03-18
|
|
D1503
|
OTHER
|
Pulmonary M >=45.50 And M <56.50
|
11
|
11
|
$26,548.17
|
$26,548.17
|
$25,220.76
|
$26,548.17
|
$26,548.17
|
2026-03-18
|
|
A1503
|
OTHER
|
Pulmonary M >=45.50 And M <56.50
|
11
|
11
|
$25,377.98
|
$25,377.98
|
$24,109.08
|
$25,377.98
|
$25,377.98
|
2026-03-18
|
|
B1502
|
OTHER
|
Pulmonary M >=56.50 And M <68.50
|
11
|
11
|
$30,239.92
|
$30,239.92
|
$28,727.93
|
$30,239.92
|
$30,239.92
|
2026-03-18
|
|
C1502
|
OTHER
|
Pulmonary M >=56.50 And M <68.50
|
11
|
11
|
$24,315.37
|
$24,315.37
|
$23,099.61
|
$24,315.37
|
$24,315.37
|
2026-03-18
|
|
D1502
|
OTHER
|
Pulmonary M >=56.50 And M <68.50
|
11
|
11
|
$22,771.48
|
$22,771.48
|
$21,632.91
|
$22,771.48
|
$22,771.48
|
2026-03-18
|
|
B1501
|
OTHER
|
Pulmonary M >=68.50
|
11
|
11
|
$24,730.60
|
$24,730.60
|
$23,494.07
|
$24,730.60
|
$24,730.60
|
2026-03-18
|
|
B0805
|
OTHER
|
Replacement Of Lower-extremity Joint M <42.50
|
11
|
11
|
$39,465.53
|
$39,465.53
|
$37,492.26
|
$39,465.53
|
$39,465.53
|
2026-03-18
|
|
C0805
|
OTHER
|
Replacement Of Lower-extremity Joint M <42.50
|
11
|
11
|
$33,239.00
|
$33,239.00
|
$31,577.05
|
$33,239.00
|
$33,239.00
|
2026-03-18
|
|
D0805
|
OTHER
|
Replacement Of Lower-extremity Joint M <42.50
|
11
|
11
|
$29,711.45
|
$29,711.45
|
$28,225.88
|
$29,711.45
|
$29,711.45
|
2026-03-18
|
|
A0805
|
OTHER
|
Replacement Of Lower-extremity Joint M <42.50
|
11
|
11
|
$27,837.26
|
$27,837.26
|
$26,445.40
|
$27,837.26
|
$27,837.26
|
2026-03-18
|
|
B0804
|
OTHER
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
11
|
11
|
$31,685.67
|
$31,685.67
|
$30,101.39
|
$31,685.67
|
$31,685.67
|
2026-03-18
|
|
C0804
|
OTHER
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
11
|
11
|
$26,687.84
|
$26,687.84
|
$25,353.44
|
$26,687.84
|
$26,687.84
|
2026-03-18
|
|
D0804
|
OTHER
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
11
|
11
|
$23,854.85
|
$23,854.85
|
$22,662.11
|
$23,854.85
|
$23,854.85
|
2026-03-18
|
|
B0803
|
OTHER
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
11
|
11
|
$27,892.00
|
$27,892.00
|
$26,497.40
|
$27,892.00
|
$27,892.00
|
2026-03-18
|
|
C0803
|
OTHER
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
11
|
11
|
$23,492.47
|
$23,492.47
|
$22,317.84
|
$23,492.47
|
$23,492.47
|
2026-03-18
|
|
B0802
|
OTHER
|
Replacement Of Lower-extremity Joint M >=57.50 And M <63.50
|
11
|
11
|
$25,344.01
|
$25,344.01
|
$24,076.81
|
$25,344.01
|
$25,344.01
|
2026-03-18
|
|
74080468
|
CDM
|
Revas Fem Pop Atherectomy
|
11
|
11
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
2026-03-18
|
|
74080469
|
CDM
|
Revas Fem Pop Stent Ather
|
11
|
11
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
2026-03-18
|
|
74080471
|
CDM
|
Revas Femoral Poplt Stent
|
11
|
11
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
$25,905.35
|
2026-03-18
|
|
74080477
|
CDM
|
Revas Tib Peron Ather Add
|
11
|
11
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
2026-03-18
|
|
74080478
|
CDM
|
Revas Tib Peron Ather Ini
|
11
|
11
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
2026-03-18
|
|
74080479
|
CDM
|
Revas Tib Peron Stent Ini
|
11
|
11
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
2026-03-18
|
|
74080481
|
CDM
|
Revas Tib Pr Stnt Ath Ini
|
11
|
11
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
$26,002.81
|
2026-03-18
|
|
74080483
|
CDM
|
Revise Tips
|
11
|
11
|
$47,034.04
|
$47,034.04
|
$47,034.04
|
$47,034.04
|
$47,034.04
|
2026-03-18
|
|
B1304
|
OTHER
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
11
|
11
|
$43,244.11
|
$43,244.11
|
$41,081.90
|
$43,244.11
|
$43,244.11
|
2026-03-18
|
|
C1304
|
OTHER
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
11
|
11
|
$34,573.39
|
$34,573.39
|
$32,844.72
|
$34,573.39
|
$34,573.39
|
2026-03-18
|
|
D1304
|
OTHER
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
11
|
11
|
$31,678.12
|
$31,678.12
|
$30,094.22
|
$31,678.12
|
$31,678.12
|
2026-03-18
|
|
A1304
|
OTHER
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
11
|
11
|
$28,775.30
|
$28,775.30
|
$27,336.54
|
$28,775.30
|
$28,775.30
|
2026-03-18
|
|
B1305
|
OTHER
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
11
|
11
|
$43,159.18
|
$43,159.18
|
$41,001.22
|
$43,159.18
|
$43,159.18
|
2026-03-18
|
|
C1305
|
OTHER
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
11
|
11
|
$34,503.56
|
$34,503.56
|
$32,778.38
|
$34,503.56
|
$34,503.56
|
2026-03-18
|
|
D1305
|
OTHER
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
11
|
11
|
$31,613.95
|
$31,613.95
|
$30,033.25
|
$31,613.95
|
$31,613.95
|
2026-03-18
|
|
A1305
|
OTHER
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
11
|
11
|
$28,718.68
|
$28,718.68
|
$27,282.74
|
$28,718.68
|
$28,718.68
|
2026-03-18
|
|
B1303
|
OTHER
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
11
|
11
|
$33,505.12
|
$33,505.12
|
$31,829.87
|
$33,505.12
|
$33,505.12
|
2026-03-18
|
|
C1303
|
OTHER
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
11
|
11
|
$26,785.98
|
$26,785.98
|
$25,446.68
|
$26,785.98
|
$26,785.98
|
2026-03-18
|
|
D1303
|
OTHER
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
11
|
11
|
$24,543.75
|
$24,543.75
|
$23,316.56
|
$24,543.75
|
$24,543.75
|
2026-03-18
|
|
B1302
|
OTHER
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
11
|
11
|
$28,990.46
|
$28,990.46
|
$27,540.94
|
$28,990.46
|
$28,990.46
|
2026-03-18
|
|
C1302
|
OTHER
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
11
|
11
|
$23,177.27
|
$23,177.27
|
$22,018.41
|
$23,177.27
|
$23,177.27
|
2026-03-18
|
|
B1301
|
OTHER
|
Rheumatoid Other Arthritis M >=62.50
|
11
|
11
|
$23,643.46
|
$23,643.46
|
$22,461.29
|
$23,643.46
|
$23,643.46
|
2026-03-18
|
|
76085035
|
CDM
|
Sm153 Lexidron To 150mci
|
11
|
11
|
$41,825.76
|
$41,825.76
|
$41,825.76
|
$41,825.76
|
$41,825.76
|
2026-03-18
|
|
92218223
|
CDM
|
Soliris 10mg/ml Inj
|
11
|
11
|
$23,482.80
|
$23,482.80
|
$23,482.80
|
$23,482.80
|
$23,482.80
|
2026-03-18
|
|
74080527
|
CDM
|
Stnt Plc Transc Vein Ini
|
11
|
11
|
$39,032.60
|
$39,032.60
|
$39,032.60
|
$39,032.60
|
$39,032.60
|
2026-03-18
|
|
74080525
|
CDM
|
Stnt Plc Transcth Art Ini
|
11
|
11
|
$38,869.80
|
$38,869.80
|
$38,869.80
|
$38,869.80
|
$38,869.80
|
2026-03-18
|
|
B0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
11
|
11
|
$53,460.61
|
$53,460.61
|
$50,787.57
|
$53,460.61
|
$53,460.61
|
2026-03-18
|
|
C0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
11
|
11
|
$47,473.77
|
$47,473.77
|
$45,100.08
|
$47,473.77
|
$47,473.77
|
2026-03-18
|
|
D0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
11
|
11
|
$43,011.96
|
$43,011.96
|
$40,861.36
|
$43,011.96
|
$43,011.96
|
2026-03-18
|
|
A0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
11
|
11
|
$40,798.04
|
$40,798.04
|
$38,758.14
|
$40,798.04
|
$40,798.04
|
2026-03-18
|
|
B0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
11
|
11
|
$47,460.56
|
$47,460.56
|
$45,087.53
|
$47,460.56
|
$47,460.56
|
2026-03-18
|
|
C0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
11
|
11
|
$42,145.64
|
$42,145.64
|
$40,038.36
|
$42,145.64
|
$42,145.64
|
2026-03-18
|
|
D0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
11
|
11
|
$38,183.99
|
$38,183.99
|
$36,274.79
|
$38,183.99
|
$38,183.99
|
2026-03-18
|
|
A0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
11
|
11
|
$36,219.21
|
$36,219.21
|
$34,408.25
|
$36,219.21
|
$36,219.21
|
2026-03-18
|
|
B0104
|
OTHER
|
Stroke M >=41.50 And M <50.50
|
11
|
11
|
$38,082.07
|
$38,082.07
|
$36,177.97
|
$38,082.07
|
$38,082.07
|
2026-03-18
|
|
C0104
|
OTHER
|
Stroke M >=41.50 And M <50.50
|
11
|
11
|
$33,818.43
|
$33,818.43
|
$32,127.51
|
$33,818.43
|
$33,818.43
|
2026-03-18
|
|
D0104
|
OTHER
|
Stroke M >=41.50 And M <50.50
|
11
|
11
|
$30,640.05
|
$30,640.05
|
$29,108.05
|
$30,640.05
|
$30,640.05
|
2026-03-18
|
|
A0104
|
OTHER
|
Stroke M >=41.50 And M <50.50
|
11
|
11
|
$29,062.19
|
$29,062.19
|
$27,609.08
|
$29,062.19
|
$29,062.19
|
2026-03-18
|
|
B0103
|
OTHER
|
Stroke M >=50.50 And M <63.50
|
11
|
11
|
$29,817.15
|
$29,817.15
|
$28,326.29
|
$29,817.15
|
$29,817.15
|
2026-03-18
|
|
C0103
|
OTHER
|
Stroke M >=50.50 And M <63.50
|
11
|
11
|
$26,478.33
|
$26,478.33
|
$25,154.42
|
$26,478.33
|
$26,478.33
|
2026-03-18
|
|
D0103
|
OTHER
|
Stroke M >=50.50 And M <63.50
|
11
|
11
|
$23,988.85
|
$23,988.85
|
$22,789.41
|
$23,988.85
|
$23,988.85
|
2026-03-18
|
|
A0103
|
OTHER
|
Stroke M >=50.50 And M <63.50
|
11
|
11
|
$22,754.49
|
$22,754.49
|
$21,616.77
|
$22,754.49
|
$22,754.49
|
2026-03-18
|
|
B0102
|
OTHER
|
Stroke M >=63.50 And M <72.50
|
11
|
11
|
$23,226.34
|
$23,226.34
|
$22,065.03
|
$23,226.34
|
$23,226.34
|
2026-03-18
|
|
76085037
|
CDM
|
Strontium Sr-89 Thera/mci
|
11
|
11
|
$38,865.52
|
$38,865.52
|
$38,865.52
|
$38,865.52
|
$38,865.52
|
2026-03-18
|
|
B0205
|
OTHER
|
Traumatic Brain Injury M <35.50
|
11
|
11
|
$51,427.88
|
$51,427.88
|
$48,856.48
|
$51,427.88
|
$51,427.88
|
2026-03-18
|
|
C0205
|
OTHER
|
Traumatic Brain Injury M <35.50
|
11
|
11
|
$40,890.52
|
$40,890.52
|
$38,845.99
|
$40,890.52
|
$40,890.52
|
2026-03-18
|
|
D0205
|
OTHER
|
Traumatic Brain Injury M <35.50
|
11
|
11
|
$37,357.31
|
$37,357.31
|
$35,489.44
|
$37,357.31
|
$37,357.31
|
2026-03-18
|
|
A0205
|
OTHER
|
Traumatic Brain Injury M <35.50
|
11
|
11
|
$35,098.09
|
$35,098.09
|
$33,343.19
|
$35,098.09
|
$35,098.09
|
2026-03-18
|
|
B0204
|
OTHER
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
11
|
11
|
$40,086.49
|
$40,086.49
|
$38,082.16
|
$40,086.49
|
$40,086.49
|
2026-03-18
|
|
C0204
|
OTHER
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
11
|
11
|
$31,872.52
|
$31,872.52
|
$30,278.90
|
$31,872.52
|
$31,872.52
|
2026-03-18
|
|
D0204
|
OTHER
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
11
|
11
|
$29,118.81
|
$29,118.81
|
$27,662.87
|
$29,118.81
|
$29,118.81
|
2026-03-18
|
|
A0204
|
OTHER
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
11
|
11
|
$27,357.86
|
$27,357.86
|
$25,989.97
|
$27,357.86
|
$27,357.86
|
2026-03-18
|
|
B0203
|
OTHER
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
11
|
11
|
$32,525.56
|
$32,525.56
|
$30,899.29
|
$32,525.56
|
$32,525.56
|
2026-03-18
|
|
C0203
|
OTHER
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
11
|
11
|
$25,861.15
|
$25,861.15
|
$24,568.10
|
$25,861.15
|
$25,861.15
|
2026-03-18
|
|
D0203
|
OTHER
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
11
|
11
|
$23,626.47
|
$23,626.47
|
$22,445.15
|
$23,626.47
|
$23,626.47
|
2026-03-18
|
|
B0202
|
OTHER
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
11
|
11
|
$26,161.25
|
$26,161.25
|
$24,853.19
|
$26,161.25
|
$26,161.25
|
2026-03-18
|
|
B0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
11
|
11
|
$85,552.07
|
$85,552.07
|
$81,274.46
|
$85,552.07
|
$85,552.07
|
2026-03-18
|
|
C0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
11
|
11
|
$69,928.17
|
$69,928.17
|
$66,431.76
|
$69,928.17
|
$69,928.17
|
2026-03-18
|
|
D0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
11
|
11
|
$68,087.96
|
$68,087.96
|
$64,683.56
|
$68,087.96
|
$68,087.96
|
2026-03-18
|
|
A0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
11
|
11
|
$61,612.29
|
$61,612.29
|
$58,531.67
|
$61,612.29
|
$61,612.29
|
2026-03-18
|
|
B0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
11
|
11
|
$59,953.26
|
$59,953.26
|
$56,955.60
|
$59,953.26
|
$59,953.26
|
2026-03-18
|
|
C0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
11
|
11
|
$49,004.45
|
$49,004.45
|
$46,554.23
|
$49,004.45
|
$49,004.45
|
2026-03-18
|
|
D0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
11
|
11
|
$47,715.36
|
$47,715.36
|
$45,329.59
|
$47,715.36
|
$47,715.36
|
2026-03-18
|
|
A0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
11
|
11
|
$43,178.05
|
$43,178.05
|
$41,019.15
|
$43,178.05
|
$43,178.05
|
2026-03-18
|
|
B0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
11
|
11
|
$62,472.94
|
$62,472.94
|
$59,349.29
|
$62,472.94
|
$62,472.94
|
2026-03-18
|
|
C0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
11
|
11
|
$51,063.61
|
$51,063.61
|
$48,510.43
|
$51,063.61
|
$51,063.61
|
2026-03-18
|
|
D0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
11
|
11
|
$49,719.78
|
$49,719.78
|
$47,233.79
|
$49,719.78
|
$49,719.78
|
2026-03-18
|
|
A0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
11
|
11
|
$44,991.84
|
$44,991.84
|
$42,742.25
|
$44,991.84
|
$44,991.84
|
2026-03-18
|
|
B0405
|
OTHER
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
11
|
11
|
$47,488.87
|
$47,488.87
|
$45,114.43
|
$47,488.87
|
$47,488.87
|
2026-03-18
|
|
C0405
|
OTHER
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
11
|
11
|
$38,816.27
|
$38,816.27
|
$36,875.45
|
$38,816.27
|
$38,816.27
|
2026-03-18
|
|
D0405
|
OTHER
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
11
|
11
|
$37,795.18
|
$37,795.18
|
$35,905.43
|
$37,795.18
|
$37,795.18
|
2026-03-18
|
|
A0405
|
OTHER
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
11
|
11
|
$34,201.58
|
$34,201.58
|
$32,491.50
|
$34,201.58
|
$34,201.58
|
2026-03-18
|
|
B0403
|
OTHER
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
11
|
11
|
$37,000.59
|
$37,000.59
|
$35,150.56
|
$37,000.59
|
$37,000.59
|
2026-03-18
|
|
C0403
|
OTHER
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
11
|
11
|
$30,243.70
|
$30,243.70
|
$28,731.51
|
$30,243.70
|
$30,243.70
|
2026-03-18
|
|
D0403
|
OTHER
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
11
|
11
|
$29,447.21
|
$29,447.21
|
$27,974.85
|
$29,447.21
|
$29,447.21
|
2026-03-18
|
|
A0403
|
OTHER
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
11
|
11
|
$26,646.31
|
$26,646.31
|
$25,314.00
|
$26,646.31
|
$26,646.31
|
2026-03-18
|
|
B0402
|
OTHER
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
11
|
11
|
$32,057.49
|
$32,057.49
|
$30,454.61
|
$32,057.49
|
$32,057.49
|
2026-03-18
|
|
C0402
|
OTHER
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
11
|
11
|
$26,202.77
|
$26,202.77
|
$24,892.64
|
$26,202.77
|
$26,202.77
|
2026-03-18
|
|
D0402
|
OTHER
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
11
|
11
|
$25,513.87
|
$25,513.87
|
$24,238.18
|
$25,513.87
|
$25,513.87
|
2026-03-18
|
|
A0402
|
OTHER
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
11
|
11
|
$23,086.68
|
$23,086.68
|
$21,932.34
|
$23,086.68
|
$23,086.68
|
2026-03-18
|
|
B0401
|
OTHER
|
Traumatic Spinal Cord Injury M >=56.50
|
11
|
11
|
$25,570.50
|
$25,570.50
|
$24,291.97
|
$25,570.50
|
$25,570.50
|
2026-03-18
|
|
74080549
|
CDM
|
Verteb Augm Ea Add W Imag
|
11
|
11
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
2026-03-18
|
|
74080548
|
CDM
|
Verteb Augm Lumbar W Imag
|
11
|
11
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
2026-03-18
|
|
74080547
|
CDM
|
Verteb Augm Thorac W Imag
|
11
|
11
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
$38,769.13
|
2026-03-18
|