hospital_name	last_updated_on	version	hospital_location	hospital_address		license_number|NV	"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated."																																																																																									
Carson Valley Health	3/18/2024	2.0.0	Carson Valley Health	"1107 US HWY 395 North, Gardnerville, NV 89410"		3986ruh24	TRUE																																																																																									
description	Revenue ID	code|1	code|1|type	code|2	code|2|type	setting	standard_charge|gross	standard_charge|discounted_cash	standard_charge|Aetna|PPO|negotiated_dollar	standard_charge|Aetna|PPO|negotiated_percentage	standard_charge|Aetna|PPO|negotiated_algorithm	standard_charge|Aetna|PPO|methodology	additional_payer_notes|Aetna|PPO	standard_charge|Aetna_medicare|HMO|negotiated_dollar	standard_charge|Aetna_medicare|HMO|negotiated_percentage	standard_charge|Aetna_medicare|HMO|negotiated_algorithm	standard_charge|Aetna_medicare|HMO|methodology	additional_payer_notes|Aetna_medicare|HMO	standard_charge|Anthem_BCBS|PPO|negotiated_dollar	standard_charge|Anthem_BCBS|PPO|negotiated_percentage	standard_charge|Anthem_BCBS|PPO|negotiated_algorithm	standard_charge|Anthem_BCBS|PPO|methodology	additional_payer_notes|Anthem_BCBS|PPO	standard_charge|Anthem_Pathway|HMO|negotiated_dollar	standard_charge|Anthem_Pathway|HMO|negotiated_percentage	standard_charge|Anthem_Pathway|HMO|negotiated_algorithm	standard_charge|Anthem_Pathway|HMO|methodology	additional_payer_notes|Anthem_Pathway|HMO	standard_charge|Atrio_St._Mary's|HMO|negotiated_dollar	standard_charge|Atrio_St._Mary's|HMO|negotiated_percentage	standard_charge|Atrio_St._Mary's|HMO|negotiated_algorithm	standard_charge|Atrio_St._Mary's|HMO|methodology	additional_payer_notes|Atrio_St._Mary's|HMO	standard_charge|Cigna_Behavioral_Health|PPO|negotiated_dollar	standard_charge|Cigna_Behavioral_Health|PPO|negotiated_percentage	standard_charge|Cigna_Behavioral_Health|PPO|negotiated_algorithm	standard_charge|Cigna_Behavioral_Health|PPO|methodology	additional_payer_notes|Cigna_Behavioral_Health|PPO	standard_charge|Cigna_Great_West|PPO|negotiated_dollar	standard_charge|Cigna_Great_West|PPO|negotiated_percentage	standard_charge|Cigna_Great_West|PPO|negotiated_algorithm	standard_charge|Cigna_Great_West|PPO|methodology	additional_payer_notes|Cigna_Great_West|PPO	standard_charge|Hometown_Health|PPO|negotiated_dollar	standard_charge|Hometown_Health|PPO|negotiated_percentage	standard_charge|Hometown_Health|PPO|negotiated_algorithm	standard_charge|Hometown_Health|PPO|methodology	additional_payer_notes|Hometown_Health|PPO	standard_charge|Hometown_Health_lease|PPO|negotiated_dollar	standard_charge|Hometown_Health_lease|PPO|negotiated_percentage	standard_charge|Hometown_Health_lease|PPO|negotiated_algorithm	standard_charge|Hometown_Health_lease|PPO|methodology	additional_payer_notes|Hometown_Health_lease|PPO	standard_charge|Northern_NV_Laborers_Operators_Engineers_Electrical_Workers|PPO|negotiated_dollar	standard_charge|Northern_NV_Laborers_Operators_Engineers_Electrical_Workers|PPO|negotiated_percentage	standard_charge|Northern_NV_Laborers_Operators_Engineers_Electrical_Workers|PPO|negotiated_algorithm	standard_charge|Northern_NV_Laborers_Operators_Engineers_Electrical_Workers|PPO|methodology	additional_payer_notes|Northern_NV_Laborers_Operators_Engineers_Electrical_Workers|PPO	standard_charge|Medicare|negotiated_dollar	standard_charge|Medicare|negotiated_percentage	standard_charge|Medicare|negotiated_algorithm	standard_charge|Medicare|methodology	additional_payer_notes|Medicare	standard_charge|Prominence_Commerical|PPO|negotiated_dollar	standard_charge|Prominence_Commerical|PPO|negotiated_percentage	standard_charge|Prominence_Commerical|PPO|negotiated_algorithm	standard_charge|Prominence_Commerical|PPO|methodology	additional_payer_notes|Prominence_Commerical|PPO	standard_charge|Prominence_Medicare|HMO|negotiated_dollar	standard_charge|Prominence_Medicare|HMO|negotiated_percentage	standard_charge|Prominence_Medicare|HMO|negotiated_algorithm	standard_charge|Prominence_Medicare|HMO|methodology	additional_payer_notes|Prominence_Medicare|HMO	standard_charge|Silversummit|PPO|negotiated_dollar	standard_charge|Silversummit|PPO|negotiated_percentage	standard_charge|Silversummit|PPO|negotiated_algorithm	standard_charge|Silversummit|PPO|methodology	additional_payer_notes|Silversummit|PPO	standard_charge|Wellcare|negotiated_dollar	standard_charge|Wellcare|negotiated_percentage	standard_charge|Wellcare|negotiated_algorithm	standard_charge|Wellcare|methodology	additional_payer_notes|Wellcare	standard_charge|UHC_Affiliates|PPO|negotiated_dollar	standard_charge|UHC_Affiliates|PPO|negotiated_percentage	standard_charge|UHC_Affiliates|PPO|negotiated_algorithm	standard_charge|UHC_Affiliates|PPO|methodology	additional_payer_notes|UHC_Affiliates|PPO	standard_charge|UHC_Medicare|HMO|negotiated_dollar	standard_charge|UHC_Medicare|HMO|negotiated_percentage	standard_charge|UHC_Medicare|HMO|negotiated_algorithm	standard_charge|UHC_Medicare|HMO|methodology	additional_payer_notes|UHC_Medicare|HMO	standard_charge|min	standard_charge|max	"additional_generic_notes
"
HCHG CVMC ROOM/CARE - PRIVATE (0110)	110	110	rc	772001	local	inpatient	3161	2212.7		87		percent of total billed charges		3264			per diem		12225		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($12225.00 base*'rw')+((los-'trim"")*3400.00pd))"	9500		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($9500.00 base*'rw')+((los-'trim"")*3400.00pd))"	3264			per diem						not applicable to this contract		90		percent of total billed charges		5750			per diem	"surgery day 1-6000, medical day 1-5750 subsequent days are 3500 per diem"	6100			per diem	"surgery day 1-8000, medical day 1-6100 subsequent days are 4025 per diem"	4181.57			per diem		3264			per diem		6726.69			per diem			31		percent of total billed charges			79		percent of total billed charges		3427.2			per diem		5408			per diem	"surgery day one-7488, medical day one-5408 subsequent days are 4160 per diem"	3264			per diem		3264	12225	
HCHG CVMC ROOM/CARE - SWING BED (0120)	120	120	RC	772004	local	inpatient	2303	1612.1		87		percent of total billed charges		2496			per diem		3353			per diem		3353			per diem		2496			per diem						not applicable to this contract		90		percent of total billed charges		3500			per diem		4025			per diem		2705.72			per diem		2496			per diem		2866.15			per diem			31		percent of total billed charges			79		percent of total billed charges		2620.8			per diem		5408			per diem	"surgery day one-7488, medical day one-5408 subsequent days are 4160 per diem"	2496			per diem		2496	5408	
HCHG CVMC ROOM/CARE - SEMI PRIVATE (0120)	120	120	RC	772002	local	inpatient	3010	2107		87		percent of total billed charges		3264			per diem		12225		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($12225.00 base*'rw')+((los-'trim"")*3400.00pd))"	9500		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($9500.00 base*'rw')+((los-'trim"")*3400.00pd))"	3264			per diem						not applicable to this contract		90		percent of total billed charges		5750			per diem	"surgery day 1-6000, medical day 1-5750 subsequent days are 3500 per diem"	6100			per diem	"surgery day 1-6000, medical day 1-5750 subsequent days are 4025 per diem"	4181.57			per diem		3264			per diem		6726.69			per diem			31		percent of total billed charges			79		percent of total billed charges		3427.2			per diem		5408			per diem	"surgery day one-7488, medical day one-5408 subsequent days are 4160 per diem"	3264			per diem		3264	12225	
HCHG CVMC ROOM/CARE - SEMI PRIVATE TELEMETRY (0120)	120	772003	rc	772003	local	inpatient	3737	2615.9		87		percent of total billed charges		3264			per diem		12225		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($12225.00 base*'rw')+((los-'trim"")*3400.00pd))"	9500		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($9500.00 base*'rw')+((los-'trim"")*3400.00pd))"	3264			per diem						not applicable to this contract		90		percent of total billed charges		5750			per diem	"surgery day 1-6000, medical day 1-5750 subsequent days are 3500 per diem"	6100			per diem	"surgery day 1-6000, medical day 1-5750 subsequent days are 4025 per diem"	4181.57			per diem		3264			per diem		6726.69			per diem			31		percent of total billed charges			79		percent of total billed charges		3427.2			per diem		5408			per diem	"surgery day one-7488, medical day one-5408 subsequent days are 4160 per diem"	3264			per diem		3264	12225	
HCHG ROOM/CARE - ICU (200)	200	200	RC	770022	local	inpatient	4383	3068.1		87		percent of total billed charges		3264			per diem		12225		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($12225.00 base*'rw')+((los-'trim"")*3400.00pd))"	9500		MS-DRG	other	"if los is>(175%*'gmlos')=trim, then allow (($9500.00 base*'rw')+((los-'trim"")*3400.00pd))"	3264			per diem						not applicable to this contract		90		percent of total billed charges		5750			per diem	"surgery day 1-6000, medical day 1-5750 subsequent days are 4400 per diem"	6100			per diem	"surgery day 1-6000, medical day 1-5750 subsequent days are 4025 per diem"	4181.57			per diem		3264			per diem		6726.69			per diem			31		percent of total billed charges			79		percent of total billed charges		3427.2			per diem		5408			per diem	"surgery day one-7488, medical day one-5408 subsequent days are 4160 per diem"	3264			per diem		3264	12225	
"HCHG BLADE, GIGLI SAW"	229	272	RC	500078	local	both	497	347.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ALBUTEROL MDI (PER PUFF)	250	0173-0682-24	NDC	310116	local	both	2.48	1.74		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC COMBIVENT MDI (PER PUFF)	250	0597-0024-02	NDC	310114	local	both	2.89	2.02		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ATROVENT MDI (PER PUFF)	250	0597-0087-17	NDC	310115	local	both	2.89	2.02		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC FLOVENT 110MCG MDI (PER PUFF)	250	66993-079-96	NDC	310120	local	both	13.41	9.39		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG IPRATROPIUM BROMIDE INHAL SOL 0.5MG	250	60687-394-79	NDC	310122	local	both	32.27	22.59		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG ALBUTEROL SULFATE INHAL SOL 2.5MG	250	76204-200-01	NDC	310123	local	both	33.9	23.73		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG 3% HYPERTONIC SALINE 150ML	250	0338-0064-03	NDC	310124	local	both	36.05	25.24		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC XOPENES LEVALBUTEROL 0.63/0.31MG	250	76204-800-11	NDC	310117	local	both	47.02	32.91		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG BMH/CVMC RHO(D)IMMUNE GLOBULIN(RHIG)HUMAN MINI-DOSE	250	90385	cpt	351006	local	both	48.21	33.75		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC MUCOMYST/MUCOSIL/ACETYCYSTEINE 10%	250	0517-7604-01	NDC	310118	local	both	51.59	36.11		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC PULMICORT RESPULES 0.5MG/2ML	250	0093-681-19	NDC	310113	local	both	61.81	43.27		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC LIDOCAINE HCL 4% 50ML	250	J2001	HCPCS	308248	local	both	74.73	52.31		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC LEXISCAN, PER 1MG"	250	J2785	HCPCS	5271905	local	both	365.66	255.96		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG BMH/CVMC RHOGRAM	250	90384	cpt	350610	local	both	420.3	294.21		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			81		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CONTRAST/LOW OSMOLAR 300-399MG-OMNIPAQUE	255	Q9967	HCPCS	4401004	local	both	2.56	1.79		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG VISIPAQUE 300-399 MG/ML PER ML	255	Q9967	HCPCS	4401017	local	both	8.82	6.17		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INJECTION GAD CONTRAST PER ML	255	A9579	HCPCS	4410179	local	both	18.03	12.62		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG BMH/CVMC IONIC CONTRAST 200	255	Q9966	HCPCS	4410518	local	both	30.68	21.48		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC CONTRAST, IS0VUE-ALL"	255	Q9966	HCPCS	5270001	local	both	243.06	170.14		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV PRE FILLED SYRINGE .9% NACL 10ML	258	8290-3065-46	NDC	309688	local	both	2	1.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SOL SOD CHL 0.9% 10ML VIAL	258	0409-4888-02	NDC	309691	local	both	3.32	2.32		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 500ML	258	J7060	HCPCS	5271906	local	both	7.6	5.32		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .45% NACL 1000ML	258	0338-0043-04	NDC	5271915	local	both	8.49	5.94		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC 1000 ML 5% DEXTROSE	258	J7070	HCPCS	310031	local	both	9.1	6.37		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC 1000 ML DEXTROSE 5%.9% NACL	258	J7042	HCPCS	310033	local	both	9.1	6.37		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC 1000 ML DEXTROSE 5% .45% NACL	258	J7042	HCPCS	310032	local	both	9.19	6.43		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG .9% NACL 1000 ML	258	J7030	HCPCS	310034	local	both	9.46	6.62		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC 1000 ML LACTATED RINGERS	258	J7120	HCPCS	310030	local	both	10.52	7.36		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5%DEX .45%NACL 40MEQ 1000ML	258	0338-0675-04	NDC	310020	local	both	11.14	7.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROS .45 NACL 1000ML	258	J7042	HCPCS	330907	local	both	13.27	9.29		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 500ML GLASS BTL	258	J7060	HCPCS	5271907	local	both	21.48	15.04		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC NORMAL SALINE 15ML/3ML	258	J7050	HCPCS	310119	local	both	33.38	23.37		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 500ML	258	J7060	HCPCS	310049	local	both	36.15	25.31		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV LACTATED RINGER 500ML	258	J7120	HCPCS	310064	local	both	36.45	25.52		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE .45% NACL 500ML	258	J7042	HCPCS	330955	local	both	36.45	25.52		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 100ML IN 150ML	258	J7060	HCPCS	330956	local	both	36.53	25.57		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 1000ML	258	J7070	HCPCS	310050	local	both	37.33	26.13		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG BMH/CVMC IV 10% DEXTROSE 500ML	258	0338-0023-03	NDC	309623	local	both	37.5	26.25		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE LR 1000ML	258	0338-0125-03	NDC	309687	local	both	37.73	26.41		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 1000ML	258	J7030	HCPCS	309669	local	both	39.06	27.34		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROS .25% NACL 1000ML	258	J7042	HCPCS	310051	local	both	39.33	27.53		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIGATION SOLUTION 3000CC	258	0338-0047-27	NDC	5270003	local	both	44.12	30.88		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE .9% NACL 1000ML	258	J7042	HCPCS	310057	local	both	52.97	37.08		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROS .45 NACL 1000ML	258	J7042	HCPCS	310054	local	both	54.62	38.23		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5%DEX 20%NACL 20MEQ 1000ML	258	J7042	HCPCS	309663	local	both	56.77	39.74		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEX.45%NACL 20MEQ 1000ML	258	J7042	HCPCS	310055	local	both	59.83	41.88		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 500ML	258	J7040	HCPCS	310074	local	both	61.06	42.74		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE .45% NACL 500ML	258	J7042	HCPCS	310053	local	both	61.07	42.75		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9%NACL 40MEQ KCL 1000ML	258	J7030	HCPCS	309672	local	both	62.1	43.47		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG BMH/CVMC IV .9% NACL 500ML	258	J7040	HCPCS	309610	local	both	62.29	43.6		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 250 ML	258	J7050	HCPCS	310073	local	both	62.31	43.62		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 250 ML	258	J7050	HCPCS	330972	local	both	63.48	44.44		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 100ML	258	0038-0049-48	NDC	310072	local	both	63.5	44.45		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 1000ML	258	J7030	HCPCS	310075	local	both	63.73	44.61		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .45% NACL 1000ML	258	J7030	HCPCS	310069	local	both	66.69	46.68		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 250ML	258	J7060	HCPCS	330975	local	both	69.88	48.92		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV LACTATED RINGER 1000ML	258	J7120	HCPCS	310065	local	both	70.56	49.39		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 50ML	258	0338-0049-41	NDC	309626	local	both	70.72	49.5		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 250ML	258	0338-0049-02	NDC	310070	local	both	71.41	49.99		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 1000ML	258	J7070	HCPCS	330978	local	both	72.87	51.01		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE .9% NACL 1000ML	258	J7042	HCPCS	330979	local	both	72.97	51.08		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEX.45%NACL 20MEQ 1000ML	258	J7042	HCPCS	309664	local	both	73	51.1		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .45% NACL 1000ML	258	J7030	HCPCS	309668	local	both	73.59	51.51		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .45% NACL 20MEQ KCL 1000ML	258	J7030	HCPCS	309671	local	both	76.29	53.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .45% NACL 20MEQ KCL 1000ML	258	J7030	HCPCS	310077	local	both	76.29	53.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9%NACL 40MEQ KCL 1000ML	258	J7030	HCPCS	310078	local	both	76.91	53.84		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 20MEQ KCL 1000ML	258	J7030	HCPCS	310076	local	both	77.13	53.99		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEX .9 NACL 20MEQ 1000ML	258	J7042	HCPCS	310056	local	both	79.91	55.94		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEX .9 NACL 20MEQ 1000ML	258	J7042	HCPCS	309665	local	both	80.36	56.25		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 20MEQ KCL 1000ML	258	J7030	HCPCS	309670	local	both	83.45	58.42		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIGATION SOLUTION 1000CC	258	0338-0048-04	NDC	5270002	local	both	91.38	63.97		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 100ML IN 150ML	258	J7060	HCPCS	330902	local	both	109.6	76.72		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV LACTATED RINGER 3000ML	258	J7120	HCPCS	310063	local	both	117.57	82.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 250ML	258	J7060	HCPCS	330905	local	both	121.77	85.24		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV .9% NACL 250 ML	258	J7050	HCPCS	307886	local	both	121.77	85.24		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE .45% NACL 500M	258	J7042	HCPCS	330917	local	both	159.26	111.48		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG BMH/CVMC IV LACTATED RINGER 1000ML	258	J7120	HCPCS	330921	local	both	169.65	118.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE 1000ML	258	J7070	HCPCS	330920	local	both	169.65	118.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROSE .9%NACL 1000ML	258	J7042	HCPCS	330919	local	both	169.65	118.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV 5% DEXTROS.45%NACL 1000ML	258	J7042	HCPCS	330918	local	both	169.65	118.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INF THERAPY-HYDRATION EA ADDHR	260	96361	cpt	304073	local	both	130	91		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG TX-PRO-DX IV PSH SAME DRG	260	96376	cpt	304127	local	both	184	128.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INJECTION-DIAG/THERAP-SQ/IM	260	96372	cpt	304123	local	both	194	135.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG TX-PRO-DX IV PUSH SNGL/INITIAL	260	96374	cpt	304122	local	both	200	140		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INF THERAPY-TH/DIAG-CONC < 1HR	260	96368	cpt	304074	local	both	205	143.5		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG TX-PRO-DX IV PUSH NEW DRG	260	96375	cpt	304125	local	both	216	151.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INF THERAPY/DIAG ADD HR	260	96366	cpt	304076	local	both	227	158.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC COLLECT BLOOD FROM PICC	260	36592	cpt	310029	local	both	281	196.7		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC COLLECT BLOOD VENOUS DEVICE	260	36591	cpt	310028	local	both	281	196.7		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INF THERAPY-TH/DIAG-SEQ < 1HR	260	96367	cpt	304077	local	both	410	287		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INF THERAPY-HYDRATION 31-60MIN	260	96360	cpt	304072	local	both	620	434		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INF THERAPY-TH/DIAG-INIT < 1HR	260	96365	cpt	304075	local	both	637	445.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG SWABSTICK PVP IODINE PREP 3/PK	270	A4247	HCPCS	307022	local	both	1.94	1.36		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DRESS ADAPTIC 3X3	270	270	RC	5270004	local	both	5.69	3.98		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DRESS ADAPTIC 3X9	270	270	RC	5270005	local	both	19.14	13.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG HYDROGEL SKINTEGRITY 1OZ	270	A6248	HCPCS	503533	local	both	22	15.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG WC HYDROGEL SKINTEGRITY 1OZ	270	A6248	HCPCS	305067	local	both	22	15.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC RESTRAINT/LIMB DISP	270	270	RC	309619	local	both	25.43	17.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG ALGINATE CAL MAXORB-EXTRA 4X4IN	270	A6196	HCPCS	503530	local	both	25.46	17.82		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DRESS STERISTRP	270	270	RC	5270006	local	both	25.91	18.14		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC CATHETER, ROBINSON-ALL"	270	270	RC	5270011	local	both	52.29	36.6		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC VELCRO WRIST SPLINT	270	270	RC	309628	local	both	57.19	40.03		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CATHETER FOLEY ALL	270	270	RC	5270009	local	both	69.39	48.57		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CANNULA	270	270	RC	309629	local	both	72.1	50.47		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC BONE WAX	270	270	RC	5270022	local	both	75.79	53.05		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC CHOLANGIOGRAM CATHETER, ALL"	270	270	RC	5270016	local	both	79.9	55.93		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC TED HOSE-ALL	270	270	RC	5270018	local	both	94.54	66.18		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC MONOFILAMENT WIRE/ALL GAUGES	270	C1713	HCPCS	5270023	local	both	111.72	78.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC RESTRAINT/CHEST	270	270	RC	309618	local	both	114.15	79.91		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC GUIDE WIRE-ALL	270	C1713	HCPCS	5270015	local	both	139.32	97.52		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SKIN GLUE	270	270	RC	309620	local	both	163.52	114.46		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ORTHO SHOE	270	270	RC	309637	local	both	173.3	121.31		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC FORCE FIBER SUTURE/INDIV NEEDLED (TAPERED) SIZE 2	270	270	RC	5270026	local	both	189.16	132.41		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC GELFILM OPTHALMIC DRESSING	270	270	RC	5270014	local	both	191.09	133.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ENDOCLOSE SUTURING DEVICE	270	270	RC	5270013	local	both	295.44	206.81		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC CATHETER, IRRIGATING"	270	270	RC	5270010	local	both	332.85	233		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC BUR-ALL	270	270	RC	5270017	local	both	378.13	264.69		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION SPRING-LOADED NUT	270	270	RC	5271734	local	both	398.71	279.1		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DRESSING BIOBRANE 5X5	270	270	RC	501777	local	both	437.42	306.19		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC STRYKER IRRIGATOR	270	270	RC	5270025	local	both	659.48	461.64		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC INDWELLING SLIT CATHETER KIT	270	270	RC	5271281	local	both	717.75	502.43		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLIP EXTERNAL FIXATION DYNAMIZATION 4 MED COMBO	270	270	RC	5271736	local	both	781.34	546.94		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC POST EXTERNAL FIXATION 30DEG OUTRIGGER 8MM	270	270	RC	5271749	local	both	786.55	550.59		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE DYNAMIZ CLIP	270	270	RC	5271735	local	both	830.1	581.07		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC POST EXTERNAL FIXATION OURTIGGER 11MM MR	270	270	RC	5271737	local	both	833.43	583.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC POST EXTERNAL FIXATION 90DEG OUTRIGGER POST 8MM	270	270	RC	5271738	local	both	859.48	601.64		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC POST EXTERNAL FIXATION OUTRIGGER POST 11MM MR SAF	270	270	RC	5271750	local	both	916.78	641.75		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC STAPLER ENDOCLIP 5MM	270	270	RC	5270012	local	both	1460.11	1022.08		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP OPEN	270	270	RC	5271757	local	both	1635.61	1144.93		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ROD EXTERNAL FIXATION ATTACHMENT 4 MED MULTI-PIN	270	270	RC	5271739	local	both	1688.66	1182.06		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ARTHROTEK ONE-STEP GUIDE PINS	270	C1713	HCPCS	5270024	local	both	1843.13	1290.19		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP ADJUSTABLE	270	270	RC	5271753	local	both	1845.99	1292.19		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DRUG DELIVERY SYSTEM <=5 ML	270	A4306	HCPCS	5270027	local	both	1865.79	1306.05		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION  MR SAFE ROD ATTACH	270	270	RC	5271751	local	both	1915.91	1341.14		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION MEDIUM PIN 6POS	270	270	RC	5271740	local	both	2006.82	1404.77		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE LG PIN 4POS	270	270	RC	5271741	local	both	2070.78	1449.55		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC FIBRIN SEALANT/2.0ML/TISSEAL	270	270	RC	5270019	local	both	2118.21	1482.75		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE LG PIN 6POS	270	270	RC	5271742	local	both	2125.69	1487.98		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP OPEN COMPRESSOR	270	270	RC	5271912	local	both	2341.09	1638.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION COMBO MEDIUM	270	270	RC	5271743	local	both	2433.35	1703.35		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION SMALL ADJUSTABLE	270	270	RC	5271744	local	both	2534.74	1774.32		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ORTHOSORB ARTHROSCOPE PINS	270	C1713	HCPCS	5270008	local	both	2551.73	1786.21		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION COMBO 8/11MM	270	270	RC	5271745	local	both	2800.45	1960.32		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP UNIVERSAL	270	270	RC	5271754	local	both	3020.71	2114.5		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE TUBE-TO-TUBE	270	270	RC	5271746	local	both	3087.14	2161		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP TRANSVERSE	270	270	RC	5271755	local	both	3087.14	2161		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION	270	270	RC	5271747	local	both	3204.65	2243.26		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP UNIV JOINT FOR 2 TUBES	270	270	RC	5271756	local	both	3359.84	2351.89		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION ADJUSTABLE	270	270	RC	5271748	local	both	3538.15	2476.71		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC AGEE WRIST JACK	270	270	RC	5270007	local	both	6259.81	4381.87		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC EXTERNAL FIXATOR ADJUSTIBLE LARGE	270	270	RC	5271752	local	both	13865.19	9705.63		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ACE 4"" NON-STERILE"	271	A6449	HCPCS	307024	local	both	4.68	3.28		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ACE 6"" NON-STERILE"	271	A6450	HCPCS	307025	local	both	6.63	4.64		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG COBAN 2"" BLUE, NON-STERILE"	271	A6453	HCPCS	307007	local	both	6.89	4.82		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG COBAN 4"" TAN NON-STERILE"	271	A6454	HCPCS	307026	local	both	12.29	8.6		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC O2 PER HR BY NASAL/MASK	271	271	RC	310104	local	both	35	24.5		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG VISCOPASTE UNNAS TYPE	271	A6261	HCPCS	307157	local	both	38.18	26.73		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG COFLEX 2 LAYER TLC	271	A6441	HCPCS	302401	local	both	86.71	60.7		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG TELFA, ISLAND 2"" X 3-1/4"""	272	A6219	HCPCS	307020	local	both	0.62	0.43		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ABD PAD 8""X10"""	272	A6253	HCPCS	307021	local	both	1.68	1.18		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,TEGADERM 2.375"" X 2.75"""	272	A6257	HCPCS	338942	local	both	1.86	1.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC ADAPTIC 3"" X 3"""	272	A6222	HCPCS	303310	local	both	2	1.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG KLING CONFORM 4"""	272	A6446	HCPCS	307023	local	both	2.12	1.48		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC WATER 10ML FOR INJ/STERIL	272	272	RC	309692	local	both	2.21	1.55		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ROLL-SOFT CONFORMING 4"""	272	272	RC	305382	local	both	3	2.1		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, XEROFORM 1"" X 8"""	272	A6222	HCPCS	338950	local	both	3.36	2.35		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING XEROFORM 1"" X 8"""	272	272	RC	310043	local	both	3.45	2.42		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, XEROFORM 5"" X 9"""	272	A6223	HCPCS	338951	local	both	3.8	2.66		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,PETROLEUM GAUZE 1""X 8"""	272	A6222	HCPCS	338946	local	both	3.89	2.72		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING XEROFORM 5"" X 9"""	272	272	RC	309677	local	both	3.89	2.72		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC ADAPTIC 3"" X 8"""	272	A6222	HCPCS	303311	local	both	4	2.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ADAPTIC  3"" X 16"""	272	A6222	HCPCS	307010	local	both	4.6	3.22		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG KERLIX, STERILE LG, 4.5"" X 4.1"""	272	A6446	HCPCS	307014	local	both	4.77	3.34		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, COVRSITE 4"" X 4"""	272	A6220	HCPCS	338933	local	both	4.77	3.34		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING COVERSITE 4"" X 4"""	272	A6219	HCPCS	309164	local	both	4.77	3.34		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,PETROLEUM GAUZE 3""X 18"""	272	A6224	HCPCS	338947	local	both	5.04	3.53		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, TEGADERM 4"" X 4.75"""	272	A6258	HCPCS	338939	local	both	5.57	3.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG SCRUB SPONGE E-Z 4%	272	A6402	HCPCS	301019	local	both	5.75	4.03		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG SPONGE,GAUZE,STER,2X2,2/PK"	272	A6402	HCPCS	305302	local	both	6	4.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, VASELINE 3"" X 9"""	272	A6223	HCPCS	338948	local	both	6.01	4.21		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING SOFT CLOTH 3""X10"""	272	272	RC	309674	local	both	7.47	5.23		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, SOFT CLOTH 3""X10"""	272	272	RC	310081	local	both	7.47	5.23		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, 3M SOFT CLOTH ADH 3""X10"""	272	A6220	HCPCS	338944	local	both	7.87	5.51		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC GAUZE VASELINE 1/2"" X 72"""	272	272	RC	309679	local	both	7.87	5.51		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, COVRSITE 6"" X 6"""	272	A6219	HCPCS	338934	local	both	8.66	6.06		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING COVERSITE 6"" X 6"""	272	A6219	HCPCS	309165	local	both	8.91	6.24		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, TEGADERM 6"" X 8"""	272	A6258	HCPCS	338941	local	both	11.23	7.86		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, FLEXIGEL STRANDS PER GRAM"	272	A6262	HCPCS	338935	local	both	11.43	8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, VASELINE .5"" X 72"""	272	A6223	HCPCS	338949	local	both	11.58	8.11		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC TEGADERM, SMALL"	272	A6257	HCPCS	5270040	local	both	12.68	8.88		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC TEGADERM	272	A6257	HCPCS	309635	local	both	12.71	8.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC GAUZE VASELINE 3"" X 9"" OVERWRP"	272	272	RC	310041	local	both	12.91	9.04		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG 1/4"" PLAIN PACKING NUGAUZE"	272	A6407	HCPCS	307027	local	both	12.99	9.09		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG 1/2"" PLAIN PACKING NUGAUZE"	272	A6407	HCPCS	307152	local	both	13.08	9.16		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, TEGADERM 4"" X 10"""	272	A6258	HCPCS	338940	local	both	13.26	9.28		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG 1/4"" IODOFORM PACKING"	272	A6407	HCPCS	307153	local	both	13.52	9.46		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC TEGADERM LARGE	272	A6258	HCPCS	5270039	local	both	14.39	10.07		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, ALGISITE PER 6 INCHES"	272	A6199	HCPCS	338932	local	both	14.41	10.09		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, SOLOSITE GEL PER OZ"	272	A6248	HCPCS	338936	local	both	15.03	10.52		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ALLEVYN  2"" X 2"" ADHESIVE"	272	A6209	HCPCS	307012	local	both	15.11	10.58		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC TEGADERM LG	272	A6258	HCPCS	309636	local	both	15.96	11.17		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG 1/2"" IODOFORM PACKING"	272	A6266	HCPCS	307154	local	both	16.18	11.33		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG FOAM-NON ADHESIVE 4X4"""	272	A6212	HCPCS	302765	local	both	16.62	11.63		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ALLEVYN LIFE  4"" X 4"" ADHESIVE"	272	A6212	HCPCS	307011	local	both	16.62	11.63		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG OPTILOCK DRESSING	272	A6251	HCPCS	302402	local	both	16.97	11.88		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DEBRIDEMENT TRAY	272	A4550	HCPCS	307155	local	both	17.15	12.01		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, SILVASORB STRANDS, 1GM"	272	A6262	HCPCS	338953	local	both	17.25	12.08		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, FLEXIGEL SHEET, 2"" X 2"""	272	A6242	HCPCS	338937	local	both	17.32	12.12		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC COVRSITE PLUS 4X4	272	272	RC	309638	local	both	18.03	12.62		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG ADAPTIC TOUCH NON-ADHERING SILICONE DRESSING 3X4 1/4	272	A6206	HCPCS	360830	local	both	18.21	12.75		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, ALLEVYN 3"" X 3"""	272	A6212	HCPCS	338925	local	both	19.36	13.55		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG INTRASITE GEL FILLER 15GM	272	A6261	HCPCS	307156	local	both	21.48	15.04		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG BMH HYDROGEL DRESSING WOUND COVER 4 X 4	272	A6242	HCPCS	5070047	local	both	22	15.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, REPLICARE 3.5""X5.5"""	272	A6235	HCPCS	338929	local	both	22.19	15.53		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC COMPRESSION STOCKING-KNEE HIGH	272	272	RC	343752	local	both	22.54	15.78		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG .9% NACL 250ML BOTTLE	272	272	RC	310066	local	both	22.57	15.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DRSSNG ADH FM 5 5/8X5 5/8	272	A6212	HCPCS	306604	local	both	23.05	16.14		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG COLLAGEN PURACOL 2X2	272	A6021	HCPCS	503853	local	both	23.65	16.56		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, FLEXIGEL SHEET,4""X4"""	272	A6242	HCPCS	338938	local	both	23.69	16.58		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC ALLEVYN LIFE 6"" X 6"""	272	A6212	HCPCS	303308	local	both	25	17.5		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG DRESSING-CA ALGINATE ROPE 12"""	272	A6199	HCPCS	303489	local	both	25.36	17.75		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, ALGISITE 4"" X 4"""	272	A6196	HCPCS	338931	local	both	25.46	17.82		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, ALLEVYN 5"" X 5"""	272	A6213	HCPCS	338926	local	both	25.63	17.94		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG HYDROCOLLOID 4X4"""	272	A6235	HCPCS	305007	local	both	25.91	18.14		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC 3-WAY CATHETER	272	A4355	HCPCS	309156	local	both	26.09	18.26		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING ALGISITE 4"" X 4"""	272	A6196	HCPCS	309158	local	both	26.55	18.59		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC TAPE UMBILICAL COTTON	272	272	RC	5271787	local	both	27.05	18.94		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG .9% NACL 250ML BOTTLE	272	272	RC	309681	local	both	29.21	20.45		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC COVRSITE 6X6	272	272	RC	309639	local	both	29.59	20.71		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG WATER STERILE 500ML	272	272	RC	309685	local	both	30.25	21.18		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG PICC/CENTRAL LINE DRESSING CHANGE KIT	272	A4649	HCPCS	307018	local	both	30.94	21.66		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,MAXORB AG SILVER ALGINATE"	272	A6196	HCPCS	338952	local	both	32.53	22.77		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DRESSING MEDIHONEY 2.8X2.8IN SHEET ADH HCS	272	A6237	HCPCS	501847	local	both	33.41	23.39		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, REPLICARE 4"" X 4"""	272	A6234	HCPCS	338930	local	both	34.38	24.07		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING ALLEVYN 5"" X 5"""	272	A6214	HCPCS	309162	local	both	35.11	24.58		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC WATER 10ML FOR INJ/STERIL	272	272	RC	310045	local	both	35.43	24.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG WATER STERILE 500ML	272	272	RC	310060	local	both	36.92	25.84		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG .9% NACL 500ML BOTTLE	272	272	RC	309682	local	both	38.23	26.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG WATER STERILE 1000ML	272	272	RC	309683	local	both	38.73	27.11		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG GEL,MEDIHONEY 0.5 OZ"	272	A6240	HCPCS	309699	local	both	39	27.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IODOSORB FLEX 4/6	272	A6262	HCPCS	501992	local	both	39.25	27.48		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, TEGADERM ABS,4"" X 4"""	272	A6203	HCPCS	338943	local	both	39.95	27.97		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG HYDROGEL SILVER 3 0Z.	272	A6248	HCPCS	306251	local	both	39.98	27.99		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING REPLICARE 4"" X 4"""	272	A6234	HCPCS	309167	local	both	42.48	29.74		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SALINE FLUSH	272	A4216	HCPCS	309151	local	both	42.78	29.95		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG WATER STERILE 2000ML	272	272	RC	309684	local	both	43.75	30.63		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG HYDROGEL WOUND DRESSING 3.75X3.75	272	A6242	HCPCS	305557	local	both	44	30.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG MARATHON SKIN PROTECTANT	272	A6250	HCPCS	302400	local	both	44.2	30.94		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ACTICOAT FLEX-7  2"" X 2"""	272	A6206	HCPCS	307008	local	both	44.28	31		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,MEPIFORM,SOFT SILICONE 2X3"	272	A4649	HCPCS	338956	local	both	44.28	31		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC BONE WAX 2.5G	272	272	RC	5271770	local	both	45.34	31.74		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC HEMOCLIPS-SM	272	272	RC	5270072	local	both	46.23	32.36		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG HYDROGEL 3 OZ	272	A6248	HCPCS	303824	local	both	47	32.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC COMPRESSION STOCKING-THIGH HIGH	272	272	RC	342753	local	both	47.02	32.91		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ALLEVYN LIFE SACRUM SMALL	272	A6213	HCPCS	303309	local	both	48	33.6		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CLIP FIXING DEVICE ENDO	272	272	RC	503105	local	both	49	34.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG .9% NACL 500ML BOTTLE	272	272	RC	310067	local	both	49.7	34.79		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG WATER STERILE 1000ML	272	272	RC	310061	local	both	50.35	35.25		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG .9% NACL 1000ML BOTTLE	272	272	RC	310068	local	both	50.35	35.25		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG DRESSING, SILVASORB GEL 0.25OZ"	272	A6248	HCPCS	305071	local	both	51.86	36.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING ALLEVYN 7"" X 7"""	272	A6214	HCPCS	309163	local	both	53	37.1		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DRESSING ALLEVYN SACRUM	272	A6213	HCPCS	5271795	local	both	53	37.1		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,ALLEVYN SACRUM 6""X6"""	272	A6213	HCPCS	338928	local	both	53.03	37.12		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,BIOPATCH DISK 2.5CM"	272	A6209	HCPCS	338957	local	both	53.65	37.56		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE/BUTTON TENDON REPAIR	272	272	RC	5271771	local	both	54	37.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC SUTURE, ALL COMMON"	272	272	RC	309630	local	both	54.78	38.35		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG SILVERCEL 1"" X 12"""	272	A6196	HCPCS	307017	local	both	56.75	39.73		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE	272	272	RC	5271784	local	both	57.95	40.57		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, ALLEVYN 6"" X 6"""	272	A6213	HCPCS	338927	local	both	59.13	41.39		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING ACTICOAT 4"" X 4"""	272	272	RC	338955	local	both	59.4	41.58		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG DRESSING PROMOGRAN W/O SILVER 4.34"""	272	A6021	HCPCS	303326	local	both	60	42		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING UNNA BOOT 4""X10'"	272	272	RC	309675	local	both	62.16	43.51		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, UNNA BOOT 4""X10'"	272	272	RC	310079	local	both	62.16	43.51		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING ACTICOAT 4"" X 4"""	272	A9270	HCPCS	309173	local	both	62.93	44.05		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG DRESSING,HYDROFERA BLUE 4X4"	272	A6209	HCPCS	338959	local	both	63.4	44.38		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG OPTIFOAM HEEL DRESSING	272	A6210	HCPCS	302247	local	both	64	44.8		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE	272	272	RC	5271772	local	both	65.57	45.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG COLLAGEN PURACOL AG WITH SILVER 2X2	272	A6021	HCPCS	503854	local	both	67	46.9		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC OP-SITE DRESSING LARGE	272	272	RC	5270034	local	both	67.04	46.93		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DRESSING BIOPATCH ANTIMICROBIAL	272	272	RC	310082	local	both	68.53	47.97		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC BIOSTEP 2X2 SHEET	272	A6021	HCPCS	342750	local	both	69.03	48.32		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG REPLICARE SACRUM  7"" X 8"""	272	A6235	HCPCS	307016	local	both	71.69	50.18		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DRESSING MEDIHONEY 2.4X2.4IN SHEET NON ADH	272	A6234	HCPCS	501845	local	both	75	52.5		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ABDOMINAL BINDER	272	272	RC	342751	local	both	79.55	55.69		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DRESSING PRMOGRN PRISMA MATRIX 4X4	272	A6021	HCPCS	303307	local	both	80	56		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING,SILVASORB SHEET,4""X4"""	272	A6242	HCPCS	338954	local	both	81.58	57.11		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DRESSING MEDIHONEY 4.3 X4.3 IN SHEET NON ADH	272	A6235	HCPCS	501846	local	both	82	57.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC HEMOCLIPS-MED	272	272	RC	5270071	local	both	83.17	58.22		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IODOSORB GEL	272	A6261	HCPCS	501991	local	both	86.89	60.82		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG SAW BLADE SAGITTAL AGGRESSIVE	272	272	RC	503997	local	both	88.48	61.94		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESS, SM BURN"	272	272	RC	309633	local	both	89.88	62.92		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, COBAN 2 COMPRESSION"	272	272	RC	310080	local	both	95.68	66.98		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG DURAFIBER AG 4"" X 4"""	272	A6196	HCPCS	307013	local	both	99.44	69.61		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG GEL,MEDIHONEY 1.5 OZ"	272	A6240	HCPCS	309698	local	both	102	71.4		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DRESSING POWDER ARGLAES PER GM	272	A6262	HCPCS	343007	local	both	102.09	71.46		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC HEMCLIP CARTRIDGE	272	272	RC	5270033	local	both	109.97	76.98		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC HEMOCLIPS-MED/LD	272	272	RC	5270069	local	both	110.84	77.59		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IRRIG .9 NACL 1000ML BOTTLE	272	272	RC	309624	local	both	112.98	79.09		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC MONOCRYL 4-0 PS-2	272	272	RC	5271758	local	both	113.32	79.32		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC HEMOCLIPS-LG	272	272	RC	5270070	local	both	113.58	79.51		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG ACTICOAT FLEX-7  4"" X 5"""	272	A6206	HCPCS	307009	local	both	120.92	84.64		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SILVASORB GEL 1.5 OZ. TUBE	272	272	RC	310040	local	both	127.28	89.1		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC IV SOLUSET	272	272	RC	309622	local	both	132.87	93.01		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESSING, SILVASORB GEL 1.5OZ"	272	A6248	HCPCS	338945	local	both	133.74	93.62		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG OPSITE FLEXIFIX FILM	272	A6257	HCPCS	307015	local	both	134.62	94.23		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DRESS MED BURN	272	272	RC	309632	local	both	134.72	94.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC FIBERWIRE 2 SUTURE	272	272	RC	5270056	local	both	159.11	111.38		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CAP PROTECTIVE 11MM TUBES&RODS	272	272	RC	5271759	local	both	161.05	112.74		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC SUTURE SURGITIE 2/0 21"" 5CM"	272	272	RC	5271911	local	both	167.85	117.5		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE WIRE FIBERWIRE	272	272	RC	5271761	local	both	168.47	117.93		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG SUTURE, QUILL"	272	272	RC	502779	local	both	169	118.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ENDOSTITCH SUTURE REFIL	272	272	RC	5270042	local	both	172.89	121.02		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DRESS, LG BURN"	272	272	RC	309631	local	both	179.53	125.67		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC TRACH DISP INNER CANNULA	272	272	RC	309634	local	both	179.53	125.67		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CASTELLANI PANT 1 OZ	272	272	RC	305072	local	both	181.2	126.84		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE	272	272	RC	5271777	local	both	186.06	130.24		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE	272	272	RC	5271781	local	both	190.13	133.09		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE	272	272	RC	5271778	local	both	197.18	138.03		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC HEM-O-LOK	272	272	RC	5270074	local	both	201.75	141.23		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE	272	272	RC	5271776	local	both	204.45	143.12		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG DILATOR, SERIAL PEEL AWAY 22-*"	272	272	RC	4410472	local	both	206	144.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC FIBERLOOP 4-0 20"" W/NEEDLE"	272	272	RC	5271914	local	both	210.61	147.43		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG STENT, SHEATH INTRO"	272	C1894	HCPCS	4410296	local	both	223.86	156.7		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG SUTURE WIRE	272	272	RC	5271794	local	both	225.14	157.6		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SKIN STAPLES	272	272	RC	309621	local	both	226.68	158.68		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE TK-5 TITANIUM TOP KNOT	272	272	RC	5271765	local	both	254.19	177.93		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC SUTURE WIRE FIBERWIRE #5  38"""	272	272	RC	5271762	local	both	261.45	183.02		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CONCEPT SHUTTLE-RELAY SUTURE	272	272	RC	5270044	local	both	266.27	186.39		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG GUIDE WIRE, HYDROPHILIC HYBRID"	272	C1769	HCPCS	4410477	local	both	276.78	193.75		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC SUTURE PDS II 2-0 STP 10 27"""	272	272	RC	5271929	local	both	286.07	200.25		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SPIKED WASHERS	272	C1713	HCPCS	5270036	local	both	312.03	218.42		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC SUTURE WIRE FIBERWIRE #2 38"""	272	272	RC	5271763	local	both	312.29	218.6		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC HEMOSTAT SURGICEL 2"" X 3"""	272	272	RC	5271785	local	both	314.32	220.02		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CAP PROTECTIVE-PINS	272	272	RC	5271760	local	both	330.08	231.06		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE WIRE FIBERSTICK #2	272	272	RC	5271764	local	both	334.07	233.85		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC STAPLES RELOAD	272	272	RC	5270066	local	both	380.77	266.54		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG BLADE, OSCILLATING"	272	272	RC	500082	local	both	396	277.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG EXTRA SUTURE	272	272	RC	303747	local	both	459	321.3		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC PORT-A-CATH INTRODUCER SET	272	272	RC	5270043	local	both	468.39	327.87		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC ON Q PAINBUSTER COMPONENT, TUNNELING"	272	C1887	HCPCS	5271901	local	both	508.37	355.86		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG DISP ENTRY NEEDLE	272	272	RC	303456	local	both	516	361.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC HEMOSTAT SURGICEL 4"" X 8"""	272	272	RC	5271786	local	both	574.02	401.81		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CATH, COMPLIANT OCCL BALLOON"	272	C2628	HCPCS	4410475	local	both	588.13	411.69		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG SUTURE NICE LOOP SZ.5 WHITE/GREEN	272	272	RC	501784	local	both	595.69	416.98		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG SUTURE NICE LOOP SZ.5 GREEN	272	272	RC	501783	local	both	595.69	416.98		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC DACRON POUCH-MEDTRONIC	272	272	RC	5270075	local	both	617.31	432.12		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC GIA RELOADS	272	272	RC	5270067	local	both	644.64	451.25		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ARISTA ABSORBABLE HEMOSTAT 1GM	272	272	RC	5271910	local	both	718.98	503.29		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC 18 GUAGE SUTURE WIRE	272	272	RC	5270061	local	both	775.85	543.1		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC FIBERTAPE-SUTURE FOR INTERNAL ROTATOR CUFF REPAIRS	272	272	RC	5270062	local	both	777.09	543.96		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC EXPRESSO SUTURES NEEDLES	272	272	RC	5270063	local	both	819.94	573.96		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC CATHETER CV 7FR 3-LUMEN POWER	272	A4300	HCPCS	5271298	local	both	864.57	605.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG WOUND SUCTION DISPOSABLE INCL DRESS ALL ACCESS	272	A9272	HCPCS	503857	local	both	959.9	671.93		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC FLEX NECK PERITONEAL DIALYSIS CATHETER	272	C1750	HCPCS	5270060	local	both	978.12	684.68		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ENDOSTITCH	272	272	RC	5270030	local	both	1065.74	746.02		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC FLOSEAL	272	272	RC	5270068	local	both	1088.61	762.03		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ORTHOSORB ABSORBABLE PIN	272	C1713	HCPCS	5270035	local	both	1170.49	819.34		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC GIA STAPLER	272	272	RC	5270032	local	both	1179.37	825.56		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ADEPT ADHESION REDUCTION SOLUTION	272	272	RC	5270065	local	both	1208.73	846.11		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SMART PORT CT LP W/6.5FR CATH	272	272	RC	5271945	local	both	1262.52	883.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SMART PORT CT W/8FRCATHETER	272	272	RC	5271944	local	both	1262.52	883.76		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG TEMP PACING KIT	272	272	RC	302892	local	both	1346	942.2		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC INTRATHECAL CATHETER PUMP SEGMENT REVISION KIT	272	272	RC	5270073	local	both	1553.86	1087.7		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG LASER FIBER FLEXIVA PULSE ID 500 MICRON	272	C1773	HCPCS	504001	local	both	1590.54	1113.38		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC STAPLER/ENDOHERNIA/UNVRSL/4.0	272	272	RC	5270029	local	both	1757.96	1230.57		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC OASIS ULTRA TRI-LAYER MATRIX	272	Q4124	HCPCS	501993	local	both	1776.92	1243.84		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC PREVENA WOUND MANAGEMENT SYSTEM	272	A4649	HCPCS	5271299	local	both	1922.91	1346.04		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC DERMA-CLOSE KIT, SURGICAL STAPLE"	272	272	RC	5270059	local	both	1942.32	1359.62		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC TOURNIER 5.0 MM INSITE BIO FORCE FIBER SUTURE	272	272	RC	5270064	local	both	2191.59	1534.11		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC CATHETER, GUIDING-ON-Q PAINBUSTER W/SILVERSOAKER"	272	C1887	HCPCS	5271733	local	both	2272.53	1590.77		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC ABSTACK-AUTOSUTURE	272	272	RC	5270031	local	both	2326.91	1628.84		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
"HCHG CVMC ELECTROPHYSIOLOGY, DIAG"	272	C1730	HCPCS	4410516	local	both	2341.51	1639.06		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG CVMC SUTURE LESS CATHETER	272	272	RC	5270076	local	both	2699.84	1889.89		87		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges	not to exceed 4150		85		percent of total billed charges	up to 3550		24.72		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			70		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			85		percent of total billed charges			23.8		percent of total billed charges			79		percent of total billed charges			25.2		percent of total billed charges			81.3		percent of total billed charges			24		percent of total billed charges				
HCHG NECK COLLAR	274	L0120	HCPCS	304418	local	both	27.22	19.05		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SHOULDER IMMOBILIZER	274	L3677	HCPCS	309519	local	both	59.31	41.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG ORTHOTIC HEEL LIFT	274	L3332	HCPCS	304706	local	both	67.48	47.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WRIST SPLINT	274	L3908	HCPCS	330981	local	both	81.35	56.95		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG GEL ANKLE CONTROL ORTHOSIS PREFAB	274	L4350	HCPCS	302040	local	both	101	70.7		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CERVICAL COLLAR PHILLY	274	L0140	HCPCS	309498	local	both	106.07	74.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FINGER SPLINT	274	L3929	HCPCS	330904	local	both	116.91	81.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG FINGER ORTHOTIC,PIP/DIP"	274	L3925	HCPCS	305138	local	both	116.91	81.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ELBOW BRACE	274	L3760	HCPCS	310093	local	both	116.91	81.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DYNAMIC FINGER SPLINT	274	L3929	HCPCS	330909	local	both	134.72	94.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LONGIT ARCH SUPPORT	274	L3040	HCPCS	309518	local	both	137.27	96.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CUSTOM ARCH SUPPORT	274	L3010	HCPCS	309513	local	both	137.27	96.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC WRIST HAND FINGER ORTHOSIS, W/O JOINT, PREFABRICATED"	274	L3807	HCPCS	309529	local	both	151.33	105.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC ELBOW ORTHOSIS, ELASTIC, PREFABRICATED"	274	L3960	HCPCS	310094	local	both	151.33	105.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SPLINT FINGER	274	L3807	HCPCS	309527	local	both	200.56	140.39		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG NON PNEUM WALK BOOT PRE OTS	274	L4387	HCPCS	302707	local	both	207	144.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KNEE IMMOBILIZER CHILD	274	L1820	HCPCS	309508	local	both	208.16	145.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG PALMER	274	L3931	HCPCS	304725	local	both	209.09	146.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SHORT THUMB SPICA (CUSTOM)	274	L3808	HCPCS	330929	local	both	209.09	146.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WALKING BOOT/SHORT - ALL SIZES	274	L4360	HCPCS	330934	local	both	217.15	152.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KNEE IMMOBILIZER ADULT	274	L1820	HCPCS	309507	local	both	231.16	161.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CUSTOM WRIST COCK UP	274	L3908	HCPCS	330941	local	both	269.43	188.6		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WALKING BOOT-XLARGE	274	L4360	HCPCS	330942	local	both	274.26	191.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LONG ARM SPLINT	274	L3982	HCPCS	309534	local	both	336.91	235.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LONG THUMB SPICA (CUSTOM)	274	L3808	HCPCS	330952	local	both	336.91	235.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DYNAMIC SPLINT	274	L3806	HCPCS	309525	local	both	373.12	261.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG KNEE BRACE	274	L1832	HCPCS	309599	local	both	517	361.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG ANKLE BRACE, ALL"	274	L1930	HCPCS	302061	local	both	580.66	406.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KNEE BRACE/HINGED POST-OP	274	L1810	HCPCS	5270077	local	both	830.41	581.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SHOULDER BRACE	274	L3678	HCPCS	310095	local	both	898.37	628.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CUSTOM POST OP HIP ABDUCTION	274	L1685	HCPCS	5271908	local	both	4284.86	2999.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LENS SUPPLY (ONLY)	276	C1780	HCPCS	5270078	local	both	32.5	22.75		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ASTIGMATISM CORRECTING IOL	276	V2787	HCPCS	5270081	local	both	732.91	513.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LENS/POSTERIOR CHAMBER INTRAOCULAR	276	V2632	HCPCS	5270079	local	both	954.95	668.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MULTIFOCAL INTRAOCULAR LENS	276	V2788	HCPCS	5270080	local	both	1294.7	906.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CRYSTALENS/PREBYOPIA CORRECTING FUNCTION	276	V2788	HCPCS	5270082	local	both	1530.1	1071.07		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			68		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		23.8		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC K-WIRE THREADED	278	C1769	HCPCS	5271927	local	both	44.73	31.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CATH, STRAIGHT/ROBINSON"	278	C1758	HCPCS	310017	local	both	52.46	36.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC METACARPOPHALANGEAL K-WIRE	278	C1713	HCPCS	5270086	local	both	54	37.8		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BRAUN EPIDURAL CATHETER SET:20	278	278	RC	5270540	local	both	60.39	42.27		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CROSS DRIVE SCREW 2.0X11MM	278	C1713	HCPCS	5270449	local	both	69.07	48.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHO MINI SCREW #25-672-09-1	278	C1713	HCPCS	5270452	local	both	69.07	48.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KIT-FEMALE CATH	278	C1758	HCPCS	310019	local	both	72.32	50.62		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHOGNATHIC SCREW #25-679-05	278	C1713	HCPCS	5270399	local	both	72.71	50.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHOGNATHIC SCREW #25-676-05	278	C1713	HCPCS	5270393	local	both	72.71	50.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHOGNATHIC SCREW #25-679-07	278	C1713	HCPCS	5270398	local	both	72.71	50.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC K-WIRE	278	C1769	HCPCS	5271652	local	both	76.37	53.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHOGNATHIC SCREW #25-678-07	278	C1713	HCPCS	5270394	local	both	79.99	55.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHOGNATHIC SCREW #25-678-05	278	C1713	HCPCS	5270395	local	both	79.99	55.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHOGNATHIC SCREW #25-673-05	278	C1713	HCPCS	5270451	local	both	79.99	55.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MINI 4 HOLE PLATE #25-550-04	278	C1713	HCPCS	5270453	local	both	107.25	75.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL SCREW 3.5MM-ALL	278	C1713	HCPCS	5270114	local	both	107.43	75.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LP PLATE STRAIGHT 4 HOLE	278	C1713	HCPCS	5270444	local	both	112.71	78.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LP PLATE L-SHAPE/4 HOLE SHORT	278	C1713	HCPCS	5270446	local	both	112.71	78.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ZIMMER CORTICAL SCREW 2.0X12	278	C1713	HCPCS	5270538	local	both	113.78	79.65		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL SCREW 2.7MM ALL	278	C1713	HCPCS	5270415	local	both	113.84	79.69		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS SCREW 4.0MM-ALL	278	C1713	HCPCS	5270115	local	both	115.69	80.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL SCREW 2.0 ALL SIZES-ZIMMER	278	C1713	HCPCS	5270264	local	both	116.94	81.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTICAL 4.5X14-75MM	278	C1713	HCPCS	5270126	local	both	119.82	83.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTICAL 2.0X10-18MM	278	C1713	HCPCS	5270124	local	both	130.25	91.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTICAL 1.5X6-16MM	278	C1713	HCPCS	5270123	local	both	130.25	91.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4-HOLE PLATE #50-321-04	278	C1713	HCPCS	5270400	local	both	132.69	92.88		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS SCREW 4.0/THREAD SYN	278	C1713	HCPCS	5270482	local	both	138.53	96.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5 CORTEX SCREW(SELF-TAPPING) ALL SIZES-SYNTHES	278	C1713	HCPCS	5270306	local	both	153.8	107.66		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KWIRE TROC PT 1.6 X 150MM	278	C1769	HCPCS	5271651	local	both	159.1	111.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW-3.5MM SCREW LCP SHFT	278	C1713	HCPCS	5271354	local	both	171.04	119.73		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5 CORTEX SCREW-DHS SET	278	C1713	HCPCS	5270190	local	both	180.56	126.39		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC K-WIRE 16MM SS	278	C1769	HCPCS	5271653	local	both	181.56	127.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH SURGIPRO MONOFILAMENT 1"" X 4"""	278	C1781	HCPCS	5272101	local	both	184.68	129.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTEX SCREW 2.0 ALL SIZES	278	C1713	HCPCS	5270258	local	both	187.4	131.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES CORTEX SCREW 3.5-ALL	278	C1713	HCPCS	5270479	local	both	189.58	132.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTEX SLFTAP	278	C1713	HCPCS	5271830	local	both	191.73	134.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC STEINMAN PIN- ALL	278	C1713	HCPCS	5270104	local	both	194.45	136.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WASHER-IMPLANT	278	C1713	HCPCS	5271367	local	both	197.68	138.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC ATRIUM, PROLITE MESH 3X6"	278	C1781	HCPCS	5270385	local	both	207.56	145.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WASHER 10.0MM	278	C1713	HCPCS	5271364	local	both	209.16	146.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WASHER	278	C1713	HCPCS	5270343	local	both	217.87	152.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTICAL 4.5X80-120MM	278	C1713	HCPCS	5270125	local	both	218.92	153.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WASHER-IMPLANT METAL 13.0MM	278	C1713	HCPCS	5271368	local	both	218.96	153.27		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LP PLATE L-SHAPE/4 HOLE-LONG	278	C1713	HCPCS	5270445	local	both	227.21	159.05		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WASHER	278	C1713	HCPCS	5270428	local	both	231.66	162.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH SURGIPRO MONOFILAMENT 3"" X 5"""	278	C1781	HCPCS	5272102	local	both	232.62	162.83		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 6 HOLE PLATE #50-330-06	278	C1713	HCPCS	5270424	local	both	236.3	165.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 6 HOLE PLATE #50-331-06	278	C1713	HCPCS	5270423	local	both	236.3	165.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH SURGIPRO MONOFILAMENT 4"" X 6"""	278	C1781	HCPCS	5272103	local	both	240.02	168.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG OASIS SKIN MATRIX PER SQUARE CM	278	Q4102	HCPCS	343159	local	both	245.71	172		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES PROTECTIVE CAPS FOR 6.0MM FIXATION PINS	278	C1713	HCPCS	5270218	local	both	247.48	173.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS BONE SCREW 6.5 32MM	278	C1713	HCPCS	5270360	local	both	254.18	177.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS SCREW 3X12-14	278	C1713	HCPCS	5270344	local	both	254.19	177.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS SCREW 4X14-22	278	C1713	HCPCS	5270345	local	both	254.19	177.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL SCREW 3.5X14	278	C1713	HCPCS	5270346	local	both	254.19	177.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW-6.5MM CANC SCREW	278	C1713	HCPCS	5271361	local	both	256.51	179.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTEX SCREW 2.7MM	278	C1713	HCPCS	5270465	local	both	259.65	181.76		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC CORTEX SCREWS, ALL SIZES"	278	C1713	HCPCS	5270234	local	both	262.46	183.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC K-WIRE TROCAR	278	C1769	HCPCS	5271928	local	both	265.17	185.62		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW-6.5MM CANC SCREW	278	C1713	HCPCS	5271362	local	both	276.12	193.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PRE STEPPED CHIN PLATE 5MM	278	C1713	HCPCS	5270448	local	both	281.75	197.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ONE THIRD TUBULAR 7 HOLE PLATE	278	C1713	HCPCS	5270413	local	both	281.81	197.27		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW-6.5MM CANC BONE SCREW FULL THR	278	C1713	HCPCS	5271363	local	both	290.5	203.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW COMPRESSING ALL SIZES	278	C1713	HCPCS	5270122	local	both	290.76	203.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ONE THIRD TUBULAR 6 HOLE PLATE	278	C1713	HCPCS	5270414	local	both	298.84	209.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PIN STEINMAN TRACTION	278	C1713	HCPCS	5271564	local	both	318.6	223.02		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,PROTECTIVE CAPS FOR 6.0MM FIXATION PINS"	278	C1713	HCPCS	5270215	local	both	321.72	225.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW DHS/DCS COMP SCREW 36MM	278	C1713	HCPCS	5271554	local	both	321.87	225.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DHS COMPRESSION SCREW	278	C1713	HCPCS	5271809	local	both	321.87	225.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH SURGIPRO MONOFILAMENT 6"" X 6"""	278	C1781	HCPCS	5272104	local	both	332.33	232.63		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG ARROW INTRODUCER (PERCUTAN KIT)	278	C1894	HCPCS	310018	local	both	336.65	235.66		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TENSION BAND PIN	278	C1713	HCPCS	5271644	local	both	341.34	238.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW #22-673-07	278	C1713	HCPCS	5270455	local	both	351.49	246.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW #25-673-11	278	C1713	HCPCS	5270456	local	both	351.49	246.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC STRAIGHT PLATE 17 HOLE	278	C1713	HCPCS	5270447	local	both	354.47	248.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG ALLOFUSE DBM PUTTY 1.0CC/PER 0.5CC	278	C9359	HCPCS	370035	local	both	363.12	254.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG ALLOFUSE DBM PUTTY 2.5CC/PER 0.5CC	278	C9359	HCPCS	370036	local	both	363.12	254.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHO SCREW #25-678-04	278	C1713	HCPCS	5270493	local	both	367.47	257.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG K-WIRE	278	C1713	HCPCS	5072201	local	both	382	267.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC KLS-SCREW, TITANIUM ALLOY"	278	C1713	HCPCS	5270480	local	both	384.92	269.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 11 HOLE PLATE #50-280-03	278	C1713	HCPCS	5270396	local	both	390.82	273.57		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 11-HOLE PLATE #50-282-03	278	C1713	HCPCS	5270397	local	both	390.82	273.57		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 11 HOLE MM PLATE #50-282-00	278	C1713	HCPCS	5270421	local	both	399.92	279.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 11 HOLE MM PLATE #50-280-00	278	C1713	HCPCS	5270422	local	both	399.92	279.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES TITANIUM LOCKING SCREWS 4.0 MM FOR IM NAILS	278	C1713	HCPCS	5270318	local	both	407.1	284.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE 1/4 TUBULAR 6 HOLE	278	C1713	HCPCS	5270085	local	both	437.28	306.1		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG STIFF GLIDEWIRE .035"" 180CM"	278	C1769	HCPCS	4410604	local	both	461	322.7		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL SCREW	278	C1713	HCPCS	5270130	local	both	479.32	335.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ACUMED 3.5MM X 20.0 MM SCREW	278	C1713	HCPCS	5270527	local	both	479.32	335.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ACUMED 3.5MM X 16.0MM SCREW	278	C1713	HCPCS	5270528	local	both	479.32	335.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW CORTICAL SCREW	278	C1713	HCPCS	5271628	local	both	479.32	335.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ACUMED 3.0-3.5 X 16-45 NON LOCKING HEXALOBE SCREW	278	C1713	HCPCS	5271799	local	both	493.85	345.7		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEMA CARTIOD PATCH VASCULAR	278	C1768	HCPCS	5270261	local	both	498.78	349.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC COMP RVS SHLDR STEINMAN PIN 9"""	278	C1713	HCPCS	5271309	local	both	516.07	361.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SCHANZ SCREWS, ALL SIZES"	278	C1713	HCPCS	5270235	local	both	517.82	362.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ZIMMER-5 HOLE PLATE	278	C1713	HCPCS	5271803	local	both	530.01	371.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW CANCELLOUS SCREW	278	C1713	HCPCS	5271629	local	both	537.42	376.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTEX ST	278	C1713	HCPCS	5271930	local	both	540.11	378.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TRIMED-CORTICAL SCREWS	278	C1713	HCPCS	5271807	local	both	544.68	381.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL HEX SCREW 3.2MM	278	C1713	HCPCS	5270245	local	both	544.69	381.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC VANGRD SSK FEMORAL STEM SCREW	278	C1713	HCPCS	5271308	local	both	551.95	386.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOCKING BONE SCREW	278	C1713	HCPCS	5270131	local	both	559.21	391.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ACUMED 3.5MM X 14.0MM SCREW	278	C1713	HCPCS	5270526	local	both	559.21	391.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ENDO HERNIA STAPLER REFILL	278	278	RC	5270089	local	both	559.34	391.54		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW NON-LOCKING HEXALOBE SCREW	278	C1713	HCPCS	5271624	local	both	566.47	396.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TITANIUM END CAP FOR ENDERNAIL	278	C1713	HCPCS	5270519	local	both	567.2	397.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WASHER AO SPIKED 8 X 3.2 SMALL	278	C1713	HCPCS	5271365	local	both	568.65	398.06		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BAR(CARBON FIBER ROD) 120MM	278	C1713	HCPCS	5270239	local	both	591.31	413.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PIN STEIMANN	278	C1713	HCPCS	5271565	local	both	591.53	414.07		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PEG SMOOTH/ ALL SIZES	278	C1713	HCPCS	5270469	local	both	599.16	419.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PEG PARTIAL THREAD-ALL	278	C1713	HCPCS	5270440	local	both	599.16	419.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL SCREW-ALL (DEPUY)	278	C1713	HCPCS	5270441	local	both	599.16	419.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW #25-677-08	278	C1713	HCPCS	5270457	local	both	599.16	419.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW #25-677-10	278	C1713	HCPCS	5270458	local	both	599.16	419.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW PEGS/ ALL SIZES	278	C1713	HCPCS	5270468	local	both	599.16	419.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ	278	C1713	HCPCS	5271566	local	both	601.33	420.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC PROSTHESIS, BREAST IMPLANT"	278	A4648	HCPCS	5270105	local	both	606	424.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW NON-LOCK GOLD	278	C1713	HCPCS	5271932	local	both	610.06	427.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL LAG SCREW 3.2MM	278	C1713	HCPCS	5270246	local	both	617.31	432.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG PEEL AWAY SUPRAPUBIC CATHETER	278	C2627	HCPCS	302524	local	both	628	439.6		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 2.5MM CANCELLOUS SCREW	278	C1713	HCPCS	5270113	local	both	631.15	441.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH-ATRIUM 6X6	278	C1781	HCPCS	5270091	local	both	639.09	447.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHREX FASTAK II SPEAR	278	C1713	HCPCS	5270411	local	both	639.09	447.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CORTICAL SCREW	278	C1713	HCPCS	5271630	local	both	639.1	447.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC REVERSE STEINMAN PIN	278	C1713	HCPCS	5270330	local	both	645.55	451.89		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW NO-TOG CORTICAL SCREW	278	C1713	HCPCS	5271631	local	both	646.36	452.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ SPDE PT	278	C1713	HCPCS	5271567	local	both	660.16	462.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW CANCELLOUS SCREW	278	C1713	HCPCS	5271632	local	both	668.15	467.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC PARIETEX MESH, PLUG AND PATCH"	278	C1781	HCPCS	5271884	local	both	694.53	486.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE NAIL	278	C1713	HCPCS	5271312	local	both	694.53	486.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX PLUG PATCH 8CM	278	C1781	HCPCS	5272077	local	both	696.78	487.75		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC VANGRD XL BONE NAIL	278	C1713	HCPCS	5271313	local	both	697.2	488.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC DEPUY DISTAL RADIUS SET, PEGS-NON LOCKING, ALL SIZES"	278	C1713	HCPCS	5270182	local	both	698.28	488.8		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW LOCKING ST T8	278	C1713	HCPCS	5271933	local	both	698.58	489.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES CONICAL SCREW ALL SIZES	278	C1713	HCPCS	5270475	local	both	699.39	489.57		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SMOOTH/THREADED PEG ALL SIZES	278	C1713	HCPCS	5270504	local	both	699.39	489.57		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW LOCKG HEXALOBE SCREW	278	C1713	HCPCS	5271626	local	both	700.32	490.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOCKING HEXALOBE SCREW	278	C1713	HCPCS	5271825	local	both	700.32	490.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX ANATOMICAL 15CM X 10CM	278	C1781	HCPCS	5272078	local	both	702.34	491.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES-LOCKING SCREW 2.0MM-ALL	278	C1713	HCPCS	5270254	local	both	708.81	496.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG STENT, URETERAL 8 X 28"	278	C2617	HCPCS	4410300	local	both	718.92	503.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW AEQ REV COMP SCREW	278	C1713	HCPCS	5271615	local	both	718.98	503.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AEQ REVERSED COMPRESSION SCREW (4.5 X 18-26MM)	278	C1713	HCPCS	5271816	local	both	718.98	503.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CANCELLOUS CHIPS 5.0CC	278	C1763	HCPCS	370037	local	both	726.25	508.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIO-CORTICAL POST	278	C1713	HCPCS	5271620	local	both	726.25	508.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW TAP-LOC SCREW	278	C1713	HCPCS	5271634	local	both	729.25	510.48		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SPIKED WASHER	278	C1713	HCPCS	5270083	local	both	730.3	511.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG SHEATH LASER LEAD EXTRACT	278	C2629	HCPCS	306407	local	both	732.63	512.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW LOCKING CORTICAL SCREW	278	C1713	HCPCS	5271633	local	both	733.51	513.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES LOCKING SCREW 2.7MM ALL	278	C1713	HCPCS	5270262	local	both	737.87	516.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW NON-LOCKING HEXALOBE SCREW	278	C1713	HCPCS	5271625	local	both	740.77	518.54		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES, SCHANZ SCREW BLUNTED TROCAR POINT 200MM"	278	C1713	HCPCS	5270214	local	both	750.67	525.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CEMENT PLUG BIO-PLUG	278	278	RC	5271793	local	both	752.4	526.68		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CONNECTIVE TISSUE (HUMAN) TISSEEL GLUE KIT 2ML ONLY	278	C1762	HCPCS	5271649	local	both	757.44	530.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW UNICORTICAL DNP-A	278	C1713	HCPCS	5271613	local	both	758.19	530.73		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW ACL INT	278	C1713	HCPCS	5271616	local	both	761.09	532.76		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KYPHX HV-R BONE CEMENT	278	C1713	HCPCS	5270450	local	both	763.95	534.77		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TIBIAL LOCKING BAR	278	C1713	HCPCS	5271306	local	both	763.98	534.79		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC EXPLOR IMPLANT LOCKING SCREW	278	C1713	HCPCS	5271311	local	both	763.98	534.79		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 6.5MM CANCELLOUS SCREW-ALL	278	C1713	HCPCS	5270111	local	both	766.38	536.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ACUMED-2.7-3.0 X 10-18 NON LOCKING HEXALOBE SCREW	278	C1713	HCPCS	5271798	local	both	769.82	538.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET MODULAR TIBIAL LOCKING BAR	278	C1776	HCPCS	5270176	local	both	774.11	541.88		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH SURGIPRO MONOFILAMENT 14"" X 9"""	278	C1781	HCPCS	5272105	local	both	775.48	542.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW VC LOCKING 2.4	278	C1713	HCPCS	5271934	local	both	777.29	544.1		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW LOCKING BLUE 2.5	278	C1713	HCPCS	5271935	local	both	781.34	546.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PEG LOCKING	278	C1713	HCPCS	5271609	local	both	784.34	549.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE FRAG PLATE PEG FT	278	C1713	HCPCS	5271611	local	both	784.34	549.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTICAL	278	C1713	HCPCS	5271612	local	both	784.34	549.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES 5.0 STEINMANN PIN W/CENTRAL THREAD, 200MM"	278	C1713	HCPCS	5270219	local	both	786.25	550.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES, 5.0MM STEINMANN PIN W/CENTRAL THREAD 200MM"	278	C1713	HCPCS	5270213	local	both	786.25	550.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,6.0MM TRANSFIXATION PIN 225MM"	278	C1713	HCPCS	5270216	local	both	791.95	554.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOCKING SCREW 3.5X14-16	278	C1713	HCPCS	5270347	local	both	798.87	559.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PIN STEINMAN CEN THRD	278	C1713	HCPCS	5271602	local	both	802.18	561.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOW PROFILE SELF TAPING SCREW	278	C1713	HCPCS	5271797	local	both	805.08	563.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH-HERNIA PLUG SMALL	278	C1781	HCPCS	5270410	local	both	806.98	564.89		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PIN TRANSFIXATION 6.0X225MM	278	C1713	HCPCS	5271833	local	both	807.39	565.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH ATRIUM-CENTRIFX MESH 9CMX15.5CM	278	C1781	HCPCS	5271886	local	both	810.28	567.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH CENTRIFX 4.1"" X 6.3""  MED"	278	C1713	HCPCS	5271622	local	both	810.28	567.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH-HERNIA PLUG MEDIUM	278	C1781	HCPCS	5270409	local	both	823.88	576.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 3/8-24 APICAL HOLE PLUG 1//CUP	278	278	RC	5271788	local	both	827.65	579.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH PLUG PARIETEX 6CM	278	C1781	HCPCS	5271197	local	both	829.52	580.66		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ZIMMER CANNULATED SCREW 4.0ALL	278	C1713	HCPCS	5270117	local	both	830.8	581.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOCKING SCREW 2.4MM	278	C1713	HCPCS	5270466	local	both	830.8	581.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCREW SCHNZ TROCR	278	C1713	HCPCS	5271571	local	both	833.43	583.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SCREW, CANN. INTERFERENCE"	278	C1713	HCPCS	5271845	local	both	835.18	584.63		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CONNECTIVE TISSUE (HUMAN) TISSEEL GLUE W/DUPLOJECT	278	C1762	HCPCS	5271648	local	both	838.81	587.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC REGENERATION BONE PASTE	278	C9359	HCPCS	5270142	local	both	839.22	587.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ATRIUM CENTRIFX 10.5 X 16CM	278	C1781	HCPCS	5271727	local	both	839.22	587.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH-HERNIA PLUG LARGE	278	C1781	HCPCS	5270408	local	both	840.84	588.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC ON-Q PAINBUSTER COMPONENT, EXPANSION"	278	C1887	HCPCS	5271900	local	both	845	591.5		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOCKING HEXALOBE SCREW	278	C1713	HCPCS	5271623	local	both	845	591.5		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW LOCKING HEXALOBE SCREW	278	C1713	HCPCS	5271627	local	both	845.01	591.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CORTEX LCKG SLFTAP	278	C1713	HCPCS	5271831	local	both	845.01	591.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OPTIONAL ACET APICAL PLUG	278	278	RC	5271789	local	both	845.01	591.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC WASHER AO SPIKED	278	C1713	HCPCS	5271366	local	both	848.54	593.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET SCREW 4.5 X 3.5	278	C1713	HCPCS	5270525	local	both	853.11	597.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW TI GLENOID SCREW LP	278	C1713	HCPCS	5271304	local	both	856.58	599.61		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TI BONE SCREW LP	278	C1713	HCPCS	5271303	local	both	856.58	599.61		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CENTRAL SCREW 6.5 MM (20-25MM)	278	C1713	HCPCS	5270331	local	both	868.16	607.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIO CEMENT PLUG	278	C1713	HCPCS	5270161	local	both	868.16	607.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TI END CAP FOR TFN	278	C1713	HCPCS	5271791	local	both	868.16	607.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC TITAN ANCHOR, MEDTRONIC NEUROSTIMULATOR"	278	C1713	HCPCS	5270323	local	both	868.17	607.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET COBALT HV BONE CEMENT	278	C1713	HCPCS	5270536	local	both	868.49	607.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES LOCKING SCREW 3.5-ALL	278	C1713	HCPCS	5270476	local	both	870.77	609.54		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TITANIUM CATHETER CONNECTOR FOR PD FLEX NECK CATHETER	278	C1788	HCPCS	5270143	local	both	873.94	611.76		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FIXED LOCKING SCREW 4.75MM (25-45MM)	278	C1713	HCPCS	5270334	local	both	877.06	613.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC NON LOCKING SCREW 4.75MM (20-30MM)	278	C1713	HCPCS	5270332	local	both	877.06	613.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MENISCAL ARROW #10	278	C1713	HCPCS	5271294	local	both	885.52	619.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LUMENS/MUTI-MED CV CATHETER	278	C1750	HCPCS	5270539	local	both	886.26	620.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MICROPLATE L RT LONG 25-315-85	278	C1713	HCPCS	5270495	local	both	891.29	623.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW 3.0 X 28 MM	278	C1713	HCPCS	5270327	local	both	896.46	627.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT AEQ REV II RETROVERSION ROD	278	C1776	HCPCS	5271720	local	both	897.1	627.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC 6MM HALF PIN, EXTERNAL FIXATION"	278	C1713	HCPCS	5270199	local	both	900.35	630.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW	278	C1713	HCPCS	5271339	local	both	901.15	630.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW PERIART LOCKING	278	C1713	HCPCS	5271370	local	both	901.15	630.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC EVICEL FIBRIN SEALANT (HUMAN) 1ML	278	C1762	HCPCS	5270377	local	both	901.21	630.85		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CANNULATED FULL TH 12-65	278	C1713	HCPCS	5270116	local	both	902.88	632.02		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH MYCROMESH 5CM X 10CM X1MM	278	C1781	HCPCS	5271730	local	both	902.89	632.02		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC VERSA-DIAL SHOULDER SYSTEM STANDARD ADAPTER	278	C1776	HCPCS	5270335	local	both	903.77	632.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ SD SS	278	C1713	HCPCS	5271568	local	both	906.36	634.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TI END CAP T40	278	C1713	HCPCS	5271347	local	both	914.46	640.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE TUBULAR 1/3 3 HOLE	278	C1713	HCPCS	5271465	local	both	932.4	652.68		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW 5.0MM CANN PART TH 42.70	278	C1713	HCPCS	5270119	local	both	933.17	653.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW 5.0 CANN FULL TH 12.65	278	C1713	HCPCS	5270118	local	both	933.17	653.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MINI QUICK ANCHOR PLUS (#2/0 SUTURE) DEPUY	278	C1713	HCPCS	5270293	local	both	934.71	654.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC XTENDOBUTTON FIXATION DEVICE	278	C1713	HCPCS	5271936	local	both	943.4	660.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW 7.0MM CANN 16MM 30-130	278	C1713	HCPCS	5270120	local	both	953.82	667.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW 7.0 CANN 32MM TH 40-120	278	C1713	HCPCS	5270121	local	both	953.82	667.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MICROPLATE L RT LONG 25-331-85	278	C1713	HCPCS	5270491	local	both	954.95	668.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MICROPLATE L LT LONG 25-330-85	278	C1713	HCPCS	5270492	local	both	954.95	668.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW COMP RVS SCREW	278	C1713	HCPCS	5271305	local	both	954.98	668.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW PERIART CON CANN	278	C1713	HCPCS	5271341	local	both	958.45	670.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW FIXED LOCKING SCREW	278	C1713	HCPCS	5271307	local	both	960.76	672.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 1/3 TUBULAR PLATE 6 HOLES	278	C1713	HCPCS	5270473	local	both	961.32	672.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHREX BI-CORTICAL POST	278	C1713	HCPCS	5270425	local	both	967.67	677.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIODESIGN-SURGISIS STAPLE LINE REINFORCEMENT	278	C1781	HCPCS	5270243	local	both	972.34	680.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 1/3 TUBULAR PLATE-7 HOLES	278	C1713	HCPCS	5270486	local	both	986.78	690.75		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL CENTRALIZER	278	C1713	HCPCS	5270159	local	both	990.86	693.6		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEX SS CRLG BUTTON-S	278	C1713	HCPCS	5271345	local	both	1000.12	700.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CRLG POS PIN	278	C1713	HCPCS	5271572	local	both	1000.12	700.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC IMPLANT CHONDRAL DART	278	C1713	HCPCS	5271598	local	both	1001.28	700.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHREX CHONDRAL DART 18MM	278	C1713	HCPCS	5270513	local	both	1005.89	704.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW NUT 5.0MM	278	C1713	HCPCS	5271369	local	both	1010.54	707.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ SD TI	278	C1713	HCPCS	5271592	local	both	1010.54	707.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES TITANIUM LOCKING SCREWS-ALL	278	C1713	HCPCS	5270433	local	both	1012.74	708.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MINI BIOSUTURE TAK 2.5MM	278	C1713	HCPCS	5271824	local	both	1012.85	709		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ SD SS	278	C1713	HCPCS	5271569	local	both	1020.96	714.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CARBON FIBER 8MM	278	C1713	HCPCS	5271579	local	both	1026.16	718.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT DISTAL CENTRALIZER	278	C1776	HCPCS	5271675	local	both	1030.22	721.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OCULAR IMPLANT ASSIST DEVICE	278	C1783	HCPCS	5270134	local	both	1041.79	729.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW AEQ REV LOCK SCREW	278	C1713	HCPCS	5271614	local	both	1041.79	729.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PARIETEX MESH TECT 1510A	278	C1781	HCPCS	5270521	local	both	1046.01	732.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ORTHOSORBABLE PIN #84-1070	278	C1713	HCPCS	5270514	local	both	1047.85	733.5		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TITANIUM END CAP FOR HINDFOOT ARTHRODESIS NAILS	278	C1713	HCPCS	5270362	local	both	1048.97	734.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ENDO GIA 30-3.5 DLU REFILL	278	248	RC	5270087	local	both	1061.62	743.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CATH PICC SOLO INTEGRATED 5FR	278	C1751	HCPCS	4410379	local	both	1072.27	750.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE TUBULAR 1/3 4 HOLE	278	C1713	HCPCS	5271293	local	both	1078.25	754.78		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC STAPLER/ENDOCLIP 10MM	278	C1760	HCPCS	5270090	local	both	1081.6	757.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CENTRAL SCREW-BIOMET	278	C1713	HCPCS	5270267	local	both	1082.3	757.61		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TITANIUM LOCK SCREWS-IM NAILS 6.0MM (SYNTHES)	278	C1713	HCPCS	5270374	local	both	1086.24	760.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4MM TI LOCK SCREW	278	C1713	HCPCS	5271350	local	both	1086.24	760.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CANCELLOUS CHIPS 15CC	278	C1763	HCPCS	370038	local	both	1089.37	762.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ SD DD	278	C1713	HCPCS	5271570	local	both	1093.88	765.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE BOLT 4.9MM TI LOCK BOLT	278	C1713	HCPCS	5271591	local	both	1093.88	765.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FIXED LOCKING SCREW-BIOMET	278	C1713	HCPCS	5270268	local	both	1093.89	765.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 5.0MM TI LOCK SCREW W/T25	278	C1713	HCPCS	5271351	local	both	1099.09	769.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ACL INTERFERENCE SCREW 9MM-ALL	278	C1713	HCPCS	5270417	local	both	1101.39	770.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TUNNELOC INTERF SCREW 7MMX20MM	278	C1713	HCPCS	5270512	local	both	1101.4	770.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PEG MULTI-DIR THREAD	278	C1713	HCPCS	5271610	local	both	1105.46	773.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW ACUTWIST ACUTK COMP SCREW	278	C1713	HCPCS	5271635	local	both	1105.46	773.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD 8MM CARBON FIBER	278	C1713	HCPCS	5271580	local	both	1114.72	780.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW BIO-INTERFERENCE SCREW	278	C1713	HCPCS	5271619	local	both	1122.82	785.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW 5.0MM TI LOCK SCREW HR	278	C1713	HCPCS	5271590	local	both	1128.03	789.62		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW-4.0MM CANN SCREW LNG THRD/50MM	278	C1713	HCPCS	5271356	local	both	1128.84	790.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW PERIART LOCK CANN	278	C1713	HCPCS	5271340	local	both	1144.81	801.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CEMENT RESTRICTOR 8-15 MM	278	C1713	HCPCS	5270223	local	both	1145.68	801.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH 6.3 X 4 XL WITH SLIT	278	C1781	HCPCS	5270524	local	both	1146.78	802.75		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC VERSA-DIAL SHOULDER ADAPTER	278	C1776	HCPCS	5271666	local	both	1151.76	806.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL POST CENTRALIZER 11MM	278	C1776	HCPCS	5271876	local	both	1151.76	806.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LCP 1/3 TUBLR PLATE W/ COLLAR	278	C1713	HCPCS	5271290	local	both	1156.39	809.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES CANNULATED SCREW 4.0 ALL	278	C1713	HCPCS	5270472	local	both	1158.68	811.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 2.5 HEADLESS SCREW	278	C1713	HCPCS	5270325	local	both	1165.4	815.78		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE STRAIGHT 1.3MM 6H	278	C1713	HCPCS	5271937	local	both	1165.94	816.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ SD TI	278	C1713	HCPCS	5271593	local	both	1166.81	816.77		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CATH, CORONARY LASER"	278	C1885	HCPCS	4410453	local	both	1170.61	819.43		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES-T-PLATE 2 HOLES HEAD, 8 HOLE SHAFT"	278	C1713	HCPCS	5270259	local	both	1171.44	820.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM STRT PLATE 6 HL	278	C1713	HCPCS	5271546	local	both	1174.72	822.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEADED SCREW 2.0 X 12MM	278	C1713	HCPCS	5270354	local	both	1174.91	822.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEADED SCREW 2.0 X 16 MM	278	C1713	HCPCS	5270353	local	both	1174.91	822.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AEQ REVERSED LOCKING SCREW (4.5X 20)	278	C1713	HCPCS	5271813	local	both	1174.91	822.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AEQ REVERSED LOCKING SCREW (4.5X 35)	278	C1713	HCPCS	5271814	local	both	1174.91	822.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANNULATED SCREW 4.5MM-ALL	278	C1713	HCPCS	5270499	local	both	1177.77	824.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 200 MM BAR/EXTERNAL FIXATION	278	C1713	HCPCS	5270197	local	both	1181.41	826.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES, CARBON FIBER ROD 400MM"	278	C1713	HCPCS	5270212	local	both	1181.64	827.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 4 HOLE 59	278	C1713	HCPCS	5271390	local	both	1181.71	827.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC REUNITE ORTHO SCREW 2.5X2.5MM	278	C1713	HCPCS	5270490	local	both	1184.13	828.89		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CONNECTIVE TISSUE (HUMAN) TISSEEL GLUE KIT 4ML ONLY	278	C1762	HCPCS	5271650	local	both	1191.11	833.78		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM LC-DCP PLATE 8 HL/51MM	278	C1713	HCPCS	5271515	local	both	1192.2	834.54		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARROW TRIPLELUMEN CATH	278	C1751	HCPCS	310370	local	both	1195.52	836.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE TUBULAR 1/3 12H/141MM	278	C1713	HCPCS	5271466	local	both	1198.06	838.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEADLESS SCREW 2.5 X 22MM	278	C1713	HCPCS	5270352	local	both	1200.35	840.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEADLESS SCREW 2.5X20	278	C1713	HCPCS	5270349	local	both	1200.36	840.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TRIMED-VOLAR BUTTRESS PIN	278	C1713	HCPCS	5271804	local	both	1204.24	842.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TRIMED-DORSAL BUTTRESS PIN	278	C1713	HCPCS	5271805	local	both	1204.24	842.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES 11.0MM CARBON FIBER ROD,400MM"	278	C1776	HCPCS	5270217	local	both	1206.19	844.33		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 1.5MM CNDLR PLATE 7 HL/36MM	278	C1713	HCPCS	5271542	local	both	1213.18	849.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ENDOBUTTON CL ULTRA 35MM	278	C1713	HCPCS	5271283	local	both	1219.78	853.85		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LCP BONE PLATE 9 HOLE	278	C1713	HCPCS	5270288	local	both	1221.34	854.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES 5.0 CANNULATED SCREWS	278	C1713	HCPCS	5270313	local	both	1224.68	857.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM LC-DCP PLATE 4 HL/35MM	278	C1713	HCPCS	5271550	local	both	1230.66	861.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES LC-DCP 2.4 MM PLATE 4 HOLE	278	C1713	HCPCS	5271817	local	both	1230.66	861.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEADED SCREW 2.5X20	278	C1713	HCPCS	5270348	local	both	1232.79	862.95		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW-4.0MM CANN SCREW SHRT	278	C1713	HCPCS	5271355	local	both	1234.52	864.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 1.5MM STRT PLATE 6 HL	278	C1713	HCPCS	5271819	local	both	1234.52	864.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OSTEORAPTOR 2.9 SUTURE ANCHOR	278	C1713	HCPCS	5271302	local	both	1235.32	864.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SUTURE ANCHOR OSTEORAPTOR	278	C1713	HCPCS	5271821	local	both	1235.32	864.72		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW SCHNZ SD TI	278	C1713	HCPCS	5271594	local	both	1239.73	867.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 5MM TI LOCK SCREW DC T25	278	C1713	HCPCS	5271352	local	both	1250.15	875.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LUPINE BR ANCHOR W/ORTHOCOD	278	C1713	HCPCS	5270092	local	both	1254.73	878.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 5 HOLE 72	278	C1713	HCPCS	5271391	local	both	1255.13	878.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PRO GRIP LAP 15CM X 10CM	278	C1781	HCPCS	5272079	local	both	1257.04	879.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MANDIBLE TRAUMA TITANIUM CORTEX SCREWS	278	C1713	HCPCS	5271801	local	both	1262.51	883.76		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 250MM BAR/EXTERNAL FIXATION	278	C1713	HCPCS	5270198	local	both	1271.92	890.34		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC Y-PLATE 3 HOLE HEAD 8 HOLE SHAFT	278	C1713	HCPCS	5270295	local	both	1277.93	894.55		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ENDOBUTTON CL ULTRA PAC 1.2	278	C1713	HCPCS	5271282	local	both	1278.05	894.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANTI-ADHESION FILM-SEPRAFILM MEMBRANE	278	C1781	HCPCS	5270107	local	both	1284.86	899.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW REFLECTION CANC. 6.5 X 4	278	C1713	HCPCS	5271646	local	both	1287.49	901.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FASTAK SUTURE ANCHOR	278	C1713	HCPCS	5270100	local	both	1291.04	903.73		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW BIO COMP INT.8X23MM	278	C1713	HCPCS	5271603	local	both	1302.24	911.57		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SCREW, BIO-COMP RETROSCREW 9MM"	278	C1713	HCPCS	5271844	local	both	1302.24	911.57		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CARBON FIBER	278	C1713	HCPCS	5271574	local	both	1304.08	912.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC STANDARD ADAPTER SHOULDER JOINT DEVICE	278	C1776	HCPCS	5270180	local	both	1306.7	914.69		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC REUNITE ORTHO SCREW	278	C1713	HCPCS	5270132	local	both	1308.01	915.61		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC HEADLESS COMPRESSION SCREWS, 3.0MM"	278	C1713	HCPCS	5270522	local	both	1309.13	916.39		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW HEADLESS COMP	278	C1713	HCPCS	5271846	local	both	1317.48	922.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM LC-DCP PLATE 4 HL/27MM	278	C1713	HCPCS	5271511	local	both	1317.87	922.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MENISCUS ARROW	278	C1713	HCPCS	5270102	local	both	1320.02	924.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 6 HOLE 85	278	C1713	HCPCS	5271392	local	both	1335.54	934.88		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW AFFIXUS CORTICAL	278	C1713	HCPCS	5271842	local	both	1342.75	939.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE 1.3MM 3H-HEAD/8H SHAFT	278	C1713	HCPCS	5271939	local	both	1343.04	940.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CYMETRA ASSEMBLY 2CC	278	C1762	HCPCS	5270501	local	both	1346.02	942.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP-T-PLATE 4H HEAD/ 3H	278	C1713	HCPCS	5271456	local	both	1349.53	944.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CANCELLOUS CHIPS 15CC ""CROUTON"""	278	C1762	HCPCS	501785	local	both	1351.43	946		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/3H 50MM RIGHT	278	C1713	HCPCS	5271447	local	both	1353.03	947.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM STRT PLATE 6 HL	278	C1713	HCPCS	5271543	local	both	1354.33	948.03		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DHS PLATE-LAG SCREWS 12.7 MM ALL LENGHTS	278	C1713	HCPCS	5270189	local	both	1356.52	949.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG ICONIX 2 ANCHOR, 2.3 MM"	278	C1713	HCPCS	5272115	local	both	1359.63	951.74		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG ICONIX 1 ANCHOR, 1.4 MM"	278	C1713	HCPCS	500153	local	both	1359.63	951.74		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC RETRO SCREW-ARTHREX	278	C1713	HCPCS	5270265	local	both	1359.63	951.74		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KLS-FRACTURE PLATE CURVED SHORT	278	C1713	HCPCS	5270139	local	both	1360.11	952.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOABSORBABLE SCREW	278	C1713	HCPCS	5270511	local	both	1360.11	952.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TITANIUM ELASTIC ENDERNAIL	278	C1713	HCPCS	5270520	local	both	1363.14	954.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OPEN ADJUSTABLE CLAMP-MEDIUM	278	C1713	HCPCS	5270237	local	both	1368.45	957.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX SKIRT ROUND 8CM	278	C1781	HCPCS	5272080	local	both	1375.87	963.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS BONE CHIPS 15CC	278	C1763	HCPCS	5270500	local	both	1388.75	972.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MEMODYN STAPLE 12MM X 10 MM	278	C1713	HCPCS	5270489	local	both	1388.75	972.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM LC-DCP PLATE 6 HL/51MM	278	C1713	HCPCS	5271551	local	both	1391.49	974.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 7 HOLE 98	278	C1713	HCPCS	5271393	local	both	1394.98	976.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 4H/4H 56MM RIGHT	278	C1713	HCPCS	5271448	local	both	1398.48	978.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 4H	278	C1713	HCPCS	5271457	local	both	1398.48	978.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SUTURE ANCHOR HEALICOIL SA PK 5.5MM	278	C1713	HCPCS	5271645	local	both	1398.48	978.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC H-PLATE EXTENDED 1.3MM	278	C1713	HCPCS	5271940	local	both	1402.08	981.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DEPUY SMALL BONE FIXATION SYSTEM 1.6MM	278	C1713	HCPCS	5270263	local	both	1402.36	981.65		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW ACL INT	278	C1713	HCPCS	5271617	local	both	1406.42	984.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH, SYMBOTEX, COMP, 15 CM X 10 CM"	278	C1781	HCPCS	5272112	local	both	1407.49	985.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MINI PUSHLOCK	278	C1713	HCPCS	5270169	local	both	1413.24	989.27		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PRO GRIP LAP 15CM X 10 CM	278	C1781	HCPCS	5272081	local	both	1413.28	989.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 7.3 MM CANNULATED SCREW	278	C1713	HCPCS	5270224	local	both	1416.38	991.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC REABSORBABLE SCREW/BIOMET-ARTH	278	C1713	HCPCS	5270093	local	both	1417.88	992.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ON-Q PUMP DUAL 40MLX4ML/HR	278	C1887	HCPCS	5271903	local	both	1417.99	992.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 1.5MM PLATE 3 HL HEAD/ 8 HL	278	C1713	HCPCS	5271539	local	both	1422.05	995.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW TRIGEN NAIL CAP 0MM	278	C1713	HCPCS	5271913	local	both	1423.78	996.65		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CONDYLAR PLATE-SYNTHES	278	C1713	HCPCS	5270272	local	both	1430.73	1001.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET 2.8X17MM ORTHOSCREW	278	C1713	HCPCS	5270532	local	both	1438.81	1007.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX PCOX ROUND 12CM	278	C1781	HCPCS	5272082	local	both	1448.32	1013.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIO-PUSHLOCK	278	C1713	HCPCS	5270443	local	both	1452.82	1016.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC BIOSURE SCREWS,SMITH AND NEPHEW,ALL SIZES"	278	C1713	HCPCS	5270191	local	both	1455.34	1018.74		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CLIK ANCHOR-BOSTON SCIENTIFIC	278	C1713	HCPCS	5270384	local	both	1456.75	1019.73		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SUTURE ANCHOR JUGGERKNOT 1.4 MM SHORT	278	C1713	HCPCS	5271601	local	both	1456.75	1019.73		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIORAPTOR 1 SUTURE ANCHOR	278	C1713	HCPCS	5270497	local	both	1458.39	1020.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW BIOSURE HA 8MMX25MM	278	C1713	HCPCS	5271941	local	both	1458.51	1020.96		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 8 HOLE 111	278	C1713	HCPCS	5271394	local	both	1464.91	1025.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE STRAIGHT 1.3MM 12H	278	C1713	HCPCS	5271942	local	both	1466.03	1026.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 4 HOLES/80MM	278	C1713	HCPCS	360831	local	both	1475	1032.5		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANCHOR BIO SWIVELOCK ANCHOR 4.75MM	278	C1713	HCPCS	5271604	local	both	1476.11	1033.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANCHOR BIO-SWIVELOCK TENODESIS	278	C1713	HCPCS	5271843	local	both	1476.17	1033.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AUTOFIX COMPRESSION SCREW	278	C1713	HCPCS	5270370	local	both	1481.66	1037.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW INT ACL	278	C1713	HCPCS	5271618	local	both	1481.66	1037.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM T-PLATE 2 HL HEAD/ 8 HL	278	C1713	HCPCS	5271544	local	both	1484.55	1039.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 1.5MM	278	C1713	HCPCS	5271540	local	both	1484.55	1039.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG PCO VENTRAL PATCH 4.6CM	278	C1781	HCPCS	5272083	local	both	1485.34	1039.74		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW DHS/DCS ONE-STEP LAG SCREW 14M	278	C1713	HCPCS	5271553	local	both	1485.88	1040.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS 4-10MM 15CC	278	C1763	HCPCS	5270094	local	both	1487.4	1041.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC ANCHOR, 5.0 ALL THREAD BIOMET"	278	C1713	HCPCS	5270266	local	both	1491.71	1044.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,CARBON FIBER ROD 200MM"	278	C1713	HCPCS	5270209	local	both	1492.74	1044.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,CARBON FIBER ROD 150MM"	278	C1713	HCPCS	5270208	local	both	1492.74	1044.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC S&N 25MM ENDOBUTTON	278	C1713	HCPCS	5270506	local	both	1492.96	1045.07		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC S&N 30MM ENDOBUTTON W/LOOP SUT	278	C1713	HCPCS	5270510	local	both	1492.96	1045.07		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CEMENT RESTRICTOR 24MM DIA	278	C1713	HCPCS	5271792	local	both	1493.23	1045.26		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CEMENT RESTRICTOR (24MM)	278	C1713	HCPCS	5271909	local	both	1493.23	1045.26		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES CANNULATED SCREW 6.5-ALL	278	C1713	HCPCS	5270483	local	both	1496.38	1047.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM LC-DCP PLATE 8 HL/67MM	278	C1713	HCPCS	5271552	local	both	1499.87	1049.91		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LCP BONE PLATE 5 HOLE	278	C1713	HCPCS	5270286	local	both	1500.17	1050.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC VERSALOK ANCHOR	278	C1713	HCPCS	5270516	local	both	1504.13	1052.89		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW PERIAR CANN	278	C1713	HCPCS	5271344	local	both	1512.22	1058.55		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/3H 52MM OBLIQU R	278	C1713	HCPCS	5271449	local	both	1517.35	1062.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/3H 52MM OBLIQU L	278	C1713	HCPCS	5271474	local	both	1520.84	1064.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 9 HOLE 124	278	C1713	HCPCS	5271395	local	both	1524.34	1067.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CARBON FIBER	278	C1713	HCPCS	5271300	local	both	1526.22	1068.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG BOSTON SCIENTIFIC MUSTANG .035 BALLOONS	278	C1725	HCPCS	4410474	local	both	1526.29	1068.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TWIN FIX SUTURE ANCHOR 5.0	278	C1713	HCPCS	5270487	local	both	1527.66	1069.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CONNECTIVE TISSUE (HUMAN) GRAFT TUTOPLAST PERICARDIAL	278	C1762	HCPCS	5271856	local	both	1533.75	1073.63		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TRIMED-WIRE PLATES	278	C1713	HCPCS	5271806	local	both	1534.44	1074.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 4H HEAD/ 5H	278	C1713	HCPCS	5271458	local	both	1534.83	1074.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIO-FULLTHREADED CORKSCREW-ALL	278	C1713	HCPCS	5270442	local	both	1538.29	1076.8		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/5H 67MM RIGHT	278	C1713	HCPCS	5271450	local	both	1538.3	1076.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANCHOR SUPER GII ANCHOR	278	C1713	HCPCS	5271605	local	both	1546.09	1082.26		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC QUICKANCHOR SUPER PLUS DS	278	C1713	HCPCS	5271822	local	both	1546.09	1082.26		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM LC-DCP PLATE 6 HL/39MM	278	C1713	HCPCS	5271512	local	both	1547.06	1082.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC DHS PLATE-SHORT BARREL, ALL SIZES"	278	C1713	HCPCS	5270188	local	both	1547.27	1083.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI HELICAL BLADE 125MM	278	C1713	HCPCS	5271820	local	both	1547.65	1083.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OSTEORAPTOR 2.3 CVRD UB COB/BL	278	C1713	HCPCS	5271921	local	both	1549.98	1084.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 1.5MM STRT PLATE 12 HL	278	C1713	HCPCS	5271541	local	both	1552.27	1086.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 3.0 BIO-SUTURE TAK/ ANCHOR]	278	C1713	HCPCS	5270412	local	both	1559.74	1091.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 10 HOLE 137	278	C1713	HCPCS	5271396	local	both	1569.79	1098.85		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM CNDLR PLATE 7 HL/39MM	278	C1713	HCPCS	5271513	local	both	1573.1	1101.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC IMPLANT PIN TRIM-IT DRILL PIN	278	C1713	HCPCS	5271597	local	both	1574.26	1101.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM	278	C1713	HCPCS	5271547	local	both	1575.71	1103		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 5 HOLES/98MM	278	C1713	HCPCS	360832	local	both	1577.56	1104.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT COMPONENT-COMPR FX HMRL POS SLV	278	C1776	HCPCS	5271656	local	both	1580.05	1106.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MENISCAL CINCH-ARTHREX	278	C1776	HCPCS	5270315	local	both	1584.93	1109.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/4H 63MM OBLIQU R	278	C1713	HCPCS	5271451	local	both	1587.27	1111.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/4H 63MM OBLIQU L	278	C1713	HCPCS	5271475	local	both	1594.26	1115.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIORAPTOR 2.3 ANCHOR	278	C1713	HCPCS	5270260	local	both	1597.41	1118.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DOUBLE LEAD THREAD SCREW 5X36MM	278	C1713	HCPCS	5271827	local	both	1597.41	1118.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW TI DBL CORTICAL	278	C1713	HCPCS	5271835	local	both	1597.41	1118.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,CARBON FIBER ROD 250MM"	278	C1713	HCPCS	5270210	local	both	1600.99	1120.69		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHREX BIO-TRANSFIX PIN	278	C1713	HCPCS	5270427	local	both	1602.37	1121.66		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TI END CAP TIB NAIL	278	C1713	HCPCS	5271348	local	both	1604.36	1123.05		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT SHLDR PC HYB GLENOID POST POLY	278	C1776	HCPCS	5271661	local	both	1608.99	1126.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PARIETEX MESH PC09	278	C1781	HCPCS	5270517	local	both	1615.22	1130.65		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MTF-CANCELLOUS CHIPS (CROUTON) 3OCC	278	C1763	HCPCS	5270256	local	both	1618.85	1133.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM LCP-DCP PLATE 12 HL/71MM	278	C1713	HCPCS	5271514	local	both	1619.99	1133.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.0MM PLATE 3 HL HEAD/ 8 HL	278	C1713	HCPCS	5271545	local	both	1619.99	1133.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 2 HOLE 33	278	C1713	HCPCS	5271388	local	both	1625.19	1137.63		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CARBON FIBER	278	C1713	HCPCS	5271301	local	both	1635.61	1144.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 11 HOLE 150	278	C1713	HCPCS	5271397	local	both	1637	1145.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET HAMMERTOE IMPLANT/2.5MM	278	C1713	HCPCS	5270531	local	both	1642.55	1149.79		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIORAPTOR 2 SUTURE ANCHOR	278	C1713	HCPCS	5270496	local	both	1645.01	1151.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW CAPTURED INT. HEX	278	C1713	HCPCS	5271839	local	both	1649.5	1154.65		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SUTURE ANCHOR 6.5MM BIOCORKSCREW	278	C1713	HCPCS	5270432	local	both	1655.24	1158.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/5H 74MM OBLIQU R	278	C1713	HCPCS	5271452	local	both	1657.2	1160.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG JUGGERKNOT 2.9MM DBL LOADED	278	C1713	HCPCS	5271955	local	both	1658.75	1161.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MICRONIZED ALLODERM TISSUE	278	C1762	HCPCS	5270437	local	both	1661.62	1163.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE SCREW-7.0MM CANN SCREW 16MM THRD	278	C1713	HCPCS	5271357	local	both	1661.66	1163.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 12 HOLE 163	278	C1713	HCPCS	5271398	local	both	1664.19	1164.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/5H 74MM OBLIQU L	278	C1713	HCPCS	5271476	local	both	1664.19	1164.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC EVICEL FIBRIN SEALANT(HUMAN) 2ML	278	C1762	HCPCS	5270378	local	both	1668.89	1168.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ON-Q C-BLOCK	278	C1887	HCPCS	5271902	local	both	1670.4	1169.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PIN CRIMP POS SS STERILE	278	C1713	HCPCS	5271346	local	both	1672.08	1170.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM T-PLATE 2 HL HEAD/ 8 HL	278	C1713	HCPCS	5271548	local	both	1672.08	1170.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH, SYMBOTEX, COMP, ROUND 9CM"	278	C1781	HCPCS	5272110	local	both	1681.97	1177.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HEADED SCREW 4.0 X 22MM	278	C1713	HCPCS	5270351	local	both	1684.23	1178.96		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ATRIUM V-PATCH SMALL	278	C1781	HCPCS	5271729	local	both	1685.94	1180.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ATRIUM V-PATCH 6.4 X 6.4	278	C1781	HCPCS	5271726	local	both	1685.94	1180.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HERBERT BONE SCREW 3MMX18MM	278	C1713	HCPCS	5270460	local	both	1687.08	1180.96		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 3 HOLE 46	278	C1713	HCPCS	5271389	local	both	1687.7	1181.39		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PORT A CATH/OPTILOCK	278	C1788	HCPCS	5270420	local	both	1687.83	1181.48		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW PERIART LOCK CANN	278	C1713	HCPCS	5271342	local	both	1693.26	1185.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 7.3MM CANN LOCK SCREW	278	C1713	HCPCS	5271343	local	both	1693.26	1185.28		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR  4"" X  6"" OBLONG"	278	C1781	HCPCS	5271895	local	both	1704.49	1193.14		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM	278	C1713	HCPCS	5271549	local	both	1721.56	1205.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 6H	278	C1713	HCPCS	5271459	local	both	1723.62	1206.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 6H	278	C1713	HCPCS	5271478	local	both	1730.62	1211.43		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HUMAN BONE GRAFTING MATERIAL CANCELLOUS CRUSHED 1-4MM	278	C1762	HCPCS	5271647	local	both	1748.1	1223.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG BIO-COMP TENODESIS SCREW 4MMX10MM	278	C1713	HCPCS	5272074	local	both	1748.1	1223.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR TACHSHIELD 4""X6"" & 5""X5"" OBLONG"	278	C1781	HCPCS	5271889	local	both	1752.95	1227.07		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG ANCHOR FAST FIX  360 CURVE NEEDLE	278	C1713	HCPCS	501776	local	both	1755.87	1229.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET COBALT HV BONE CEMENT	278	C1713	HCPCS	5270158	local	both	1758.24	1230.77		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC RETRO SCREW	278	C1713	HCPCS	5270429	local	both	1769.82	1238.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANNULATED DELTA BIO SCREW	278	C1713	HCPCS	5270426	local	both	1769.82	1238.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FEMORAL RETRO SCREW	278	C1713	HCPCS	5270430	local	both	1769.82	1238.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC GROSHONG IMPLANTABLE CATHETER	278	A4301	HCPCS	5270484	local	both	1772.07	1240.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC S&N SUTURE ANCHOR 5.5MM	278	C1713	HCPCS	5270530	local	both	1782.6	1247.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 6 HOLES/116MM	278	C1713	HCPCS	360842	local	both	1782.71	1247.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 6H	278	C1713	HCPCS	5271460	local	both	1786.52	1250.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 4H/6H 78MM RIGHT	278	C1713	HCPCS	5271453	local	both	1793.55	1255.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/7H 96MM OBLIQU R	278	C1713	HCPCS	5271454	local	both	1800.54	1260.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5 MM HEADLESS COMPRESSION SCREW/LONG THREAD 34MM	278	C1713	HCPCS	5270225	local	both	1800.6	1260.42		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/7H 96MM OBLIQU L	278	C1713	HCPCS	5271477	local	both	1804.05	1262.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 8 HOLE PLATE #51-110-08	278	C1713	HCPCS	5270454	local	both	1814.4	1270.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 5.5 BIO CORKSCREW SUTURE ANCHO	278	C1713	HCPCS	5270099	local	both	1814.41	1270.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TWIN FX SUTURE ANCHOR W/DIA 5.	278	C1713	HCPCS	5270488	local	both	1821.79	1275.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANCHOR MINI QUICK MITEK	278	C1713	HCPCS	5270109	local	both	1827.14	1279		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG ARGON OPTION ELITER AC/POP IVC FILTER	278	C1880	HCPCS	4410129	local	both	1831.54	1282.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG PCO VENTRAL 6.6 CM	278	C1781	HCPCS	5272084	local	both	1831.58	1282.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 4 HL/56M	278	C1713	HCPCS	5271516	local	both	1839	1287.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG PARIETEX SKIRT 15CM X 10CM	278	C1781	HCPCS	5272085	local	both	1840.59	1288.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CALAXO SCREW 11MMX30MM	278	C1713	HCPCS	5270461	local	both	1846.22	1292.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CALAXO SCREW 12MMX35MM	278	C1713	HCPCS	5270463	local	both	1846.22	1292.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CALAXO SCREW 11MMX35MM	278	C1713	HCPCS	5270478	local	both	1846.23	1292.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FASTIN ROTATOR CUFF ANCHOR 6.5MM	278	C1713	HCPCS	5270515	local	both	1846.25	1292.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SUTURE ANCHOR TWINFIX 5.5	278	C1713	HCPCS	5271285	local	both	1846.27	1292.39		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 5H/70	278	C1713	HCPCS	5271517	local	both	1852.98	1297.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM DIST RAD L-PLATE/-90 2/3	278	C1713	HCPCS	5271501	local	both	1859.98	1301.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIO-TENODESIS SCREW-ALL	278	C1713	HCPCS	5270419	local	both	1878.05	1314.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHREX PEEK TENO SCREW 5.5X8.0	278	C1713	HCPCS	5270507	local	both	1878.06	1314.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FAST FIX CURVED ABSORB ANCHOR	278	C1713	HCPCS	5270505	local	both	1879.72	1315.8		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE DEG DHS PLATE-STD BRL	278	C1713	HCPCS	5271556	local	both	1880.18	1316.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,ATTACHMENT FOR LARGE MULTI PIN CLAMP"	278	C1713	HCPCS	5270204	local	both	1881.44	1317.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 7 HOLES/134MM	278	C1713	HCPCS	360843	local	both	1892.37	1324.66		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 8H	278	C1713	HCPCS	5271461	local	both	1894.94	1326.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 8H	278	C1713	HCPCS	5271479	local	both	1901.93	1331.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC POWER PORT MRI 9.5FR CATHETER	278	C1788	HCPCS	5271899	local	both	1919.02	1343.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATELET RICH PLASMA	278	C9250	HCPCS	5270257	local	both	1922.91	1346.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG TIGHTROPE SYNDESMOSIS	278	C1713	HCPCS	501778	local	both	1922.91	1346.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM LCP DIST RAD PLATE	278	C1713	HCPCS	5271499	local	both	1922.91	1346.04		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM LCP DIST RAD PLATE ST/5H	278	C1713	HCPCS	5271498	local	both	1925.01	1347.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 7 HOLES/134MM	278	C1713	HCPCS	360834	local	both	1934.79	1354.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 6 HOLES/116MM	278	C1713	HCPCS	360833	local	both	1947	1362.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM DIST RAD L-PLATE	278	C1713	HCPCS	5271502	local	both	1954.37	1368.06		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION MEDIUM PIN 4POS	278	C1713	HCPCS	5271790	local	both	1957.87	1370.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS 4-10MM 30CC	278	C1763	HCPCS	5270095	local	both	1972.75	1380.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 13 HOLE 176	278	C1713	HCPCS	5271399	local	both	1996.33	1397.43		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR TACHSHIELD 4.5"" ROUND"	278	C1781	HCPCS	5271888	local	both	2000.21	1400.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 1.0 MM CABLE W/CRIMP	278	C1713	HCPCS	5270326	local	both	2003.32	1402.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CABLE TI CABLE W/ CRIMP 750MM	278	C1713	HCPCS	5271595	local	both	2003.32	1402.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 2.4MM LCP DIST RAD T-PLATE 4H	278	C1713	HCPCS	5271500	local	both	2006.82	1404.77		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROTATOR CUFF QUICK ANCHOR	278	C1713	HCPCS	5270103	local	both	2017.87	1412.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH, SYMBOTEX, COMP, ROUND 15 CM"	278	C1781	HCPCS	5272111	local	both	2026.47	1418.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANCHOR ROTATOR CUFF MITEK	278	C1713	HCPCS	5270110	local	both	2026.7	1418.69		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TRIMED-RADIAL COLUMN PIN PLATE	278	C1713	HCPCS	5271808	local	both	2039.45	1427.62		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 8 HOLES/152MM	278	C1713	HCPCS	360835	local	both	2044.5	1431.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES TITANIUM SPIRAL BLADE FOR HUMERAL NAILS(34-54MM)	278	C1713	HCPCS	5270319	local	both	2057.32	1440.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SUTURE ANCHOR BIO SWIVELOCK	278	C1713	HCPCS	5270157	local	both	2057.51	1440.26		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TUTOPLAST PERICARDIUM	278	C1762	HCPCS	5270251	local	both	2058.88	1441.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ATRIUM V-PATCH MECH LG (8CM X 8CM)	278	C1781	HCPCS	5271728	local	both	2114.61	1480.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 140 DEG DHS PLATE-STD BRL 4 HL	278	C1713	HCPCS	5271557	local	both	2122.19	1485.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC GLENOID POST-SHOULDER JOINT DEVICE	278	C1776	HCPCS	5270181	local	both	2124.02	1486.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TRUFIT PLUG 9MM	278	248	RC	5270462	local	both	2136.51	1495.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CANCELLOUS BONE CHIPS-30CC	278	C1763	HCPCS	5270477	local	both	2136.54	1495.58		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 6H/84	278	C1713	HCPCS	5271518	local	both	2143.17	1500.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 9 HOLES/170MM	278	C1713	HCPCS	360836	local	both	2143.52	1500.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC POWER PORT	278	C1788	HCPCS	5271898	local	both	2152.1	1506.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MANDIBLE TRAUMA 2.0MM TITANIUM ADAPTION PLATE	278	C1713	HCPCS	5271802	local	both	2155.99	1509.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL FIBULA PLATE 7 HOLE LCP	278	C1713	HCPCS	5270324	local	both	2159.87	1511.91		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE UNI LOCK TROCH 131MM	278	C1713	HCPCS	5271321	local	both	2182.06	1527.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE TROCHANTER STAB.	278	C1713	HCPCS	5271832	local	both	2205.71	1544		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC STANDARD ACUTRAK 2 BONE SCREW, ACUMED 22 MM"	278	C1713	HCPCS	5270380	local	both	2225.91	1558.14		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC COMBINATION CLAMP-MEDIUM	278	C1713	HCPCS	5270236	local	both	2226.54	1558.58		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LAB SCREW TI NAIL	278	C1713	HCPCS	5271923	local	both	2232.13	1562.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 4H HEAD/ 7H	278	C1713	HCPCS	5271462	local	both	2237.56	1566.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SMALL FRAG LOCKING PLATE HF-Y	278	C1713	HCPCS	5270503	local	both	2243.37	1570.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TITANIUM HELICAL BLADE 80MM-120MM	278	C1713	HCPCS	5270144	local	both	2246.82	1572.77		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE T 3H/7H 87MM RIGHT	278	C1713	HCPCS	5271455	local	both	2248.05	1573.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 7H/98	278	C1713	HCPCS	5271519	local	both	2251.55	1576.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH, SYMBOTEX, COMP, 20 CM X 15 CM"	278	C1781	HCPCS	5272113	local	both	2257.88	1580.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TITANIUM SPIRAL BLADE FOR RETROGRADE FEMORAL NAIL	278	C1713	HCPCS	5270363	local	both	2262.27	1583.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CONNECTIVE TISSUE (HUMAN) AMNIOGRAFT 2.0 X 1.5 CM SIZE B	278	C1762	HCPCS	5271857	local	both	2311.37	1617.96		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES-LOCKING CALCANEAL PLATE-SHORT	278	C1713	HCPCS	5270253	local	both	2312.15	1618.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH PARITEX COMPOSITE OPT ROUND 15CM	278	C1781	HCPCS	5271894	local	both	2313.31	1619.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 8 HOLES/152MM	278	C1713	HCPCS	360844	local	both	2316.85	1621.8		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX PCOX 20CM X 15CM	278	C1781	HCPCS	5272086	local	both	2323.38	1626.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 10 HOLES/188MM	278	C1713	HCPCS	360837	local	both	2327.45	1629.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL FIBULA PLATE-11 HOLE-SYNTHES	278	C1713	HCPCS	5270307	local	both	2343.22	1640.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 8H/112	278	C1713	HCPCS	5271520	local	both	2349.44	1644.61		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PCO VENTRAL PATCH 8.6CM	278	C1781	HCPCS	5272087	local	both	2352.63	1646.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BAR TO BAR CLAMP/EXTERNAL FIXATION SET	278	C1713	HCPCS	5270194	local	both	2362.86	1654		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC 6 MM BAR TO PIN CLAMP, EXTERNAL FIXATION"	278	C1713	HCPCS	5270195	local	both	2363.44	1654.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FIBULA PLATE 2.7/3.5 MM 4 HOLE-SYNTHES	278	C1713	HCPCS	5270276	local	both	2376.63	1663.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR  6"" X  8"" OBLONG"	278	C1781	HCPCS	5271896	local	both	2380.33	1666.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 9H/126	278	C1713	HCPCS	5271521	local	both	2401.89	1681.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT ORTHOSORBABLE PIN LONG	278	C1713	HCPCS	5271621	local	both	2408.49	1685.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AMBIODRY ALLOGRAFT 1X2CM	278	C1762	HCPCS	5270389	local	both	2410.55	1687.39		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 10H/140	278	C1713	HCPCS	5271522	local	both	2433.35	1703.35		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES LARGE OPEN ADJUSTABLE CLAMP	278	C1713	HCPCS	5270203	local	both	2435.93	1705.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 3H	278	C1713	HCPCS	5271847	local	both	2436.85	1705.8		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HELICAL BLADE FOR TROCH NAIL	278	C1713	HCPCS	5270371	local	both	2451.69	1716.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC DEPUY DISTAL RADIUS SET, FRAGMENT PLATES, ALL"	278	C1713	HCPCS	5270183	local	both	2452.39	1716.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC IMPLANT PORT W/GROSHONG CATH	278	A4301	RC	5270308	local	both	2453.87	1717.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 4H	278	C1713	HCPCS	5271848	local	both	2476.47	1733.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES LARGE OPEN ADJUSTABLE CLAMP	278	C1713	HCPCS	5270220	local	both	2478.8	1735.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC LOCKING CALCANEAL PLATE-LONG, SYNTHES"	278	C1713	HCPCS	5270305	local	both	2493.95	1745.77		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE DEG DHS PLATE-STD BRL	278	C1713	HCPCS	5271555	local	both	2501.72	1751.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 11 HOLES/206MM	278	C1713	HCPCS	360838	local	both	2507.82	1755.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 9 HOLES/170MM	278	C1713	HCPCS	360845	local	both	2507.82	1755.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 5H	278	C1713	HCPCS	5271849	local	both	2509.49	1756.64		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI	278	C1713	HCPCS	5271586	local	both	2520.76	1764.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AXOGUARD NERVE CONNECTOR	278	C9352	HCPCS	5271904	local	both	2525.03	1767.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH ACCUMESH ROUND 15CM	278	C1781	HCPCS	5272098	local	both	2541.5	1779.05		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 6H	278	C1713	HCPCS	5271850	local	both	2549.11	1784.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ENDO GIA 30 STAPLER	278	278	RC	5270088	local	both	2552.29	1786.6		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 11H/155	278	C1713	HCPCS	5271523	local	both	2555.72	1789		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC COMBINATION CLAMP 8.0MM/11MM	278	C1713	HCPCS	5270238	local	both	2562.48	1793.74		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC EVICEL FIBRIN SEALANT(HUMAN) 5ML	278	C1762	HCPCS	5270379	local	both	2576.38	1803.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC PEEK SUTURE TAK, 3MM SUTURE ANCHOR"	278	C1713	HCPCS	5270185	local	both	2577.09	1803.96		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 7H	278	C1713	HCPCS	5271851	local	both	2585.44	1809.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 14 HOLE 189	278	C1713	HCPCS	5271400	local	both	2597.67	1818.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 4H HEAD/ 8H	278	C1713	HCPCS	5271463	local	both	2601.17	1820.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 8H	278	C1713	HCPCS	5271464	local	both	2611.66	1828.16		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 9H	278	C1713	HCPCS	5271852	local	both	2621.76	1835.23		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHREX-TIGHTROPE AND SYDESMOSIS SINGLE USE REPAIR KT	278	C1713	HCPCS	5270250	local	both	2622.1	1835.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE RECON 3.5MM 12H/168	278	C1713	HCPCS	5271524	local	both	2643.12	1850.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW FEMORAL TROCHLEA 20MM	278	C1713	HCPCS	5271919	local	both	2645.45	1851.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC 5 MM BAR TO PIN CLAMP, EXTERNAL FIXATION"	278	C1713	HCPCS	5270196	local	both	2647.43	1853.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 11H	278	C1713	HCPCS	5271853	local	both	2661.38	1862.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PORT-A-CATH/TITANIUM	278	C1788	HCPCS	5270098	local	both	2663.78	1864.65		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 13H	278	C1713	HCPCS	5271854	local	both	2694.4	1886.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 12 HOLES/224MM	278	C1713	HCPCS	360839	local	both	2695.29	1886.7		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 10 HOLES/188MM	278	C1713	HCPCS	360846	local	both	2695.29	1886.7		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CURVD CARBN FIBR 11 X 213M	278	C1713	HCPCS	5271575	local	both	2695.57	1886.9		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 15 HOLE 202	278	C1713	HCPCS	5271401	local	both	2699.06	1889.34		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC INTRATHECAL CATHETER-MEDTRONIC INDURA	278	E0785	HCPCS	5270382	local	both	2699.84	1889.89		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OSTEOTOMY COMPRESSION PLATE	278	C1713	HCPCS	5270244	local	both	2699.84	1889.89		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MENISCAL BEARING MED 3MM THICK	278	C1776	HCPCS	5270329	local	both	2700.38	1890.27		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ALLODERM-ACELLULAR DERMAL GRAFT 3CMX7CM	278	C1762	HCPCS	5270106	local	both	2709.12	1896.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI  75MM	278	C1713	HCPCS	5271587	local	both	2713.05	1899.14		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC GLAUCOMA IMPLANT	278	L8612	HCPCS	5270252	local	both	2715.38	1900.77		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC TUBULAR HOOK PLATE-3 HOLE	278	C1713	HCPCS	5270342	local	both	2719.26	1903.48		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI  130MM	278	C1713	HCPCS	5271596	local	both	2720.04	1904.03		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 4 H	278	C1713	HCPCS	5271531	local	both	2727.03	1908.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE LCP DFP 2.7/3.5MM 15H	278	C1713	HCPCS	5271855	local	both	2734.02	1913.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PRO OSTEON BONE GFT SUBSTITUTE	278	C1762	HCPCS	5270494	local	both	2735.54	1914.88		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MODULAR HEAD COMPONENT	278	C1776	HCPCS	5270152	local	both	2747.5	1923.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 13 HL/18	278	C1713	HCPCS	5271525	local	both	2779.47	1945.63		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LAG SCREW SOLID FIXED 90MM	278	C1713	HCPCS	5271826	local	both	2781.42	1946.99		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE F3 FRAG	278	C1713	HCPCS	5271607	local	both	2785.3	1949.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX PCOX ROUND 20CM	278	C1781	HCPCS	5272106	local	both	2787.79	1951.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PARIETEX MESH-PC0151005	278	C1781	HCPCS	5270518	local	both	2815.12	1970.58		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL RADIUS PLATE 8 HEAD/3 SHAFT	278	C1713	HCPCS	5270358	local	both	2820.26	1974.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 16 HOLE 215	278	C1713	HCPCS	5271402	local	both	2824.92	1977.44		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG PARIETEX SKIRT 20CM X 15CM	278	C1781	HCPCS	5272088	local	both	2836.31	1985.42		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR TACHSHIELD 6"" X 8"""	278	C1781	HCPCS	5271731	local	both	2837.94	1986.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR TACHSHIELD 6"" X 8"" OBLONG"	278	C1781	HCPCS	5271890	local	both	2837.94	1986.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FINGER JOINT IMPLANTS W/GROMETS (SIZE 4-6)	278	C1776	HCPCS	5270359	local	both	2838.79	1987.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 11 HOLES/206MM	278	C1713	HCPCS	360847	local	both	2872.16	2010.51		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 14 HL/19	278	C1713	HCPCS	5271526	local	both	2887.86	2021.5		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHROSURFACE-FIXATION STUD	278	C1713	HCPCS	5271314	local	both	2925.15	2047.61		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CLAMP EXTERNAL FIXATION MEDIUM MULTI-PIN 4POS	278	C1713	HCPCS	5271573	local	both	2947.29	2063.1		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PATELLA BUTTON 20MM	278	C1713	HCPCS	5271920	local	both	2948.46	2063.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 6 H	278	C1713	HCPCS	5271532	local	both	2950.79	2065.55		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET ALL POLY PATELLA BUTTON 37X10	278	C1713	HCPCS	5270156	local	both	2956.01	2069.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH ACCUMESH 20CM X 15CM	278	C1781	HCPCS	5272100	local	both	2957.12	2069.98		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CURVD CARBN FIBR 11 X 425M	278	C1713	HCPCS	5271576	local	both	2964.77	2075.34		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DVRA SHORT RIGHT PLATE	278	C1713	HCPCS	5270439	local	both	2969.73	2078.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 6 HOLE SMALL LOCKING CLAVICLE PLATE	278	C1713	HCPCS	5270129	local	both	2969.81	2078.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOCKING CLAVICLE PLATE 8 HOLES	278	C1713	HCPCS	5270529	local	both	2969.81	2078.87		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,LARGE COMBINATION CLAMP"	278	C1713	HCPCS	5270206	local	both	2992.74	2094.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AMBIODRY ALLOGRAFT 2X3CM	278	C1762	HCPCS	5270390	local	both	3019.52	2113.66		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 14 HOLES/260MM	278	C1713	HCPCS	360840	local	both	3024.29	2117		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 12 HOLES/224MM	278	C1713	HCPCS	360848	local	both	3045.46	2131.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT VANGRD CR STEM HOUSING	278	C1776	HCPCS	5271680	local	both	3103.84	2172.69		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 16 HL/22	278	C1713	HCPCS	5271527	local	both	3129.09	2190.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC CONTACT EXTENSION KIT (55CM, 8 CONTACT) NEUROSTIM COMP"	278	C1883	HCPCS	5270367	local	both	3138.81	2197.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SCREW AFFIXUS LAG	278	C1713	HCPCS	5271841	local	both	3146.57	2202.6		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PORT-A-CATH/DUAL LUMEN TITANIUM	278	C1788	HCPCS	5270101	local	both	3156.78	2209.75		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 10 HL	278	C1713	HCPCS	5271382	local	both	3159.45	2211.62		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE DVR ANATOMIC	278	C1713	HCPCS	5271606	local	both	3160.08	2212.06		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIO AMNIOGRAFT W/ TISSEAL (D)	278	C1762	HCPCS	5270431	local	both	3165.06	2215.54		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL RADIUS PLATE / 4 HOLE	278	C1713	HCPCS	5270467	local	both	3166.28	2216.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL RADIUS PLATE 5/3 HOLES	278	C1713	HCPCS	5270498	local	both	3166.36	2216.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 18 HOLE 241	278	C1713	HCPCS	5271403	local	both	3167.55	2217.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 8 H	278	C1713	HCPCS	5271533	local	both	3202.51	2241.76		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC GRAFTON DBM PUTTY/ 5CC	278	C1763	HCPCS	5270508	local	both	3204.81	2243.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LOCKING DELTOID HOOK PLATE-3 HOLE	278	C1713	HCPCS	5270341	local	both	3204.84	2243.39		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 14	278	C1713	HCPCS	5271536	local	both	3207.75	2245.43		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 11 HL	278	C1713	HCPCS	5271383	local	both	3213.43	2249.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 20 HL/28	278	C1713	HCPCS	5271529	local	both	3236.16	2265.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CURVD CARBN FIBR 11 X 638M	278	C1713	HCPCS	5271577	local	both	3237.48	2266.24		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT BIOMET A STD PATELLA	278	C1776	HCPCS	5271687	local	both	3243.69	2270.58		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC STANDARD PATELLAR-BIOMET	278	C1776	HCPCS	5271867	local	both	3243.69	2270.58		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE VADR 2COL 2.4MM	278	C1713	HCPCS	5271948	local	both	3246.89	2272.82		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ARTHROSURFACE-ANATOMIC PATELLA	278	C1776	HCPCS	5271714	local	both	3263.11	2284.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LCP SUPERIOR CLAVICLE PLATE 7 HOLE-SYNTHES	278	C1713	HCPCS	5270386	local	both	3267.41	2287.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 18 HL/25	278	C1713	HCPCS	5271528	local	both	3277.57	2294.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC SYNTHES,LARGE MULTI-PIN CLAMP-6 POSITION"	278	C1713	HCPCS	5270205	local	both	3286.42	2300.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE 2.5 DR WATERSHED LEFT	278	C1713	HCPCS	5271949	local	both	3298.98	2309.29		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG TIGHTROPE KNOTLESS SYNDESMOSIS	278	C1713	HCPCS	501779	local	both	3301.96	2311.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC DISTAL BICEPS REPAIR IMPLANT SYSTEM-ARTHREX	278	C1713	HCPCS	5270247	local	both	3301.96	2311.37		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT M2A HI-C MODULAR HEAD	278	C1776	HCPCS	5271690	local	both	3311.61	2318.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 2.4MM VA-LCP TWO COLUMN VOLAR DISTAL RADIAL PLATE	278	C1713	HCPCS	5271810	local	both	3312.87	2319.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ACUMED-OLECRANON PLATE 5 HOLE	278	C1713	HCPCS	5271800	local	both	3321.38	2324.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE DISTAL CLAV PLATE	278	C1713	HCPCS	5271639	local	both	3340.02	2338.01		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 16 HOLES/296MM	278	C1713	HCPCS	360850	local	both	3351.67	2346.17		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 10	278	C1713	HCPCS	5271534	local	both	3356.35	2349.45		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 22 HL/30	278	C1713	HCPCS	5271530	local	both	3358.33	2350.83		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 5.0MM ALLTHREAD TI ANCHOR	278	C1713	HCPCS	5270227	local	both	3371.55	2360.09		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP DIST RAD PLATE VOLAR 3H	278	C1713	HCPCS	5271599	local	both	3373.83	2361.68		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE VOLAR DIST RAD	278	C1713	HCPCS	5271496	local	both	3375.51	2362.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PATELLA SERIES A STANDARD 34MM X 8.5MM	278	C1776	HCPCS	5270301	local	both	3375.76	2363.03		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE OLECRANON PLATE	278	C1713	HCPCS	5271640	local	both	3377.9	2364.53		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE	278	C1713	HCPCS	5271641	local	both	3393.69	2375.58		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM BROAD LCP PLATE 14 HOLES/260MM	278	C1713	HCPCS	360849	local	both	3395.66	2376.96		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH ACCUMESH ROUND 20CM	278	C1781	HCPCS	5272099	local	both	3408.44	2385.91		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC REPLIFORM	278	C1762	HCPCS	5270523	local	both	3412.93	2389.05		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT OXFORD UNI KNEE BRG	278	C1776	HCPCS	5271673	local	both	3425.26	2397.68		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 16	278	C1713	HCPCS	5271537	local	both	3426.52	2398.56		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE POST-LAT DIST HUM PLATE	278	C1713	HCPCS	5271642	local	both	3444.2	2410.94		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC M2A CARBON MODULAR HEAD (32MM)	278	C1776	HCPCS	5270297	local	both	3447.35	2413.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH HERNIA PATCH 5.4"" X 7"""	278	C1781	HCPCS	5271887	local	both	3450.45	2415.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT MODULAR HEAD	278	C1776	HCPCS	5271677	local	both	3469	2428.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MODULAR HEAD 36MM	278	C1776	HCPCS	5270202	local	both	3486	2440.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 95 DEG DCS PLATE	278	C1713	HCPCS	5271559	local	both	3489.03	2442.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC CALCANEOUS PLATE	278	C1713	HCPCS	5270146	local	both	3491.54	2444.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ROD CURVD CARBN FIBR 11 X 850M	278	C1713	HCPCS	5271578	local	both	3494.44	2446.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 12	278	C1713	HCPCS	5271535	local	both	3510.18	2457.13		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PRECISION PROGRAMMER KIT-NEUROSTIMRLATOR	278	C1787	HCPCS	5270312	local	both	3510.49	2457.34		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PRECISION PATIENT PROGRAMMER	278	C1787	HCPCS	5271732	local	both	3510.49	2457.34		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MENISCAL BEARING SMALL 4MM	278	C1776	HCPCS	5270350	local	both	3510.49	2457.34		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANATOMIC ARCOM MENISCAL BEARING SMALL 4MM	278	C1776	HCPCS	5270361	local	both	3510.49	2457.34		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 20 HOLE 267	278	C1713	HCPCS	5271404	local	both	3517.17	2462.02		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP 3.5MM 22 HOLE 293	278	C1713	HCPCS	5271818	local	both	3520.67	2464.47		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT AEQ REV LAT HUM INSERT 36MM DI	278	C1776	HCPCS	5271719	local	both	3526.28	2468.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AEQUALIS REVERSED LATERALILZED HUMERAL INSERT(36MMX6MM)	278	C1776	HCPCS	5271870	local	both	3526.28	2468.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE VOLAR DIST RAD	278	C1713	HCPCS	5271330	local	both	3531.16	2471.81		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX PCOX 25CM X 20CM	278	C1781	HCPCS	5272089	local	both	3531.23	2471.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC 4.5MM NARROW LCP PLATE 16 HOLES/296MM	278	C1713	HCPCS	360841	local	both	3533.6	2473.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SMART TOE-IMPLANT (ALL SIZES)	278	C1776	HCPCS	5270372	local	both	3551.54	2486.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE VOLAR DIST RAD	278	C1713	HCPCS	5271497	local	both	3573.11	2501.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE LCP DIST RAD PLATE VOLAR 5H	278	C1713	HCPCS	5271600	local	both	3573.11	2501.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT ARCOMXL HMRL BRG	278	C1776	HCPCS	5271711	local	both	3598.89	2519.22		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG MESH, SYMBOTEX, COMP, 25 CM X 20 CM"	278	C1781	HCPCS	5272114	local	both	3603.29	2522.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MODULAR HEAD COMPONENT 28MM	278	C1776	HCPCS	5270356	local	both	3608.84	2526.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC BIOMET SERIES A THIN PATELLA, JOINT DEVICE, TOTAL KNEE"	278	C1776	HCPCS	5270193	local	both	3612.08	2528.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES DBX PUTTY MIX 5CC	278	C1763	HCPCS	5270164	local	both	3615.76	2531.03		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC GENESIS II RESURFACING PATELLAR COMPONENT	278	C1776	HCPCS	5271863	local	both	3630.46	2541.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 6HL	278	C1713	HCPCS	5271378	local	both	3639.54	2547.68		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE VOLAR DIST RAD	278	C1713	HCPCS	5271331	local	both	3643.03	2550.12		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH-KUGEL COMPOSIX MEDIUM	278	C1781	HCPCS	5270406	local	both	3649.14	2554.4		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SYNTHES DBX PUTTY 5 CC	278	C1763	HCPCS	5270162	local	both	3657.8	2560.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE OLECRANON PLATE	278	C1713	HCPCS	5271636	local	both	3663.23	2564.26		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LCP WRIST FUSION PLATE	278	C1713	HCPCS	5271950	local	both	3675.6	2572.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AMBIODRY ALLOGRAFT 4X4CM	278	C1762	HCPCS	5270391	local	both	3679.25	2575.48		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE	278	C1713	HCPCS	5271637	local	both	3682.66	2577.86		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FINGER JOINT IMPLANT W/GROMMETS (SIZE 4-6)	278	C1776	HCPCS	5270340	local	both	3690.44	2583.31		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 18	278	C1713	HCPCS	5271538	local	both	3693.6	2585.52		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE DORSAL NAIL DNP ANTM	278	C1713	HCPCS	5271608	local	both	3702.08	2591.46		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE VADR 2COL 2.4MM	278	C1713	HCPCS	5271946	local	both	3704.8	2593.36		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC HUMAN AMNIOTIC MEMBRANE W/TISSEAL GLUE	278	C1762	HCPCS	5270416	local	both	3705.55	2593.89		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 7 HL	278	C1713	HCPCS	5271379	local	both	3709.46	2596.62		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 95 DEG DCS PLATE 16 HL/274MM	278	C1713	HCPCS	5271560	local	both	3719.17	2603.42		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SUTURE PATELLAR BUTTON	278	C1713	HCPCS	5271310	local	both	3729.27	2610.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE VOLAR DIST RAD	278	C1713	HCPCS	5271332	local	both	3747.92	2623.54		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 8 HL	278	C1713	HCPCS	5271380	local	both	3765.4	2635.78		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC ANTERIOR CLAVICLE PLATE 3.5MM 5 HOLE-SYNTHES	278	C1713	HCPCS	5271811	local	both	3772.39	2640.67		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR TACHSHIELD 8"" X 10"" OBLONG"	278	C1781	HCPCS	5271891	local	both	3778.83	2645.18		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIPOLAR ACETABULAR CUP	278	C1776	HCPCS	5270151	local	both	3779.88	2645.92		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 95 DEG DCS PLATE	278	C1713	HCPCS	5271558	local	both	3800.36	2660.25		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIO AMNIOGRAFT SIZE B W/TISEEL	278	C1762	HCPCS	5270502	local	both	3806.01	2664.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MESH-KUGEL COMPOSIX LARGE	278	C1781	HCPCS	5270407	local	both	3821.01	2674.71		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 9 HL	278	C1713	HCPCS	5271381	local	both	3828.33	2679.83		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE	278	C1713	HCPCS	5271638	local	both	3837.04	2685.93		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT MODULAR HEAD 36MM	278	C1776	HCPCS	5271695	local	both	3849.7	2694.79		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX SKIRT 25CM X 20CM	278	C1781	HCPCS	5272090	local	both	3849.77	2694.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PLATE VADR 2COL 2.4MM	278	C1713	HCPCS	5271947	local	both	3850.09	2695.06		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OXFORD UNICOMP KNEE SM RT 3MM	278	C1776	HCPCS	5270533	local	both	3851.08	2695.76		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC OXFORD UNICOMP KNEE MED LT 4MM	278	C1776	HCPCS	5270537	local	both	3851.08	2695.76		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE CORONOID PLATE STD	278	C1713	HCPCS	5271643	local	both	3883.01	2718.11		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT RNGLC BI-POLAR 28 CUP	278	C1776	HCPCS	5271691	local	both	3886.17	2720.32		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX PCOX 30CM X 20CM	278	C1781	HCPCS	5272091	local	both	3923.29	2746.3		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT EXPLOR IMPLANT HEAD	278	C1776	HCPCS	5271693	local	both	3924.05	2746.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LCP PROXIMAL TIBIA PLATE 4 HOLE	278	C1713	HCPCS	5270357	local	both	3974.56	2782.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG PERMACOL PROCINE 10CM X 10CM X 1.0MM	278	C1781	HCPCS	5272092	local	both	4003.7	2802.59		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG COVODIEN SYMBOTEX MESH 30CM X 20CM	278	C1781	HCPCS	360829	local	both	4003.92	2802.74		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC PATIENT PROGRAMMER, MEDTRONIC NEUROSTIMULATOR"	278	C1787	HCPCS	5270320	local	both	4009.29	2806.5		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC RINGLOC ACETABULAR CUP 28MM	278	C1776	HCPCS	5270355	local	both	4044	2830.8		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC LCP OLECRANAN PLATE 8 HOLE	278	C1713	HCPCS	5270470	local	both	4085.11	2859.58		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG MESH PARIETEX SKIRT 30CM X 20CM	278	C1781	HCPCS	5272093	local	both	4089.16	2862.41		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC REVERSE SHOULDER HUMERAL BEARING (44-36MM)-BIOMET	278	C1776	HCPCS	5270271	local	both	4097.68	2868.38		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC SOLYX-MESH	278	C1781	HCPCS	5271885	local	both	4141.25	2898.88		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 12 HL	278	C1713	HCPCS	5271384	local	both	4148.19	2903.73		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MENISCAL BEARING-SMALL,MEDIUM, LARGE"	278	C1776	HCPCS	5270166	local	both	4148.27	2903.79		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC PROXIMAL HUMERUS PLATE 3 HOLE-SYNTHES LCP	278	C1713	HCPCS	5270277	local	both	4154.5	2908.15		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
"HCHG CVMC MESH C-QUR TACHSHIELD 8.7"" X 10.7"" OVAL"	278	C1781	HCPCS	5271892	local	both	4210.7	2947.49		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT BIO-MOD HMRL HEAD	278	C1776	HCPCS	5271660	local	both	4230.27	2961.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PASTE	278	C1765	HCPCS	5270147	local	both	4258.62	2981.03		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC KNEE JOINT DEVICE	278	C1776	HCPCS	5270128	local	both	4264.56	2985.19		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 14 HL	278	C1713	HCPCS	5271385	local	both	4284.57	2999.2		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT VANGRD CR TIB BRG	278	C1776	HCPCS	5271684	local	both	4287.1	3000.97		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC FEMORAL NAIL TITANIUM LATERAL ENTRY (ALL SIZES)	278	C1713	HCPCS	5270294	local	both	4321.19	3024.83		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC JOINT DEVICE COMPONENT VANGRD M UNI BRG	278	C1776	HCPCS	5271705	local	both	4366.02	3056.21		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 1 HL	278	C1713	HCPCS	5271386	local	both	4375.49	3062.84		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC MEDTRONIC SPINAL STIMULATOR LEAD 1X8 COMPACT	278	C1897	HCPCS	5270381	local	both	4388.12	3071.68		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BOIMET VANGUARD M SERIES KNEE JOINT DEVICE	278	C1776	HCPCS	5270171	local	both	4411.54	3088.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC BIOMET RINGLOC ACETABULAR LINER-HIP COMPONENT	278	C1776	HCPCS	5270175	local	both	4411.54	3088.08		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AEQ REV LAT HUM INSERT 42MM DI	278	C1776	HCPCS	5271878	local	both	4419.7	3093.79		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contract		90		percent of total billed charges			67		percent of total billed charges			80		percent of total billed charges			75		percent of total billed charges			24		percent of total billed charges			80		percent of total billed charges	when medical centers charges exceed $2500 in aggregate for a single revenue code (paid in addition to all other negotiated rates)		33.5		percent of total billed charges			79		percent of total billed charges			40		percent of total billed charges			81.3		percent of total billed charges	if inpatient billed charges must be over 1000		24		percent of total billed charges				
HCHG CVMC AEQ REV GLEN BASEPLATE 29MM	278	C1776	HCPCS	5271879	local	both	4419.7	3093.79		87		percent of total billed charges			24		percent of total billed charges			47		percent of total billed charges			45		percent of total billed charges			38		percent of total billed charges						not applicable to this contra