Bundled Services
These procedure codes will not be considered for separate reimbursement when submitted on outpatient claims. These codes will not be considered for separate reimbursement if they are the only services billed for a date of service or if they are billed with other services for the same date of service.
| CPT Codes | Code description |
| 74713 | Mri fetal ea addl gestation |
| 74742 | X-ray fallopian tube |
| 75565 | Card mri veloc flow mapping |
| 75774 | Artery x-ray each vessel |
| 75894 | X-rays transcath therapy |
| 75901 | Remove cva device obstruct |
| 75902 | Remove cva lumen obstruct |
| 75970 | Vascular biopsy |
| 75984 | Xray control catheter change |
| 75989 | Abscess drainage under x-ray |
| 76125 | Cine/video x-rays add-on |
| 76376 | 3d render w/intrp postproces |
| 76377 | 3d render w/intrp postproces |
| 76802 | Ob us < 14 wks addl fetus |
| 76810 | Ob us >= 14 wks addl fetus |
| 76812 | Ob us detailed addl fetus |
| 76814 | Ob us nuchal meas add-on |
| 76932 | Echo guide for heart biopsy |
| 76937 | Us guide vascular access |
| 76940 | Us guide tissue ablation |
| 76941 | Echo guide for transfusion |
| 76942 | Echo guide for biopsy |
| 76945 | Echo guide villus sampling |
| 76946 | Echo guide for amniocentesis |
| 76948 | Echo guide ova aspiration |
| 76965 | Echo guidance radiotherapy |
| 76979 | Us trgt dyn mbubb ea addl |
| 76983 | Use ea addl target lesion |
| 76998 | Us guide intraop |
| 77001 | Fluoroguide for vein device |
| 77002 | Needle localization by xray |
| 77003 | Fluoroguide for spine inject |
| 77011 | Ct scan for localization |
| 77012 | Ct scan for needle biopsy |
| 77013 | Ct guide for tissue ablation |
| 77014 | Ct scan for therapy guide |
| 77021 | Mri guidance ndl plmt rs&i |
| 77022 | Mri gdn parnchyma tiss abltj |
| 77293 | Respirator motion mgmt simul |
| 77387 | Guidance for radj tx dlvr |
| 77417 | Radiology port images(s) |
| 77435 | Sbrt management |
| 77790 | Radiation handling |
| 78020 | Thyroid met uptake |
| 78434 | Aqmbf pet rest & rx stress |
| 78496 | Heart first pass add-on |
| 78730 | Urinary bladder retention |
| 78835 | Rp quan meas single area |
| 85396 | Clotting assay whole blood |
| 86849 | Immunology procedure |
| 87999 | Microbiology procedure |
| 88141 | Cytopath c/v interpret |
| 88177 | Cytp fna eval ea addl |
| 88185 | Flowcytometry/tc add-on |
| 88311 | Decalcify tissue |
| 88314 | Histochemical stains add-on |
| 88332 | Path consult intraop addl |
| 88334 | Intraop cyto path consult 2 |
| 88341 | Immunohisto antb addl slide |
| 88350 | Immunofluor antb addl stain |
| 88364 | Insitu hybridization (fish) |
| 88369 | M/phmtrc alysishquant/semiq |
| 88371 | Protein western blot tissue |
| 88372 | Protein analysis w/probe |
| 88373 | M/phmtrc alys ishquant/semiq |
| 88380 | Microdissection laser |
| 88381 | Microdissection manual |
| 88387 | Tiss exam molecular study |
| 88388 | Tiss ex molecul study add-on |
| 90296 | Diphtheria antitoxin |
| 90472 | Immunization admin each add |
| 90474 | Immune admin oral/nasal addl |
| 90476 | Adenovirus vaccine type 4 |
| 90632 | Hepa vaccine adult im |
| 90633 | Hepa vacc ped/adol 2 dose im |
| 90634 | Hepa vacc ped/adol 3 dose |
| 90636 | Hep a/hep b vacc adult im |
| 90647 | Hib prp-omp vacc 3 dose im |
| 90648 | Hib prp-t vaccine 4 dose im |
| 90680 | Rv5 vacc 3 dose live oral |
| 90690 | Typhoid vaccine oral |
| 90691 | Typhoid vaccine im |
| 90696 | Dtap-ipv vaccine 4-6 yrs im |
| 90698 | Dtap-ipv/hib vaccine im |
| 90700 | Dtap vaccine < 7 yrs im |
| 90702 | Dt vaccine under 7 yrs im |
| 90707 | Mmr vaccine sc |
| 90710 | Mmrv vaccine sc |
| 90713 | Poliovirus ipv sc/im |
| 90714 | Td vacc no presv 7 yrs+ im |
| 90715 | Tdap vaccine 7 yrs/> im |
| 90717 | Yellow fever vaccine subq |
| 90749 | Vaccine toxoid |
| 90785 | Psytx complex interactive |
| 90833 | Psytx w pt w e/m 30 min |
| 90836 | Psytx w pt w e/m 45 min |
| 90838 | Psytx w pt w e/m 60 min |
| 90840 | Psytx crisis ea addl 30 min |
| 90885 | Psy evaluation of records |
| 90887 | Consultation with family |
| 90889 | Preparation of report |
| 90940 | Hemodialysis access study |
| 91013 | Esophgl motil w/stim/perfus |
| 92071 | Contact lens fitting for tx |
| 92072 | Fit contac lens for management |
| 92100 | Serial tonometry exam(s) |
| 92504 | Ear microscopy examination |
| 92531 | Spontaneous nystagmus study |
| 92532 | Positional nystagmus test |
| 92533 | Caloric vestibular test |
| 92534 | Optokinetic nystagmus test |
| 92547 | Supplemental electrical test |
| 92621 | Auditory function + 15 min |
| 92627 | Eval aud funcj ea addl 15 |
| 92921 | Prq cardiac angio addl art |
| 92925 | Prq card angio/athrect addl |
| 92929 | Prq card stent w/angio addl |
| 92934 | Prq card stent/ath/angio |
| 92938 | Prq revasc byp graft addl |
| 92944 | Prq card revasc chronic addl |
| 92973 | Prq coronary mech thrombect |
| 92974 | Cath place cardio brachytx |
| 92978 | Endoluminl ivus oct c 1st |
| 92979 | Endoluminl ivus oct c ea |
| 92998 | Pul art balloon repr percut |
| 93286 | Peri-px eval pm/ldls pm ip |
| 93287 | Peri-px device eval & prgr |
| 93314 | Echo transesophageal |
| 93317 | Echo transesophageal |
| 93320 | Doppler echo exam heart |
| 93321 | Doppler echo exam heart |
| 93325 | Doppler color flow add-on |
| 93355 | Echo transesophageal (tee) |
| 93356 | Myocrd strain img spckl trck |
| 93462 | L hrt cath trnsptl puncture |
| 93463 | Drug admin & hemodynmic meas |
| 93464 | Exercise w/hemodynamic meas |
| 93561 | Cardiac output measurement |
| 93562 | Card output measure subsq |
| 93563 | Inject congenital card cath |
| 93564 | Inject hrt congntl art/grft |
| 93565 | Inject l ventr/atrial angio |
| 93566 | Inject r ventr/atrial angio |
| 93567 | Inject suprvlv aortography |
| 93568 | Inject pulm art hrt cath |
| 93571 | Heart flow reserve measure |
| 93572 | Heart flow reserve measure |
| 93592 | Perq transcath closure each |
| 93609 | Map tachycardia add-on |
| 93613 | Electrophys map 3d add-on |
| 93621 | Electrophysiology evaluation |
| 93622 | Electrophysiology evaluation |
| 93623 | Stimulation pacing heart |
| 93631 | Heart pacing mapping |
| 93640 | Evaluation heart device |
| 93641 | Electrophysiology evaluation |
| 93644 | Electrophysiology evaluation |
| 93655 | Ablate arrhythmia add on |
| 93657 | Tx l/r atrial fib addl |
| 93662 | Intracardiac ecg (ice) |
| 93770 | Measure venous pressure |
| 94645 | Cbt each addl hour |
| 94729 | Co/membane diffuse capacity |
| 94760 | Measure blood oxygen level |
| 94761 | Measure blood oxygen level |
| 94781 | Cars/bd tst inft-12mo +30min |
| 95079 | Ingest challenge addl 60 min |
| 95829 | Surgery electrocorticogram |
| 95873 | Guide nerv destr elec stim |
| 95874 | Guide nerv destr needle emg |
| 95885 | Musc tst done w/nerv tst lim |
| 95886 | Musc test done w/n test comp |
| 95887 | Musc tst done w/n tst nonext |
| 95940 | Ionm in operating room 15 min |
| 95941 | Ionm remote/>1 pt or per hr |
| 95955 | Eeg during surgery |
| 95957 | Eeg digital analysis |
| 95962 | Electrode stim brain add-on |
| 95967 | Meg evoked each addl |
| 95980 | Io anal gast n-stim init |
| 95984 | Alys brn npgt prgrmg addl 15 |
| 96020 | Functional brain mapping |
| 96113 | Devel tst phys/qhp ea addl |
| 96121 | Nubhvl xm phy/qhp ea addl hr |
| 96131 | Psycl tst eval phys/qhp ea |
| 96133 | Nrpsyc tst eval phys/qhp ea |
| 96137 | Psycl/nrpsyc tst phy/qhp ea |
| 96139 | Psycl/nrpsyc tst tech ea |
| 96159 | Hlth bhv ivntj indiv ea addl |
| 96165 | Hlth bhv ivntj grp ea addl |
| 96168 | Hlth bhv ivntj fam ea addl |
| 96368 | Ther/diag concurrent inf |
| 96376 | Tx/pro/dx inj same drug adon |
| 96570 | Photodynmc tx 30 min add-on |
| 96571 | Photodynamic tx addl 15 min |
| 96902 | Trichogram |
| 96904 | Whole body photography |
| 96932 | Rcm celulr subcelulr img skn |
| 96934 | Rcm celulr subcelulr img skn |
| 96935 | Rcm celulr subcelulr img skn |
| 96936 | Rcm celulr subcelulr img skn |
| 97598 | Rmvl devital tis addl 20cm/< |
| 97811 | Acupunct w/o stimul addl 15m |
| 97814 | Acupunct w/stimul addl 15m |
| 99078 | Group health education |
| 99091 | Collj & interpj data ea 30 d |
| 99151 | Mod sed same phys/qhp <5 yrs |
| 99152 | Mod sed same phys/qhp 5/>yrs |
| 99153 | Mod sed same phys/qhp ea |
| 99155 | Mod sed oth phys/qhp <5 yrs |
| 99156 | Mod sed oth phys/qhp 5/>yrs |
| 99157 | Mod sed other phys/qhp ea |
| 99175 | Induction of vomiting |
| 99292 | Critical care addl 30 min |
| 99354 | Prolng svc o/p 1st hour |
| 99355 | Prolng svc o/p ea addl 30 |
| 99358 | Prolong service w/o contact |
| 99359 | Prolong serv w/o contact add |
| 99366 | Team conf w/pat by hc prof |
| 99367 | Team conf w/o pat by phys |
| 99368 | Team conf w/o pat by hc pro |
| 99439 | Chrnc care mgmt svc ea addl |
| 99464 | Attendance at delivery |
| 99466 | Ped crit care transport |
| 99467 | Ped crit care transport addl |
| 99489 | Cplx chrnc care ea addl 30 |
| 99494 | 1st/sbsq psyc collab care |
| 99498 | Advncd care plan addl 30 min |
| A4206 | 1 cc sterile syringe&needle |
| A4207 | 2 cc sterile syringe&needle |
| A4208 | 3 cc sterile syringe&needle |
| A4209 | 5+ cc sterile syringe&needle |
| A4211 | Supp for self-adm injections |
| A4212 | Non coring needle or stylet |
| A4213 | 20+ cc syringe only |
| A4215 | Sterile needle |
| A4216 | Sterile water/saline, 10 ml |
| A4217 | Sterile water/saline, 500 ml |
| A4218 | Sterile saline or water |
| A4220 | Infusion pump refill kit |
| A4221 | Supp non-insulin inf cath/wk |
| A4222 | Infusion supplies with pump |
| A4223 | Infusion supplies w/o pump |
| A4224 | Supply insulin inf cath/wk |
| A4225 | Sup/ext insulin inf pump syr |
| A4230 | Infus insulin pump non needl |
| A4231 | Infusion insulin pump needle |
| A4244 | Alcohol or peroxide per pint |
| A4245 | Alcohol wipes per box |
| A4246 | Betadine/phisohex solution |
| A4247 | Betadine/iodine swabs/wipes |
| A4248 | Chlorhexidine antisept |
| A4253 | Blood glucose/reagent strips |
| A4255 | Glucose monitor platforms |
| A4256 | Calibrator solution/chips |
| A4258 | Lancet device each |
| A4259 | Lancets per box |
| A4262 | Temporary tear duct plug |
| A4263 | Permanent tear duct plug |
| A4265 | Paraffin |
| A4270 | Disposable endoscope sheath |
| A4280 | Brst prsths adhsv attchmnt |
| A4290 | Sacral nerve stim test lead |
| A4300 | Cath impl vasc access portal |
| A4301 | Implantable access syst perc |
| A4305 | Drug delivery system >=50 ml |
| A4306 | Drug delivery system <=50 ml |
| A4310 | Insert tray w/o bag/cath |
| A4311 | Catheter w/o bag 2-way latex |
| A4312 | Cath w/o bag 2-way silicone |
| A4313 | Catheter w/bag 3-way |
| A4314 | Cath w/drainage 2-way latex |
| A4315 | Cath w/drainage 2-way silcne |
| A4316 | Cath w/drainage 3-way |
| A4320 | Irrigation tray |
| A4321 | Cath therapeutic irrig agent |
| A4322 | Irrigation syringe |
| A4326 | Male external catheter |
| A4327 | Fem urinary collect dev cup |
| A4328 | Fem urinary collect pouch |
| A4330 | Stool collection pouch |
| A4331 | Extension drainage tubing |
| A4332 | Lube sterile packet |
| A4333 | Urinary cath anchor device |
| A4334 | Urinary cath leg strap |
| A4335 | Incontinence supply |
| A4336 | Urethral insert |
| A4337 | Incontinent rectal insert |
| A4338 | Indwelling catheter latex |
| A4340 | Indwelling catheter special |
| A4344 | Cath indw foley 2 way silicn |
| A4346 | Cath indw foley 3 way |
| A4349 | Disposable male external cat |
| A4351 | Straight tip urine catheter |
| A4352 | Coude tip urinary catheter |
| A4353 | Intermittent urinary cath |
| A4354 | Cath insertion tray w/bag |
| A4355 | Bladder irrigation tubing |
| A4356 | Ext ureth clmp or compr dvc |
| A4357 | Bedside drainage bag |
| A4358 | Urinary leg or abdomen bag |
| A4360 | Disposable ext urethral dev |
| A4361 | Ostomy face plate |
| A4362 | Solid skin barrier |
| A4364 | Adhesive, liquid or equal |
| A4366 | Ostomy vent |
| A4367 | Ostomy belt |
| A4368 | Ostomy filter |
| A4369 | Skin barrier liquid per oz |
| A4371 | Skin barrier powder per oz |
| A4372 | Skin barrier solid 4x4 equiv |
| A4373 | Skin barrier with flange |
| A4375 | Drainable plastic pch w fcpl |
| A4376 | Drainable rubber pch w fcplt |
| A4377 | Drainable plstic pch w/o fp |
| A4378 | Drainable rubber pch w/o fp |
| A4379 | Urinary plastic pouch w fcpl |
| A4380 | Urinary rubber pouch w fcplt |
| A4381 | Urinary plastic pouch w/o fp |
| A4382 | Urinary hvy plstc pch w/o fp |
| A4383 | Urinary rubber pouch w/o fp |
| A4384 | Ostomy faceplt/silicone ring |
| A4385 | Ost skn barrier sld ext wear |
| A4387 | Ost clsd pouch w att st barr |
| A4388 | Drainable pch w ex wear barr |
| A4389 | Drainable pch w st wear barr |
| A4390 | Drainable pch ex wear convex |
| A4391 | Urinary pouch w ex wear barr |
| A4392 | Urinary pouch w st wear barr |
| A4393 | Urine pch w ex wear bar conv |
| A4394 | Ostomy pouch liq deodorant |
| A4395 | Ostomy pouch solid deodorant |
| A4396 | Peristomal hernia supprt blt |
| A4397 | Irrigation supply sleeve |
| A4398 | Ostomy irrigation bag |
| A4399 | Ostomy irrig cone/cath w brs |
| A4400 | Ostomy irrigation set |
| A4402 | Lubricant per ounce |
| A4404 | Ostomy ring each |
| A4405 | Nonpectin based ostomy paste |
| A4406 | Pectin based ostomy paste |
| A4407 | Ext wear ost skn barr <=4sq" |
| A4408 | Ext wear ost skn barr >4sq" |
| A4409 | Ost skn barr convex <=4 sq i |
| A4410 | Ost skn barr extnd >4 sq |
| A4411 | Ost skn barr extnd =4sq |
| A4412 | Ost pouch drain high output |
| A4413 | 2 pc drainable ost pouch |
| A4414 | Ost sknbar w/o conv<=4 sq in |
| A4415 | Ost skn barr w/o conv >4 sqi |
| A4416 | Ost pch clsd w barrier/filtr |
| A4417 | Ost pch w bar/bltinconv/fltr |
| A4418 | Ost pch clsd w/o bar w filtr |
| A4419 | Ost pch for bar w flange/flt |
| A4420 | Ost pch clsd for bar w lk fl |
| A4421 | Ostomy supply misc |
| A4422 | Ost pouch absorbent material |
| A4423 | Ost pch for bar w lk fl/fltr |
| A4424 | Ost pch drain w bar & filter |
| A4425 | Ost pch drain for barrier fl |
| A4426 | Ost pch drain 2 piece system |
| A4427 | Ost pch drain/barr lk flng/f |
| A4428 | Urine ost pouch w faucet/tap |
| A4429 | Urine ost pouch w bltinconv |
| A4430 | Ost urine pch w b/bltin conv |
| A4431 | Ost pch urine w barrier/tapv |
| A4432 | Os pch urine w bar/fange/tap |
| A4433 | Urine ost pch bar w lock fln |
| A4434 | Ost pch urine w lock flng/ft |
| A4435 | 1pc ost pch drain hgh output |
| A4450 | Non-waterproof tape |
| A4452 | Waterproof tape |
| A4455 | Adhesive remover per ounce |
| A4456 | Adhesive remover, wipes |
| A4458 | Reusable enema bag |
| A4459 | Manual pump enema, reusable |
| A4461 | Surgicl dress hold non-reuse |
| A4463 | Surgical dress holder reuse |
| A4465 | Non-elastic extremity binder |
| A4470 | Gravlee jet washer |
| A4480 | Vabra aspirator |
| A4481 | Tracheostoma filter |
| A4483 | Moisture exchanger |
| A4556 | Electrodes, pair |
| A4557 | Lead wires, pair |
| A4558 | Conductive gel or paste |
| A4559 | Coupling gel or paste |
| A4561 | Pessary rubber, any type |
| A4562 | Pessary, non rubber,any type |
| A4565 | Slings |
| A4595 | Tens suppl 2 lead per month |
| A4602 | Replace lithium battery 1.5v |
| A4604 | Tubing with heating element |
| A4605 | Trach suction cath close sys |
| A4606 | Oxygen probe used w oximeter |
| A4608 | Transtracheal oxygen cath |
| A4614 | Hand-held pefr meter |
| A4615 | Cannula nasal |
| A4616 | Tubing (oxygen) per foot |
| A4617 | Mouth piece |
| A4618 | Breathing circuits |
| A4619 | Face tent |
| A4620 | Variable concentration mask |
| A4623 | Tracheostomy inner cannula |
| A4624 | Tracheal suction tube |
| A4625 | Trach care kit for new trach |
| A4626 | Tracheostomy cleaning brush |
| A4628 | Oropharyngeal suction cath |
| A4629 | Tracheostomy care kit |
| A4634 | Replacement bulb th lightbox |
| A4641 | Radiopharm dx agent noc |
| A4642 | In111 satumomab |
| A4648 | Implantable tissue marker |
| A4649 | Surgical supplies |
| A4650 | Implant radiation dosimeter |
| A4651 | Calibrated microcap tube |
| A4652 | Microcapillary tube sealant |
| A4653 | Pd catheter anchor belt |
| A4657 | Syringe w/wo needle |
| A4660 | Sphyg/bp app w cuff and stet |
| A4663 | Dialysis blood pressure cuff |
| A4680 | Activated carbon filter, ea |
| A4690 | Dialyzer, each |
| A4706 | Bicarbonate conc sol per gal |
| A4707 | Bicarbonate conc pow per pac |
| A4708 | Acetate conc sol per gallon |
| A4709 | Acid conc sol per gallon |
| A4714 | Treated water per gallon |
| A4719 | "y set" tubing |
| A4720 | Dialysat sol fld vol > 249cc |
| A4721 | Dialysat sol fld vol > 999cc |
| A4722 | Dialys sol fld vol > 1999cc |
| A4723 | Dialys sol fld vol > 2999cc |
| A4724 | Dialys sol fld vol > 3999cc |
| A4725 | Dialys sol fld vol > 4999cc |
| A4726 | Dialys sol fld vol > 5999cc |
| A4730 | Fistula cannulation set, ea |
| A4736 | Topical anesthetic, per gram |
| A4737 | Inj anesthetic per 10 ml |
| A4740 | Shunt accessory |
| A4750 | Art or venous blood tubing |
| A4755 | Comb art/venous blood tubing |
| A4760 | Dialysate sol test kit, each |
| A4765 | Dialysate conc pow per pack |
| A4766 | Dialysate conc sol add 10 ml |
| A4770 | Blood collection tube/vacuum |
| A4771 | Serum clotting time tube |
| A4772 | Blood glucose test strips |
| A4773 | Occult blood test strips |
| A4774 | Ammonia test strips |
| A4802 | Protamine sulfate per 50 mg |
| A4860 | Disposable catheter tips |
| A4870 | Plumb/elec wk hm hemo equip |
| A4890 | Repair/maint cont hemo equip |
| A4911 | Drain bag/bottle |
| A4913 | Misc dialysis supplies noc |
| A4918 | Venous pressure clamp |
| A4927 | Non-sterile gloves |
| A4928 | Surgical mask |
| A4929 | Tourniquet for dialysis, ea |
| A4930 | Sterile, gloves per pair |
| A4931 | Reusable oral thermometer |
| A4932 | Reusable rectal thermometer |
| A5051 | Pouch clsd w barr attached |
| A5052 | Clsd ostomy pouch w/o barr |
| A5053 | Clsd ostomy pouch faceplate |
| A5054 | Clsd ostomy pouch w/flange |
| A5055 | Stoma cap |
| A5056 | 1 pc ost pouch w filter |
| A5057 | 1 pc ost pou w built-in conv |
| A5061 | Pouch drainable w barrier at |
| A5062 | Drnble ostomy pouch w/o barr |
| A5063 | Drain ostomy pouch w/flange |
| A5071 | Urinary pouch w/barrier |
| A5072 | Urinary pouch w/o barrier |
| A5073 | Urinary pouch on barr w/flng |
| A5081 | Stoma plug or seal, any type |
| A5082 | Continent stoma catheter |
| A5083 | Stoma absorptive cover |
| A5093 | Ostomy accessory convex inse |
| A5102 | Bedside drain btl w/wo tube |
| A5105 | Urinary suspensory |
| A5112 | Urinary leg bag |
| A5120 | Skin barrier, wipe or swab |
| A5121 | Solid skin barrier 6x6 |
| A5122 | Solid skin barrier 8x8 |
| A5126 | Disk/foam pad +or- adhesive |
| A5131 | Appliance cleaner |
| A5200 | Percutaneous catheter anchor |
| A5510 | Compression form shoe insert |
| A6010 | Collagen based wound filler |
| A6011 | Collagen gel/paste wound fil |
| A6021 | Collagen dressing <=16 sq in |
| A6022 | Collagen drsg>16<=48 sq in |
| A6023 | Collagen dressing >48 sq in |
| A6024 | Collagen dsg wound filler |
| A6025 | Silicone gel sheet, each |
| A6154 | Wound pouch each |
| A6196 | Alginate dressing <=16 sq in |
| A6197 | Alginate drsg >16 <=48 sq in |
| A6198 | Alginate dressing > 48 sq in |
| A6199 | Alginate drsg wound filler |
| A6203 | Composite drsg <= 16 sq in |
| A6204 | Composite drsg >16<=48 sq in |
| A6205 | Composite drsg > 48 sq in |
| A6206 | Contact layer <= 16 sq in |
| A6207 | Contact layer >16<= 48 sq in |
| A6208 | Contact layer > 48 sq in |
| A6209 | Foam drsg <=16 sq in w/o bdr |
| A6210 | Foam drg >16<=48 sq in w/o b |
| A6211 | Foam drg > 48 sq in w/o brdr |
| A6212 | Foam drg <=16 sq in w/border |
| A6213 | Foam drg >16<=48 sq in w/bdr |
| A6214 | Foam drg > 48 sq in w/border |
| A6215 | Foam dressing wound filler |
| A6216 | Non-sterile gauze<=16 sq in |
| A6217 | Non-sterile gauze>16<=48 sq |
| A6218 | Non-sterile gauze > 48 sq in |
| A6219 | Gauze <= 16 sq in w/border |
| A6220 | Gauze >16 <=48 sq in w/bordr |
| A6221 | Gauze > 48 sq in w/border |
| A6222 | Gauze <=16 in no w/sal w/o b |
| A6223 | Gauze >16<=48 no w/sal w/o b |
| A6224 | Gauze > 48 in no w/sal w/o b |
| A6228 | Gauze <= 16 sq in water/sal |
| A6229 | Gauze >16<=48 sq in watr/sal |
| A6230 | Gauze > 48 sq in water/salne |
| A6231 | Hydrogel dsg<=16 sq in |
| A6232 | Hydrogel dsg>16<=48 sq in |
| A6233 | Hydrogel dressing >48 sq in |
| A6234 | Hydrocolld drg <=16 w/o bdr |
| A6235 | Hydrocolld drg >16<=48 w/o b |
| A6236 | Hydrocolld drg > 48 in w/o b |
| A6237 | Hydrocolld drg <=16 in w/bdr |
| A6238 | Hydrocolld drg >16<=48 w/bdr |
| A6239 | Hydrocolld drg > 48 in w/bdr |
| A6240 | Hydrocolld drg filler paste |
| A6241 | Hydrocolloid drg filler dry |
| A6242 | Hydrogel drg <=16 in w/o bdr |
| A6243 | Hydrogel drg >16<=48 w/o bdr |
| A6244 | Hydrogel drg >48 in w/o bdr |
| A6245 | Hydrogel drg <= 16 in w/bdr |
| A6246 | Hydrogel drg >16<=48 in w/b |
| A6247 | Hydrogel drg > 48 sq in w/b |
| A6248 | Hydrogel drsg gel filler |
| A6250 | Skin seal protect moisturizr |
| A6251 | Absorpt drg <=16 sq in w/o b |
| A6252 | Absorpt drg >16 <=48 w/o bdr |
| A6253 | Absorpt drg > 48 sq in w/o b |
| A6254 | Absorpt drg <=16 sq in w/bdr |
| A6255 | Absorpt drg >16<=48 in w/bdr |
| A6256 | Absorpt drg > 48 sq in w/bdr |
| A6257 | Transparent film <= 16 sq in |
| A6258 | Transparent film >16<=48 in |
| A6259 | Transparent film > 48 sq in |
| A6260 | Wound cleanser any type/size |
| A6261 | Wound filler gel/paste /oz |
| A6262 | Wound filler dry form / gram |
| A6266 | Impreg gauze no h20/sal/yard |
| A6402 | Sterile gauze <= 16 sq in |
| A6403 | Sterile gauze>16 <= 48 sq in |
| A6404 | Sterile gauze > 48 sq in |
| A6407 | Packing strips, non-impreg |
| A6410 | Sterile eye pad |
| A6411 | Non-sterile eye pad |
| A6412 | Occlusive eye patch |
| A6441 | Pad band w>=3" <5"/yd |
| A6442 | Conform band n/s w<3"/yd |
| A6443 | Conform band n/s w>=3"<5"/yd |
| A6444 | Conform band n/s w>=5"/yd |
| A6445 | Conform band s w <3"/yd |
| A6446 | Conform band s w>=3" <5"/yd |
| A6447 | Conform band s w >=5"/yd |
| A6448 | Lt compres band <3"/yd |
| A6449 | Lt compres band >=3" <5"/yd |
| A6450 | Lt compres band >=5"/yd |
| A6451 | Mod compres band w>=3"<5"/yd |
| A6452 | High compres band w>=3"<5"yd |
| A6453 | Self-adher band w <3"/yd |
| A6454 | Self-adher band w>=3" <5"/yd |
| A6455 | Self-adher band >=5"/yd |
| A6456 | Zinc paste band w >=3"<5"/yd |
| A6457 | Tubular dressing |
| A6460 | Synthetic drsg <= 16 sq in |
| A6461 | Synthetic drsg >16<=48 sq in |
| A6501 | Compres burngarment bodysuit |
| A6502 | Compres burngarment chinstrp |
| A6503 | Compres burngarment facehood |
| A6504 | Cmprsburngarment glove-wrist |
| A6505 | Cmprsburngarment glove-elbow |
| A6506 | Cmprsburngrmnt glove-axilla |
| A6507 | Cmprs burngarment foot-knee |
| A6508 | Cmprs burngarment foot-thigh |
| A6509 | Compres burn garment jacket |
| A6510 | Compres burn garment leotard |
| A6511 | Compres burn garment panty |
| A6512 | Compres burn garment, noc |
| A6531 | Compression stocking bk30-40 |
| A6532 | Compression stocking bk40-50 |
| A6545 | Grad comp non-elastic bk |
| A6550 | Neg pres wound ther drsg set |
| A7025 | Replace chest compress vest |
| A7040 | One way chest drain valve |
| A7041 | Water seal drain container |
| A7047 | Resp suction oral interface |
| A7048 | Vacuum drain bottle/tube kit |
| A7501 | Tracheostoma valve w diaphra |
| A7502 | Replacement diaphragm/fplate |
| A7503 | Hmes filter holder or cap |
| A7504 | Tracheostoma hmes filter |
| A7505 | Hmes or trach valve housing |
| A7506 | Hmes/trachvalve adhesivedisk |
| A7507 | Integrated filter & holder |
| A7508 | Housing & integrated adhesiv |
| A7509 | Heat & moisture exchange sys |
| A7520 | Trach/laryn tube non-cuffed |
| A7521 | Trach/laryn tube cuffed |
| A7522 | Trach/laryn tube stainless |
| A7523 | Tracheostomy shower protect |
| A7524 | Tracheostoma stent/stud/bttn |
| A7525 | Tracheostomy mask |
| A7526 | Tracheostomy tube collar |
| A7527 | Trach/laryn tube plug/stop |
| A9284 | Non-electronic spirometer |
| A9500 | Tc99m sestamibi |
| A9501 | Technetium tc-99m teboroxime |
| A9502 | Tc99m tetrofosmin |
| A9503 | Tc99m medronate |
| A9504 | Tc99m apcitide |
| A9505 | Tl201 thallium |
| A9507 | In111 capromab |
| A9508 | I131 iodobenguate, dx |
| A9509 | Iodine i-123 sod iodide mil |
| A9510 | Tc99m disofenin |
| A9512 | Tc99m pertechnetate |
| A9515 | Choline c-11 |
| A9516 | Iodine i-123 sod iodide mic |
| A9520 | Tc99 tilmanocept diag 0.5mci |
| A9521 | Tc99m exametazime |
| A9524 | I131 serum albumin, dx |
| A9526 | Nitrogen n-13 ammonia |
| A9528 | Iodine i-131 iodide cap, dx |
| A9529 | I131 iodide sol, dx |
| A9531 | I131 max 100uci |
| A9532 | I125 serum albumin, dx |
| A9536 | Tc99m depreotide |
| A9537 | Tc99m mebrofenin |
| A9538 | Tc99m pyrophosphate |
| A9539 | Tc99m pentetate |
| A9540 | Tc99m maa |
| A9541 | Tc99m sulfur colloid |
| A9542 | In111 ibritumomab, dx |
| A9546 | Co57/58 |
| A9547 | In111 oxyquinoline |
| A9548 | In111 pentetate |
| A9550 | Tc99m gluceptate |
| A9551 | Tc99m succimer |
| A9552 | F18 fdg |
| A9553 | Cr51 chromate |
| A9554 | I125 iothalamate, dx |
| A9555 | Rb82 rubidium |
| A9556 | Ga67 gallium |
| A9557 | Tc99m bicisate |
| A9558 | Xe133 xenon 10mci |
| A9559 | Co57 cyano |
| A9560 | Tc99m labeled rbc |
| A9561 | Tc99m oxidronate |
| A9562 | Tc99m mertiatide |
| A9566 | Tc99m fanolesomab |
| A9567 | Technetium tc-99m aerosol |
| A9568 | Technetium tc99m arcitumomab |
| A9569 | Technetium tc-99m auto wbc |
| A9570 | Indium in-111 auto wbc |
| A9571 | Indium in-111 auto platelet |
| A9572 | Indium in-111 pentetreotide |
| A9575 | Inj gadoterate meglumi 0.1ml |
| A9576 | Inj prohance multipack |
| A9577 | Inj multihance |
| A9578 | Inj multihance multipack |
| A9579 | Gad-base mr contrast nos,1ml |
| A9580 | Sodium fluoride f-18 |
| A9581 | Gadoxetate disodium inj |
| A9582 | Iodine i-123 iobenguane |
| A9583 | Gadofosveset trisodium inj |
| A9584 | Iodine i-123 ioflupane |
| A9585 | Gadobutrol injection |
| A9586 | Florbetapir f18 |
| A9587 | Gallium ga-68 |
| A9588 | Fluciclovine f-18 |
| A9589 | Insti hexaminolevulinate hcl |
| A9597 | Pet, dx, for tumor id, noc |
| A9598 | Pet dx for non-tumor id, noc |
| A9698 | Non-rad contrast materialnoc |
| A9699 | Radiopharm rx agent noc |
| A9700 | Echocardiography contrast |
| C1713 | Anchor/screw bn/bn,tis/bn |
| C1714 | Cath, trans atherectomy, dir |
| C1715 | Brachytherapy needle |
| C1721 | Aicd, dual chamber |
| C1722 | Aicd, single chamber |
| C1724 | Cath, trans atherec,rotation |
| C1725 | Cath, translumin non-laser |
| C1726 | Cath, bal dil, non-vascular |
| C1727 | Cath, bal tis dis, non-vas |
| C1728 | Cath, brachytx seed adm |
| C1729 | Cath, drainage |
| C1730 | Cath, ep, 19 or few elect |
| C1731 | Cath, ep, 20 or more elec |
| C1732 | Cath, ep, diag/abl, 3d/vect |
| C1733 | Cath, ep, other than cool-tip |
| C1749 | Endo, colon, retro imaging |
| C1750 | Cath, hemodialysis,long-term |
| C1751 | Cath, inf, per/cent/midline |
| C1752 | Cath,hemodialysis,short-term |
| C1753 | Cath, intravas ultrasound |
| C1754 | Catheter, intradiscal |
| C1755 | Catheter, intraspinal |
| C1756 | Cath, pacing, transesoph |
| C1757 | Cath, thrombectomy/embolect |
| C1758 | Catheter, ureteral |
| C1759 | Cath, intra echocardiography |
| C1760 | Closure dev, vasc |
| C1762 | Conn tiss, human(inc fascia) |
| C1763 | Conn tiss, non-human |
| C1764 | Event recorder, cardiac |
| C1765 | Adhesion barrier |
| C1766 | Intro/sheath,strble,non-peel |
| C1767 | Generator, neuro non-recharg |
| C1768 | Graft, vascular |
| C1769 | Guide wire |
| C1770 | Imaging coil, mr, insertable |
| C1771 | Rep dev, urinary, w/sling |
| C1772 | Infusion pump, programmable |
| C1773 | Ret dev, insertable |
| C1776 | Joint device (implantable) |
| C1777 | Lead, aicd, endo single coil |
| C1778 | Lead, neurostimulator |
| C1779 | Lead, pmkr, transvenous vdd |
| C1780 | Lens, intraocular (new tech) |
| C1781 | Mesh (implantable) |
| C1782 | Morcellator |
| C1783 | Ocular imp, aqueous drain de |
| C1784 | Ocular dev, intraop, det ret |
| C1785 | Pmkr, dual, rate-resp |
| C1786 | Pmkr, single, rate-resp |
| C1787 | Patient progr, neurostim |
| C1788 | Port, indwelling, imp |
| C1789 | Prosthesis, breast, imp |
| C1813 | Prosthesis, penile, inflatab |
| C1814 | Retinal tamp, silicone oil |
| C1815 | Pros, urinary sph, imp |
| C1816 | Receiver/transmitter, neuro |
| C1817 | Septal defect imp sys |
| C1818 | Integrated keratoprosthesis |
| C1819 | Tissue localization-excision |
| C1820 | Generator neuro rechg bat sy |
| C1821 | Interspinous implant |
| C1822 | Gen, neuro, hf, rechg bat |
| C1830 | Power bone marrow bx needle |
| C1840 | Telescopic intraocular lens |
| C1841 | Retinal prosth int/ext comp |
| C1849 | Skin substitute, synthetic |
| C1874 | Stent, coated/cov w/del sys |
| C1875 | Stent, coated/cov w/o del sy |
| C1876 | Stent, non-coa/non-cov w/del |
| C1877 | Stent, non-coat/cov w/o del |
| C1878 | Matrl for vocal cord |
| C1880 | Vena cava filter |
| C1881 | Dialysis access system |
| C1882 | Aicd, other than sing/dual |
| C1883 | Adapt/ext, pacing/neuro lead |
| C1884 | Embolization protect syst |
| C1885 | Cath, translumin angio laser |
| C1886 | Catheter, ablation |
| C1887 | Catheter, guiding |
| C1888 | Endovas non-cardiac abl cath |
| C1889 | Implant/insert device, noc |
| C1891 | Infusion pump,non-prog, perm |
| C1892 | Intro/sheath,fixed,peel-away |
| C1893 | Intro/sheath, fixed,non-peel |
| C1894 | Intro/sheath, non-laser |
| C1895 | Lead, aicd, endo dual coil |
| C1896 | Lead, aicd, non sing/dual |
| C1897 | Lead, neurostim test kit |
| C1898 | Lead, pmkr, other than trans |
| C1899 | Lead, pmkr/aicd combination |
| C1900 | Lead, coronary venous |
| C2613 | Lung bx plug w/del sys |
| C2614 | Probe, perc lumb disc |
| C2615 | Sealant, pulmonary, liquid |
| C2617 | Stent, non-cor, tem w/o del |
| C2618 | Probe/needle, cryo |
| C2619 | Pmkr, dual, non rate-resp |
| C2620 | Pmkr, single, non rate-resp |
| C2621 | Pmkr, other than sing/dual |
| C2622 | Prosthesis, penile, non-inf |
| C2623 | Cath, translumin, drug-coat |
| C2624 | Wireless pressure sensor |
| C2625 | Stent, non-cor, tem w/del sy |
| C2626 | Infusion pump, non-prog,temp |
| C2627 | Cath, suprapubic/cystoscopic |
| C2628 | Catheter, occlusion |
| C2629 | Intro/sheath, laser |
| C2630 | Cath, ep, cool-tip |
| C2631 | Rep dev, urinary, w/o sling |
| C5272 | Low cost skin substitute app |
| C5274 | Low cost skin substitute app |
| C5276 | Low cost skin substitute app |
| C5278 | Low cost skin substitute app |
| C8937 | Cad breast mri |
| C9113 | Inj pantoprazole sodium, via |
| C9254 | Injection, lacosamide |
| C9285 | Patch, lidocaine/tetracaine |
| C9290 | Inj, bupivacaine liposome |
| C9352 | Neuragen nerve guide, per cm |
| C9353 | Neurawrap nerve protector,cm |
| C9354 | Veritas collagen matrix, cm2 |
| C9355 | Neuromatrix nerve cuff, cm |
| C9356 | Tenoglide tendon prot, cm2 |
| C9358 | Surgimend, fetal |
| C9359 | Implnt,bon void filler-putty |
| C9360 | Surgimend, neonatal |
| C9361 | Neuromend nerve wrap |
| C9362 | Implnt,bon void filler-strip |
| C9363 | Integra meshed bil wound mat |
| C9364 | Porcine implant, permacol |
| C9601 | Perc drug-el cor stent bran |
| C9603 | Perc d-e cor stent ather br |
| C9605 | Perc d-e cor revasc t cabg b |
| C9608 | Perc d-e cor revasc chro add |
| C9726 | Rxt breast appl place/remov |
| C9738 | Blue light cysto imag agent |
| C9753 | Intraosseous destruct add'l |
| C9756 | Fluorescence lymph map w/icg |
| C9759 | Transcath intraop microinf |
| C9768 | Endo us-guide hep porto grad |
| C9776 | Fluo bile duct imaging w/icg |
| C9777 | Esophag mucosal integ add-on |
| C9898 | Inpnt stay radiolabeled item |
| D9110 | Tx dental pain minor proc |
| D9230 | Analgesia |
| D9248 | Sedation (non-iv) |
| E0445 | Oximeter non-invasive |
| E0487 | Electronic spirometer |
| E0603 | Electric breast pump |
| E0616 | Cardiac event recorder |
| E0746 | Electromyograph biofeedback |
| E0749 | Elec osteogen stim implanted |
| E0782 | Non-programble infusion pump |
| E0783 | Programmable infusion pump |
| E0785 | Replacement impl pump cathet |
| E0786 | Implantable pump replacement |
| E0830 | Ambulatory traction device |
| G0102 | Prostate ca screening; dre |
| G0177 | Opps/php; train & educ serv |
| G0259 | Inject for sacroiliac joint |
| G0268 | Removal of impacted wax md |
| G0269 | Occlusive device in vein art |
| G0278 | Iliac art angio,cardiac cath |
| G0288 | Recon, cta for surg plan |
| G0289 | Arthro, loose body + chondro |
| G0378 | Hospital observation per hr |
| G0453 | Cont intraop neuro monitor |
| G0500 | Mod sedat endo service >5yrs |
| G0501 | Resource-inten svc during ov |
| G0506 | Comp asses care plan ccm svc |
| G0513 | Prolong prev svcs, first 30m |
| G0514 | Prolong prev svcs, addl 30m |
| G2088 | Off base opioid tx, add30 |
| G2212 | Prolong outpt/office vis |
| G2213 | Initiat med assist tx in er |
| G9143 | Warfarin respon genetic test |
| J0120 | Tetracyclin injection |
| J0122 | Inj., eravacycline, 1 mg |
| J0130 | Abciximab injection |
| J0131 | Acetaminophen injection |
| J0132 | Acetylcysteine injection |
| J0133 | Acyclovir injection |
| J0153 | Adenosine inj 1mg |
| J0171 | Adrenalin epinephrine inject |
| J0278 | Amikacin sulfate injection |
| J0280 | Aminophyllin 250 mg inj |
| J0282 | Amiodarone hcl |
| J0285 | Amphotericin b |
| J0290 | Ampicillin 500 mg inj |
| J0295 | Ampicillin sulbactam 1.5 gm |
| J0330 | Succinycholine chloride inj |
| J0348 | Anidulafungin injection |
| J0360 | Hydralazine hcl injection |
| J0400 | Aripiprazole injection |
| J0456 | Azithromycin |
| J0461 | Atropine sulfate injection |
| J0470 | Dimecaprol injection |
| J0476 | Baclofen intrathecal trial |
| J0500 | Dicyclomine injection |
| J0515 | Inj benztropine mesylate |
| J0567 | Inj., cerliponase alfa 1 mg |
| J0583 | Bivalirudin |
| J0592 | Buprenorphine hydrochloride |
| J0593 | Inj., lanadelumab-flyo, 1 mg |
| J0595 | Butorphanol tartrate 1 mg |
| J0606 | Inj, etelcalcetide, 0.1 mg |
| J0610 | Calcium gluconate injection |
| J0620 | Calcium glycer & lact/10 ml |
| J0636 | Inj calcitriol per 0.1 mcg |
| J0637 | Caspofungin acetate |
| J0640 | Leucovorin calcium injection |
| J0670 | Inj mepivacaine hcl/10 ml |
| J0690 | Cefazolin sodium injection |
| J0692 | Cefepime hcl for injection |
| J0694 | Cefoxitin sodium injection |
| J0696 | Ceftriaxone sodium injection |
| J0697 | Sterile cefuroxime injection |
| J0698 | Cefotaxime sodium injection |
| J0702 | Betamethasone acet&sod phosp |
| J0706 | Caffeine citrate injection |
| J0713 | Inj ceftazidime per 500 mg |
| J0715 | Ceftizoxime sodium / 500 mg |
| J0720 | Chloramphenicol sodium injec |
| J0725 | Chorionic gonadotropin/1000u |
| J0735 | Clonidine hydrochloride |
| J0743 | Cilastatin sodium injection |
| J0744 | Ciprofloxacin iv |
| J0770 | Colistimethate sodium inj |
| J0780 | Prochlorperazine injection |
| J0800 | Corticotropin injection |
| J0834 | Inj., cosyntropin, 0.25 mg |
| J0878 | Daptomycin injection |
| J0887 | Epoetin beta esrd use |
| J0895 | Deferoxamine mesylate inj |
| J0945 | Brompheniramine maleate inj |
| J1000 | Depo-estradiol cypionate inj |
| J1020 | Methylprednisolone 20 mg inj |
| J1030 | Methylprednisolone 40 mg inj |
| J1040 | Methylprednisolone 80 mg inj |
| J1050 | Medroxyprogesterone acetate |
| J1071 | Inj testosterone cypionate |
| J1094 | Inj dexamethasone acetate |
| J1097 | Phenylep ketorolac opth soln |
| J1100 | Dexamethasone sodium phos |
| J1110 | Inj dihydroergotamine mesylt |
| J1120 | Acetazolamid sodium injectio |
| J1130 | Inj diclofenac sodium 0.5mg |
| J1160 | Digoxin injection |
| J1165 | Phenytoin sodium injection |
| J1170 | Hydromorphone injection |
| J1200 | Diphenhydramine hcl injectio |
| J1205 | Chlorothiazide sodium inj |
| J1230 | Methadone injection |
| J1240 | Dimenhydrinate injection |
| J1245 | Dipyridamole injection |
| J1250 | Inj dobutamine hcl/250 mg |
| J1260 | Dolasetron mesylate |
| J1265 | Dopamine injection |
| J1267 | Doripenem injection |
| J1270 | Injection, doxercalciferol |
| J1320 | Amitriptyline injection |
| J1325 | Epoprostenol injection |
| J1327 | Eptifibatide injection |
| J1335 | Ertapenem injection |
| J1380 | Estradiol valerate 10 mg inj |
| J1428 | Inj, eteplirsen, 10 mg |
| J1450 | Fluconazole |
| J1570 | Ganciclovir sodium injection |
| J1580 | Garamycin gentamicin inj |
| J1599 | Ivig non-lyophilized, nos |
| J1626 | Granisetron hcl injection |
| J1627 | Inj, granisetron, xr, 0.1 mg |
| J1630 | Haloperidol injection |
| J1631 | Haloperidol decanoate inj |
| J1642 | Inj heparin sodium per 10 u |
| J1644 | Inj heparin sodium per 1000u |
| J1645 | Dalteparin sodium |
| J1650 | Inj enoxaparin sodium |
| J1652 | Fondaparinux sodium |
| J1655 | Tinzaparin sodium injection |
| J1700 | Hydrocortisone acetate inj |
| J1710 | Hydrocortisone sodium ph inj |
| J1720 | Hydrocortisone sodium succ i |
| J1741 | Ibuprofen injection |
| J1743 | Idursulfase injection |
| J1756 | Iron sucrose injection |
| J1790 | Droperidol injection |
| J1800 | Propranolol injection |
| J1815 | Insulin injection |
| J1817 | Insulin for insulin pump use |
| J1840 | Kanamycin sulfate 500 mg inj |
| J1885 | Ketorolac tromethamine inj |
| J1890 | Cephalothin sodium injection |
| J1940 | Furosemide injection |
| J1953 | Levetiracetam injection |
| J1956 | Levofloxacin injection |
| J1960 | Levorphanol tartrate inj |
| J1980 | Hyoscyamine sulfate inj |
| J1990 | Chlordiazepoxide injection |
| J2001 | Lidocaine injection |
| J2010 | Lincomycin injection |
| J2020 | Linezolid injection |
| J2060 | Lorazepam injection |
| J2150 | Mannitol injection |
| J2170 | Mecasermin injection |
| J2175 | Meperidine hydrochl /100 mg |
| J2180 | Meperidine/promethazine inj |
| J2185 | Meropenem |
| J2210 | Methylergonovin maleate inj |
| J2212 | Methylnaltrexone injection |
| J2250 | Inj midazolam hydrochloride |
| J2260 | Inj milrinone lactate / 5 mg |
| J2270 | Morphine sulfate injection |
| J2274 | Inj morphine pf epid ithc |
| J2280 | Inj, moxifloxacin 100 mg |
| J2300 | Inj nalbuphine hydrochloride |
| J2310 | Inj naloxone hydrochloride |
| J2320 | Nandrolone decanoate 50 mg |
| J2354 | Octreotide inj, non-depot |
| J2355 | Oprelvekin injection |
| J2360 | Orphenadrine injection |
| J2370 | Phenylephrine hcl injection |
| J2400 | Chloroprocaine hcl injection |
| J2405 | Ondansetron hcl injection |
| J2410 | Oxymorphone hcl injection |
| J2430 | Pamidronate disodium /30 mg |
| J2440 | Papaverin hcl injection |
| J2469 | Palonosetron hcl |
| J2501 | Paricalcitol |
| J2503 | Pegaptanib sodium injection |
| J2510 | Penicillin g procaine inj |
| J2540 | Penicillin g potassium inj |
| J2543 | Piperacillin/tazobactam |
| J2550 | Promethazine hcl injection |
| J2590 | Oxytocin injection |
| J2650 | Prednisolone acetate inj |
| J2675 | Inj progesterone per 50 mg |
| J2680 | Fluphenazine decanoate 25 mg |
| J2690 | Procainamide hcl injection |
| J2700 | Oxacillin sodium injeciton |
| J2704 | Inj, propofol, 10 mg |
| J2710 | Neostigmine methylslfte inj |
| J2720 | Inj protamine sulfate/10 mg |
| J2730 | Pralidoxime chloride inj |
| J2765 | Metoclopramide hcl injection |
| J2780 | Ranitidine hydrochloride inj |
| J2785 | Regadenoson injection |
| J2787 | Riboflavin 5'phos opth<=3ml |
| J2788 | Rho d immune globulin 50 mcg |
| J2790 | Rho d immune globulin inj |
| J2791 | Rhophylac injection |
| J2795 | Ropivacaine hcl injection |
| J2800 | Methocarbamol injection |
| J2805 | Sincalide injection |
| J2810 | Inj theophylline per 40 mg |
| J2916 | Na ferric gluconate complex |
| J2920 | Methylprednisolone injection |
| J2930 | Methylprednisolone injection |
| J2950 | Promazine hcl injection |
| J3000 | Streptomycin injection |
| J3010 | Fentanyl citrate injection |
| J3030 | Sumatriptan succinate / 6 mg |
| J3070 | Pentazocine injection |
| J3105 | Terbutaline sulfate inj |
| J3121 | Inj testostero enanthate 1mg |
| J3230 | Chlorpromazine hcl injection |
| J3250 | Trimethobenzamide hcl inj |
| J3260 | Tobramycin sulfate injection |
| J3265 | Injection torsemide 10 mg/ml |
| J3300 | Triamcinolone a inj prs-free |
| J3301 | Triamcinolone acet inj nos |
| J3302 | Triamcinolone diacetate inj |
| J3303 | Triamcinolone hexacetonl inj |
| J3310 | Perphenazine injeciton |
| J3360 | Diazepam injection |
| J3364 | Urokinase 5000 iu injection |
| J3370 | Vancomycin hcl injection |
| J3397 | Inj., vestronidase alfa-vjbk |
| J3410 | Hydroxyzine hcl injection |
| J3411 | Thiamine hcl 100 mg |
| J3415 | Pyridoxine hcl 100 mg |
| J3420 | Vitamin b12 injection |
| J3430 | Vitamin k phytonadione inj |
| J3465 | Injection, voriconazole |
| J3470 | Hyaluronidase injection |
| J3471 | Ovine, up to 999 usp units |
| J3472 | Ovine, 1000 usp units |
| J3473 | Hyaluronidase recombinant |
| J3475 | Inj magnesium sulfate |
| J3480 | Inj potassium chloride |
| J3485 | Zidovudine |
| J3486 | Ziprasidone mesylate |
| J3489 | Zoledronic acid 1mg |
| J3490 | Drugs unclassified injection |
| J3530 | Nasal vaccine inhalation |
| J3590 | Unclassified biologics |
| J7030 | Normal saline solution infus |
| J7040 | Normal saline solution infus |
| J7042 | 5% dextrose/normal saline |
| J7050 | Normal saline solution infus |
| J7060 | 5% dextrose/water |
| J7070 | D5w infusion |
| J7100 | Dextran 40 infusion |
| J7110 | Dextran 75 infusion |
| J7120 | Ringers lactate infusion |
| J7121 | 5% dextrose in lac ringers |
| J7131 | Hypertonic saline sol |
| J7177 | Inj., fibryga, 1 mg |
| J7196 | Antithrombin recombinant |
| J7315 | Ophthalmic mitomycin |
| J7321 | Hyalgan supartz visco-3 dose |
| J7332 | Inj., triluron, 1 mg |
| J7500 | Azathioprine oral 50mg |
| J7502 | Cyclosporine oral 100 mg |
| J7503 | Tacrol envarsus ex rel oral |
| J7505 | Monoclonal antibodies |
| J7507 | Tacrolimus imme rel oral 1mg |
| J7508 | Tacrol astagraf ex rel oral |
| J7509 | Methylprednisolone oral |
| J7510 | Prednisolone oral per 5 mg |
| J7512 | Prednisone ir or dr oral 1mg |
| J7515 | Cyclosporine oral 25 mg |
| J7516 | Cyclosporin parenteral 250mg |
| J7517 | Mycophenolate mofetil oral |
| J7518 | Mycophenolic acid |
| J7520 | Sirolimus, oral |
| J7527 | Oral everolimus |
| J7599 | Immunosuppressive drug noc |
| J7665 | Mannitol for inhaler |
| J7674 | Methacholine chloride, neb |
| J7799 | Non-inhalation drug for dme |
| J7999 | Compounded drug, noc |
| J8501 | Oral aprepitant |
| J8510 | Oral busulfan |
| J8520 | Capecitabine, oral, 150 mg |
| J8521 | Capecitabine, oral, 500 mg |
| J8530 | Cyclophosphamide oral 25 mg |
| J8540 | Oral dexamethasone |
| J8597 | Antiemetic drug oral nos |
| J8600 | Melphalan oral 2 mg |
| J8610 | Methotrexate oral 2.5 mg |
| J8700 | Temozolomide |
| J8705 | Topotecan oral |
| J9000 | Doxorubicin hcl injection |
| J9030 | Bcg live intravesical 1mg |
| J9040 | Bleomycin sulfate injection |
| J9045 | Carboplatin injection |
| J9060 | Cisplatin 10 mg injection |
| J9098 | Cytarabine liposome inj |
| J9100 | Cytarabine hcl 100 mg inj |
| J9130 | Dacarbazine 100 mg inj |
| J9171 | Docetaxel injection |
| J9175 | Elliotts b solution per ml |
| J9178 | Inj, epirubicin hcl, 2 mg |
| J9181 | Etoposide injection |
| J9185 | Fludarabine phosphate inj |
| J9190 | Fluorouracil injection |
| J9200 | Floxuridine injection |
| J9201 | In gemcitabine hcl nos 200mg |
| J9206 | Irinotecan injection |
| J9208 | Ifosfamide injection |
| J9209 | Mesna injection |
| J9211 | Idarubicin hcl injection |
| J9213 | Interferon alfa-2a inj |
| J9218 | Leuprolide acetate injeciton |
| J9250 | Methotrexate sodium inj |
| J9260 | Methotrexate sodium inj |
| J9263 | Oxaliplatin |
| J9267 | Paclitaxel injection |
| J9351 | Topotecan injection |
| J9360 | Vinblastine sulfate inj |
| J9370 | Vincristine sulfate 1 mg inj |
| J9390 | Vinorelbine tartrate inj |
| J9999 | Chemotherapy drug |
| L8600 | Implant breast silicone/eq |
| L8603 | Collagen imp urinary 2.5 ml |
| L8604 | Dextranomer/hyaluronic acid |
| L8605 | Inj bulking agent anal canal |
| L8606 | Synthetic implnt urinary 1ml |
| L8607 | Inj vocal cord bulking agent |
| L8608 | Arg ii ext com/sup/acc misc |
| L8609 | Artificial cornea |
| L8610 | Ocular implant |
| L8612 | Aqueous shunt prosthesis |
| L8613 | Ossicular implant |
| L8614 | Cochlear device |
| L8630 | Metacarpophalangeal implant |
| L8631 | Mcp joint repl 2 pc or more |
| L8641 | Metatarsal joint implant |
| L8642 | Hallux implant |
| L8658 | Interphalangeal joint spacer |
| L8659 | Interphalangeal joint repl |
| L8670 | Vascular graft, synthetic |
| L8679 | Imp neurosti pls gn any type |
| L8682 | Implt neurostim radiofq rec |
| L8690 | Aud osseo dev, int/ext comp |
| L8699 | Prosthetic implant nos |
| L9900 | O&p supply/accessory/service |
| P9615 | Urine specimen collect mult |
| Q0092 | Set up port xray equipment |
| Q0161 | Chlorpromazine hcl 5mg oral |
| Q0162 | Ondansetron oral |
| Q0163 | Diphenhydramine hcl 50mg |
| Q0164 | Prochlorperazine maleate 5mg |
| Q0166 | Granisetron hcl 1 mg oral |
| Q0167 | Dronabinol 2.5mg oral |
| Q0169 | Promethazine hcl 12.5mg oral |
| Q0173 | Trimethobenzamide hcl 250mg |
| Q0175 | Perphenazine 4mg oral |
| Q0177 | Hydroxyzine pamoate 25mg |
| Q0180 | Dolasetron mesylate oral |
| Q0181 | Unspecified oral anti-emetic |
| Q2004 | Bladder calculi irrig sol |
| Q2009 | Fosphenytoin inj pe |
| Q3031 | Collagen skin test |
| Q4081 | Epoetin alfa, 100 units esrd |
| Q4100 | Skin substitute, nos |
| Q4101 | Apligraf |
| Q4102 | Oasis wound matrix |
| Q4103 | Oasis burn matrix |
| Q4104 | Integra bmwd |
| Q4105 | Integra drt or omnigraft |
| Q4106 | Dermagraft |
| Q4107 | Graftjacket |
| Q4108 | Integra matrix |
| Q4110 | Primatrix |
| Q4111 | Gammagraft |
| Q4112 | Cymetra injectable |
| Q4113 | Graftjacket xpress |
| Q4114 | Integra flowable wound matri |
| Q4115 | Alloskin |
| Q4116 | Alloderm |
| Q4117 | Hyalomatrix |
| Q4118 | Matristem micromatrix |
| Q4121 | Theraskin |
| Q4122 | Dermacell, awm, porous sq cm |
| Q4123 | Alloskin |
| Q4124 | Oasis tri-layer wound matrix |
| Q4125 | Arthroflex |
| Q4126 | Memoderm/derma/tranz/integup |
| Q4127 | Talymed |
| Q4128 | Flexhd/allopatchhd/matrixhd |
| Q4130 | Strattice tm |
| Q4132 | Grafix core, grafixpl core |
| Q4133 | Grafix stravix prime pl sqcm |
| Q4134 | Hmatrix |
| Q4135 | Mediskin |
| Q4136 | Ezderm |
| Q4137 | Amnioexcel biodexcel 1sq cm |
| Q4138 | Biodfence dryflex, 1cm |
| Q4139 | Amnio or biodmatrix, inj 1cc |
| Q4140 | Biodfence 1cm |
| Q4141 | Alloskin ac, 1 cm |
| Q4142 | Xcm biologic tiss matrix 1cm |
| Q4143 | Repriza, 1cm |
| Q4145 | Epifix, inj, 1mg |
| Q4146 | Tensix, 1cm |
| Q4147 | Architect ecm px fx 1 sq cm |
| Q4148 | Neox neox rt or clarix cord |
| Q4149 | Excellagen, 0.1 cc |
| Q4150 | Allowrap ds or dry 1 sq cm |
| Q4151 | Amnioband, guardian 1 sq cm |
| Q4152 | Dermapure 1 square cm |
| Q4153 | Dermavest, plurivest sq cm |
| Q4154 | Biovance 1 square cm |
| Q4155 | Neoxflo or clarixflo 1 mg |
| Q4156 | Neox 100 or clarix 100 |
| Q4157 | Revitalon 1 square cm |
| Q4158 | Kerecis omega3, per sq cm |
| Q4159 | Affinity1 square cm |
| Q4160 | Nushield 1 square cm |
| Q4161 | Bio-connekt per square cm |
| Q4162 | Wndex flw, bioskn flw, 0.5cc |
| Q4163 | Woundex, bioskin, per sq cm |
| Q4164 | Helicoll, per square cm |
| Q4165 | Keramatrix, kerasorb sq cm |
| Q4166 | Cytal, per square centimeter |
| Q4167 | Truskin, per sq centimeter |
| Q4168 | Amnioband, 1 mg |
| Q4169 | Artacent wound, per sq cm |
| Q4170 | Cygnus, per sq cm |
| Q4171 | Interfyl, 1 mg |
| Q4173 | Palingen or palingen xplus |
| Q4174 | Palingen or promatrx |
| Q4175 | Miroderm |
| Q4176 | Neopatch or therion, 1 sq cm |
| Q4177 | Floweramnioflo, 0.1 cc |
| Q4178 | Floweramniopatch, per sq cm |
| Q4179 | Flowerderm, per sq cm |
| Q4180 | Revita, per sq cm |
| Q4181 | Amnio wound, per square cm |
| Q4182 | Transcyte, per sq centimeter |
| Q4183 | Surgigraft, 1 sq cm |
| Q4184 | Cellesta or duo per sq cm |
| Q4185 | Cellesta flowab amnion 0.5cc |
| Q4186 | Epifix 1 sq cm |
| Q4187 | Epicord 1 sq cm |
| Q4188 | Amnioarmor 1 sq cm |
| Q4189 | Artacent ac, 1 mg |
| Q4190 | Artacent ac 1 sq cm |
| Q4191 | Restorigin 1 sq cm |
| Q4192 | Restorigin, 1 cc |
| Q4193 | Coll-e-derm 1 sq cm |
| Q4194 | Novachor 1 sq cm |
| Q4195 | Puraply 1 sq cm |
| Q4196 | Puraply am 1 sq cm |
| Q4197 | Puraply xt 1 sq cm |
| Q4198 | Genesis amnio membrane 1sqcm |
| Q4200 | Skin te 1 sq cm |
| Q4201 | Matrion 1 sq cm |
| Q4202 | Keroxx (2.5g/cc), 1cc |
| Q4203 | Derma-gide, 1 sq cm |
| Q4204 | Xwrap 1 sq cm |
| Q4205 | Membrane graft or wrap sq cm |
| Q4206 | Fluid flow or fluid gf 1 cc |
| Q4208 | Novafix per sq cm |
| Q4209 | Surgraft per sq cm |
| Q4210 | Axolotl graf dualgraf sq cm |
| Q4211 | Amnion bio or axobio sq cm |
| Q4212 | Allogen, per cc |
| Q4213 | Ascent, 0.5 mg |
| Q4214 | Cellesta cord per sq cm |
| Q4215 | Axolotl ambient, cryo 0.1 mg |
| Q4216 | Artacent cord per sq cm |
| Q4217 | Woundfix biowound plus xplus |
| Q4218 | Surgicord per sq cm |
| Q4219 | Surgigraft dual per sq cm |
| Q4220 | Bellacell hd, surederm sq cm |
| Q4221 | Amniowrap2 per sq cm |
| Q4222 | Progenamatrix, per sq cm |
| Q4226 | Myown harv prep proc sq cm |
| Q4227 | Amniocore per sq cm |
| Q4228 | Bionextpatch, per sq cm |
| Q4229 | Cogenex amnio memb per sq cm |
| Q4230 | Cogenex flow amnion 0.5 cc |
| Q4231 | Corplex p, per cc |
| Q4232 | Corplex, per sq cm |
| Q4233 | Surfactor /nudyn per 0.5 cc |
| Q4234 | Xcellerate, per sq cm |
| Q4235 | Amniorepair or altiply sq cm |
| Q4236 | Carepatch per sq cm |
| Q4237 | Cryo-cord, per sq cm |
| Q4238 | Derm-maxx, per sq cm |
| Q4239 | Amnio-maxx or lite per sq cm |
| Q4240 | Corecyte topical only 0.5 cc |
| Q4241 | Polycyte, topical only 0.5cc |
| Q4242 | Amniocyte plus, per 0.5 cc |
| Q4244 | Procenta, per 200 mg |
| Q4245 | Amniotext, per cc |
| Q4246 | Coretext or protext, per cc |
| Q4247 | Amniotext patch, per sq cm |
| Q4248 | Dermacyte amn mem allo sq cm |
| Q4249 | Amniply, per sq cm |
| Q4250 | Amnioamp-mp per sq cm |
| Q4254 | Novafix dl per sq cm |
| Q4255 | Reguard, topical use per sq |
| Q9950 | Inj sulf hexa lipid microsph |
| Q9951 | Locm >= 400 mg/ml iodine,1ml |
| Q9953 | Inj fe-based mr contrast,1ml |
| Q9954 | Oral mr contrast, 100 ml |
| Q9955 | Inj perflexane lip micros,ml |
| Q9956 | Inj octafluoropropane mic,ml |
| Q9957 | Inj perflutren lip micros,ml |
| Q9958 | Hocm <=149 mg/ml iodine, 1ml |
| Q9959 | Hocm 150-199mg/ml iodine,1ml |
| Q9960 | Hocm 200-249mg/ml iodine,1ml |
| Q9961 | Hocm 250-299mg/ml iodine,1ml |
| Q9962 | Hocm 300-349mg/ml iodine,1ml |
| Q9963 | Hocm 350-399mg/ml iodine,1ml |
| Q9964 | Hocm>= 400mg/ml iodine, 1ml |
| Q9965 | Locm 100-199mg/ml iodine,1ml |
| Q9966 | Locm 200-299mg/ml iodine,1ml |
| Q9967 | Locm 300-399mg/ml iodine,1ml |
| Q9982 | Flutemetamol f18 diagnostic |
| Q9983 | Florbetaben f18 diagnostic |
| V2630 | Anter chamber intraocul lens |
| V2631 | Iris support intraoclr lens |
| V2632 | Post chmbr intraocular lens |
| V2790 | Amniotic membrane |