Default Fee Schedules Part 1

Default Fee Schedules

CodePriceTypeDescription
100601690HCPCS / CPT®INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS,
100611404HCPCS / CPT®INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS
100801690HCPCS / CPT®INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE
100811536HCPCS / CPT®INCISION AND DRAINAGE OF PILONIDAL CYST; COMPLICATED
101201182HCPCS / CPT®REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE
101211530HCPCS / CPT®INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED
101601298HCPCS / CPT®PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST
110111239HCPCS / CPT®DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTUR
110401998HCPCS / CPT®DBRDMT, SKIN, PARTIAL THICK
11042330HCPCS / CPT®DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED);
112001267HCPCS / CPT®REMOVAL OF SKIN TAGS
114041757HCPCS / CPT®EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED
117301264HCPCS / CPT®AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE
117401275HCPCS / CPT®EVACUATION OF SUBUNGUAL HEMATOMA
117501483HCPCS / CPT®EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED
117601483HCPCS / CPT®REPAIR OF NAIL BED
117651310HCPCS / CPT®WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, FOR INGROWN TOENAIL)
117711270HCPCS / CPT®EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE
120011386HCPCS / CPT®SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA,
120021451HCPCS / CPT®SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL
120041598HCPCS / CPT®SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL
120051598HCPCS / CPT®SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL
120111690HCPCS / CPT®SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR
120131478HCPCS / CPT®SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR
120141663HCPCS / CPT®SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR
120201291HCPCS / CPT®TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE
120311458HCPCS / CPT®Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms,
120321692HCPCS / CPT®Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, a
120341643HCPCS / CPT®Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms,
120351289HCPCS / CPT®Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms,
120361693HCPCS / CPT®Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms,
120410HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.5
12042780HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA;
120441693HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 7.6
120451691HCPCS / CPT®REPAIR INTERMIEDIAT N/H/F /XTRNAL GEN 12.6-20 CM
120511540HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS ME
12052644HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS ME
120531870HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS ME
120541786HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS ME
124051691HCPCS / CPT®REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 12.
131212124HCPCS / CPT®REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 2.6 CM TO 7.5 CM
131221483HCPCS / CPT®REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; EACH ADDITIONAL 5 CM OR LESS (LIST
131322329HCPCS / CPT®REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS
131511959HCPCS / CPT®REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1 CM TO 2.5 CM
131522664HCPCS / CPT®REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 2.6 CM TO 7.5 CM
131531608HCPCS / CPT®REPAIR COMPLEX EYELID/NOSE/EAR/LIP EA 4 CM<
158501594HCPCS / CPT®REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), SAME SURGEON
160001249HCPCS / CPT®INITIAL TREATMENT, FIRST DEGREE BURN, WHEN NO MORE THAN LOCAL TREATMENT IS REQUI
160201245HCPCS / CPT®DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT;
205521160HCPCS / CPT®INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S), ONE OR TWO MUSCLE(S)
206001582HCPCS / CPT®ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL JOINT OR BURSA (EG, FINGERS,
206051140HCPCS / CPT®ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTERMEDIATE JOINT OR BURSA (EG,
206101328HCPCS / CPT®ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR BURSA (EG,
213101453HCPCS / CPT®CLOSED TREATMENT OF NASAL BONE FRACTURE WITHOUT MANIPULATION
214801411HCPCS / CPT®CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT
218001386HCPCS / CPT®CLTX RIB FX UNCOMP EA
218901677HCPCS / CPT®RMVL FB BODY FOOT SUBQ
235001740HCPCS / CPT®CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITHOUT MANIPULATION
235701763HCPCS / CPT®CLOSED TREATMENT OF SCAPULAR FRACTURE; WITHOUT MANIPULATION
236001346HCPCS / CPT®CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE;
23650849HCPCS / CPT®CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; WITHOUT ANESTHESIA
245001344HCPCS / CPT®CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHOUT MANIPULATION
245302265HCPCS / CPT®CLTX SPRCNDYLR/TRANSCNDYL
245761346HCPCS / CPT®CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL; WITHOUT
246001591HCPCS / CPT®TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA
246401472HCPCS / CPT®CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, NURSEMAID ELBOW, WITH
246501872HCPCS / CPT®CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUT MANIPULATION
246701856HCPCS / CPT®
CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROC
255001591HCPCS / CPT®CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITHOUT MANIPULATION
255053012HCPCS / CPT®CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITH MANIPULATION
255301344HCPCS / CPT®CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITHOUT MANIPULATION
255601344HCPCS / CPT®CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITHOUT MANIPULATION
256001950HCPCS / CPT®CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYS
256052811HCPCS / CPT®CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR
256221591HCPCS / CPT®CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; WITHOUT MANIPULATION
256351986HCPCS / CPT®CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL SCAPHOID
256501997HCPCS / CPT®CLOSED TREATMENT OF ULNAR STYLOID FRACTURE
260101271HCPCS / CPT®DRAINAGE OF FINGER ABSCESS; SIMPLE
266001826HCPCS / CPT®CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUT MANIPULATION, EACH BONE
266051957HCPCS / CPT®CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITH MANIPULATION, EACH BONE
266072518HCPCS / CPT®CLOSED TREATMENT OF METACARPAL FRACTURE, WITH MANIPULATION, WITH EXTERNAL
267001346HCPCS / CPT®CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION;
267201571HCPCS / CPT®CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX,
267251934HCPCS / CPT®CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX,
267501562HCPCS / CPT®CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITHOUT
267551720HCPCS / CPT®CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITH
267701509HCPCS / CPT®CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH
272201577HCPCS / CPT®CLOSED TREATMENT OF ACETABULUM (HIP SOCKET) FRACTURE(S); WITHOUT MANIPULATION
273721318HCPCS / CPT®REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA
275081346HCPCS / CPT®CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE,
275202095HCPCS / CPT®CLOSED TREATMENT OF PATELLAR FRACTURE, WITHOUT MANIPULATION
275301461HCPCS / CPT®CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITHOUT MANIPULATION
275502242HCPCS / CPT®CLOSED TREATMENT OF KNEE DISLOCATION; WITHOUT ANESTHESIA
275601346HCPCS / CPT®CLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIA
277522789HCPCS / CPT®CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE);
277602048HCPCS / CPT®CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITHOUT MANIPULATION
277801959HCPCS / CPT®CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITHOUT MANIPULATION
277860HCPCS / CPT®CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITHOUT
278081461HCPCS / CPT®CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI,
278102549HCPCS / CPT®CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI,
278401091HCPCS / CPT®CLOSED TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIA
281901677HCPCS / CPT®RMVL FB BODY FOOT SUBQ
281922248HCPCS / CPT®REMOVAL OF FOREIGN BODY, FOOT; DEEP
284001591HCPCS / CPT®CLOSED TREATMENT OF CALCANEAL FRACTURE; WITHOUT MANIPULATION
284301096HCPCS / CPT®CLOSED TREATMENT OF TALUS FRACTURE; WITHOUT MANIPULATION
284501577HCPCS / CPT®TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT
284701764HCPCS / CPT®CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION, EACH
284901540HCPCS / CPT®CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES; WITHOUT
285101475HCPCS / CPT®CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE;
285151565HCPCS / CPT®CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE; WITH
286601565HCPCS / CPT®CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION; WITHOUT ANESTHESIA
290851160HCPCS / CPT®APPLICATION, CAST; HAND AND LOWER FOREARM (GAUNTLET)
291050HCPCS / CPT®APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND)
291251160HCPCS / CPT®APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC
29126460HCPCS / CPT®APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); DYNAMIC
291301160HCPCS / CPT®APPLICATION OF FINGER SPLINT; STATIC
292401236HCPCS / CPT®STRAPPING; SHOULDER (EG, VELPEAU)
292801217HCPCS / CPT®STRAPPING; HAND OR FINGER
295051160HCPCS / CPT®APPLICATION OF LONG LEG SPLINT (THIGH TO ANKLE OR TOES)
29515168HCPCS / CPT®APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)
29530265HCPCS / CPT®KNEE STRAPPING
295401200HCPCS / CPT®STRAPPING; ANKLE AND/OR FOOT
295501160HCPCS / CPT®STRAPPING; TOES
295801200HCPCS / CPT®STRAPPING; UNNA BOOT
297001115HCPCS / CPT®REMOVAL OR BIVALVING; GAUNTLET, BOOT OR BODY CAST
303001451HCPCS / CPT®REMOVAL FOREIGN BODY, INTRANASAL; OFFICE TYPE PROCEDURE
309011119HCPCS / CPT®CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY
309031403HCPCS / CPT®CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX (EXTENSIVE CAUTERY AND/OR PACKING)
312521180HCPCS / CPT®LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, EXCEPT NEWBORN
315001519HCPCS / CPT®INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE
315021810HCPCS / CPT®TRACHEOTOMY TUBE CHANGE PRIOR TO ESTABLISHMENT OF FISTULA TRACT
315151609HCPCS / CPT®LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; FOR ASPIRATION
325512200HCPCS / CPT®TUBE THORACOSTOMY, INCLUDES CONNECTION TO DRAINAGE SYSTEM (EG, WATER SEAL), WHEN
334151891HCPCS / CPT®RESECTION OR INCISION OF SUBVALVULAR TISSUE FOR DISCRETE SUBVALVULAR AORTIC
360001222HCPCS / CPT®INTRODUCTION OF NEEDLE OR INTRACATHETER, VEIN
364101062HCPCS / CPT®VENIPUNCTURE, AGE 3 YEARS OR OLDER, NECESSITATING THE SKILL OF A PHYSICIAN OR OT
3641512HCPCS / CPT®Blood Draw
364161037HCPCS / CPT®COLLECTION OF CAPILLARY BLOOD SPECIMEN (EG, FINGER, HEEL, EAR STICK)
365582960HCPCS / CPT®INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER, WITHOUT
365911133HCPCS / CPT®COLLECTION OF BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VENOUS ACCESS DEVICE
383001275HCPCS / CPT®DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; SIMPLE
392001346HCPCS / CPT®REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITHOUT GENERAL ANESTHESIA
406503718HCPCS / CPT®RPR LIP FULL THICKNESS
418001436HCPCS / CPT®DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR STRUCTURES
427001779HCPCS / CPT®INCISION AND DRAINAGE ABSCESS; PERITONSILLAR
437531116HCPCS / CPT®Insertion of stomach tube and aspirations of gastric contents
460402779HCPCS / CPT®INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTAL ABSCESS (SEPARATE
460831446HCPCS / CPT®INCISION OF THROMBOSED HEMORRHOID, EXTERNAL
463201556HCPCS / CPT®EXCISION OF THROMBOSED HEMORRHOID, EXTERNAL
517001088HCPCS / CPT®BLDR IRR SMPL LVG&INSTLJ
517011088HCPCS / CPT®INSERTION OF NON-INDWELLING BLADDER CATHETER (EG, STRAIGHT CATHETERIZATION FOR
517021328HCPCS / CPT®INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; SIMPLE (EG, FOLEY)
517031517HCPCS / CPT®INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; COMPLICATED (EG, ALTERED
564051235HCPCS / CPT®INCISION AND DRAINAGE OF VULVA OR PERINEAL ABSCESS
564201091HCPCS / CPT®Incision and drainage of female genital gland abscess
590251545HCPCS / CPT®FETAL NON-STRESS TEST
594094600HCPCS / CPT®VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS);
622701504HCPCS / CPT®SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC
644021582HCPCS / CPT®INJECTION, ANESTHETIC AGENT; FACIAL NERVE
644501508HCPCS / CPT®INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH
6445599.3HCPCS / CPT®N block inj plantar digit
646402109HCPCS / CPT®DESTRUCTION BY NEUROLYTIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH
652051222HCPCS / CPT®REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL SUPERFICIAL
652201345HCPCS / CPT®REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITHOUT SLIT LAMP
652221408HCPCS / CPT®REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITH SLIT LAMP
677001703HCPCS / CPT®BLEPHAROTOMY, DRAINAGE OF ABSCESS, EYELID
690051330HCPCS / CPT®DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; COMPLICATED
692001346HCPCS / CPT®RMVL OF FOREIGN BODY EAR
692051372HCPCS / CPT®REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA
692091309HCPCS / CPT®removal impacted cerumen using irrigation/lavage, unilateral
692101178HCPCS / CPT®Removal of impact ear wax, one ear
700301239HCPCS / CPT®RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY
701001319HCPCS / CPT®RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS
701101319HCPCS / CPT®RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS
701201143HCPCS / CPT®RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE
701401343HCPCS / CPT®RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS
701501454HCPCS / CPT®RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS
701601213HCPCS / CPT®RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS
702001425HCPCS / CPT®RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS
702201448HCPCS / CPT®RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS
702501344HCPCS / CPT®RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS
702601455HCPCS / CPT®RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS
703281319HCPCS / CPT®RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH;
703501234HCPCS / CPT®CEPHALOGRAM, ORTHODONTIC
703601620HCPCS / CPT®RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE
704502785HCPCS / CPT®COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL
704603330HCPCS / CPT®COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S)
704705285HCPCS / CPT®COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY
704802591HCPCS / CPT®COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR
704814200HCPCS / CPT®COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR
704863619HCPCS / CPT®COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL
704873228HCPCS / CPT®COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITH CONTRAST MATERIAL(S)
704903745HCPCS / CPT®COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL
704914184HCPCS / CPT®COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S)
704962703HCPCS / CPT®COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITH CONTRAST MATERIAL(S), INCLUDING NON
705443864HCPCS / CPT®MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S)
705473520HCPCS / CPT®MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S)
705513520HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT
705533971HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT
710101272HCPCS / CPT®RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL
710301476HCPCS / CPT®RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;
710451272HCPCS / CPT®X-ray exam chest 1 view
71046422HCPCS / CPT®RADIOLOGIC EXAMINATION,CHEST,TWO VIEWS,FRONTAL AND LATERL
710601488HCPCS / CPT®BRONCHOGRAPY BI RS&I
711001240HCPCS / CPT®RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS
711011440HCPCS / CPT®RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST,
711101131HCPCS / CPT®RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS
711111239HCPCS / CPT®RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST,
711201232HCPCS / CPT®RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS
712503885HCPCS / CPT®COMPUTED TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL
712604780HCPCS / CPT®COMPUTED TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)
712704840HCPCS / CPT®COMPUTED TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
712753443HCPCS / CPT®
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST (NONCORONARY), WITH CONTRAST MATERIAL(S)
715503519HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND
720201285HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL
720401374HCPCS / CPT®X-ray of spine of neck, 2 or 3 views
720501446HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 4 OR 5 VIEWS
720521764HCPCS / CPT®SPINE CERV. COMP FLEX/EXT
720691340HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS)
720701246HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE; THORACIC, TWO VIEWS
720721246HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE; THORACIC, THREE VIEWS
720741486HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE; THORACIC, MINIMUM OF FOUR VIEWS
721001530HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; TWO OR THREE VIEWS
721101721HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF FOUR VIEWS
721141424HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS, M
721201504HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; BENDING VIEWS ONLY, 2 OR 3 VIEWS
721251745HCPCS / CPT®COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL
721263240HCPCS / CPT®COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST MATERIAL
721275093HCPCS / CPT®COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY
721283032HCPCS / CPT®COMPUTED TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL
721294240HCPCS / CPT®COMPUTED TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL
721312984HCPCS / CPT®COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL
721328640HCPCS / CPT®COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST MATERIAL
721412697HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL;
721463520HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC;
721483520HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR
721563971HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT
721573520HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT
721583546HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT
721701345HCPCS / CPT®RADIOLOGIC EXAMINATION, PELVIS; ONE OR TWO VIEWS
721901394HCPCS / CPT®RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS
721913059HCPCS / CPT®COMPUTED TOMOGRAPHIC ANGIOGRAPHY, PELVIS, WITH CONTRAST MATERIAL(S), INCLUDING N
721924789HCPCS / CPT®COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL
721933500HCPCS / CPT®COMPUTED TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)
721947885HCPCS / CPT®COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
721953520HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S)
721963395HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITH CONTRAST MATERIAL(S)
722201258HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITH CONTRAST MATERIAL(S)
730001253HCPCS / CPT®RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE
730101322HCPCS / CPT®RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE
730201210HCPCS / CPT®RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW
73030353HCPCS / CPT®RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS
730501388HCPCS / CPT®RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT
73060334HCPCS / CPT®RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS
730701213HCPCS / CPT®RADIOLOGIC EXAMINATION, ELBOW; TWO VIEWS
730801307HCPCS / CPT®RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS
73090260HCPCS / CPT®RADIOLOGIC EXAMINATION; FOREARM, TWO VIEWS
731001344HCPCS / CPT®RADIOLOGIC EXAMINATION, WRIST; TWO VIEWS
731101334HCPCS / CPT®RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS
731201293HCPCS / CPT®RADIOLOGIC EXAMINATION, HAND; TWO VIEWS
731301378HCPCS / CPT®RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS
731401323HCPCS / CPT®RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF TWO VIEWS
732002994HCPCS / CPT®COMPUTED TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL
732203971HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT;
732213520HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT
735001345HCPCS / CPT®RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW
735021637HCPCS / CPT®RADIOLOGIC ECAMINATION, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED, 2-3 VIEWS
735101433HCPCS / CPT®RADIOLOGIC EXAMINATION, HIP, UNILATERAL; COMPLETE, MINIMUM OF TWO VIEWS
73520461HCPCS / CPT®RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF EACH HIP,
735501283HCPCS / CPT®RADIOLOGIC EXAMINATION, FEMUR, TWO VIEWS
735601284HCPCS / CPT®RADIOLOGIC EXAMINATION, KNEE; ONE OR TWO VIEWS
735621237HCPCS / CPT®RADIOLOGIC EXAMINATION, KNEE; THREE VIEWS
73564357HCPCS / CPT®RADIOLOGIC EXAMINATION, KNEE; COMPLETE, FOUR OR MORE VIEWS
73590346HCPCS / CPT®RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, TWO VIEWS
736001213HCPCS / CPT®RADIOLOGIC EXAMINATION, ANKLE; TWO VIEWS
73610441HCPCS / CPT®RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS
73620347HCPCS / CPT®RADIOLOGIC EXAMINATION, FOOT; TWO VIEWS
736301488HCPCS / CPT®RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS
736501291HCPCS / CPT®RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS
736601212HCPCS / CPT®RADIOLOGIC EXAMINATION; TOE(S), MINIMUM OF TWO VIEWS
737005321HCPCS / CPT®COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL
737017885HCPCS / CPT®COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S)
737025003HCPCS / CPT®COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY
737213250HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT
737223796HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITH
737235590HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT
737254395HCPCS / CPT®MAGNETIC RESONANCE ANGIOGRAPHY, LOWER EXTREMITY, WITH OR WITHOUT CONTRAST
740007690HCPCS / CPT®RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW
740101387HCPCS / CPT®RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL OBLIQUE AND
740201413HCPCS / CPT®RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS AND/OR ERECT
740221518HCPCS / CPT®Imaging of abdomen and chest
741462542HCPCS / CPT®Computed tomography, abdomen and pelvis; without contrast material
741503968HCPCS / CPT®COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL
741604491HCPCS / CPT®COMPUTED TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S)
741704113HCPCS / CPT®COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
741755407HCPCS / CPT®COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN, WITH CONTRAST MATERIAL(S), INCLUDING
741762542HCPCS / CPT®COMP TOMOG AB/PEL W/O CON
741773385HCPCS / CPT®Computed tomography, abdomen and pelvis; with contrast material(s)
741782945HCPCS / CPT®Computed tomography, abdomen and pelvis; without contrast material in one or bot
741813520HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S)
741833971HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S),
742411907HCPCS / CPT®MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S),
742471918HCPCS / CPT®RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH
763761976HCPCS / CPT®3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC
763801657HCPCS / CPT®ULTRASOUND, TRANSVAGINAL
765361907HCPCS / CPT®ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), R
766451654HCPCS / CPT®US BREAST R-T W/IMAGE DOCUMENTATION
767002051HCPCS / CPT®ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
76705934HCPCS / CPT®ULTRASOUND, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION;
767701758HCPCS / CPT®ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCU
767751682HCPCS / CPT®ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME
768011721HCPCS / CPT®ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATER
768051721HCPCS / CPT®ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND
768151324HCPCS / CPT®ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED (EG,
768171547HCPCS / CPT®ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL
76830657HCPCS / CPT®TRANSVAGINAL ULTRASOUND
768561763HCPCS / CPT®ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
768571398HCPCS / CPT®ULTRASOUND, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE
768701693HCPCS / CPT®ULTRASOUND, SCROTUM AND CONTENTS
768801830HCPCS / CPT®us extremity
768821410HCPCS / CPT®Ultrasound, extremity, nonvascular, real-time with image documentation; limited,
770791557HCPCS / CPT®CT BONE MINERAL DENSITY STUDY 1+SITS APPND
772521764HCPCS / CPT®RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 6 OR MORE VIEWS
777771011HCPCS / CPT®INTERSTITIAL RADIATION SOURCE APPLICATION; INTERMEDIATE
780754289HCPCS / CPT®ADRENAL IMAGING, CORTEX AND/OR MEDULLA
782233281HCPCS / CPT®HIDA SCAN-HEPATBL DUX SYS IMG GLBDR
783062309HCPCS / CPT®BONE AND/OR JOINT IMAGING; WHOLE BODY
783152309HCPCS / CPT®BONE AND/OR JOINT IMAGING; THREE PHASE STUDY
783201839HCPCS / CPT®BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)
784721854HCPCS / CPT®BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)
800471232HCPCS / CPT®BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)
800481245HCPCS / CPT®Blood test, basic group of blood chemicals
80051252HCPCS / CPT®Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)
80053294HCPCS / CPT®Blood test, comprehensive group of blood chemicals
80061350HCPCS / CPT®Blood test, lipids (cholesterol and triglycerides)
800761259HCPCS / CPT®Liver function blood test panel
801001209HCPCS / CPT®DRUG ABUSE PANEL II
801041156HCPCS / CPT®DRUG SCREEN
801781054HCPCS / CPT®LITHIUM
801961102HCPCS / CPT®SALICYLATE
801971318HCPCS / CPT®TACRLIMUS
802021208HCPCS / CPT®VANCOMYCIN PEAK
803001201HCPCS / CPT®DRUG SCREEN
803041192HCPCS / CPT®DRUG SCREEN
80306322HCPCS / CPT®URINE DRUG SCREEN
803291180HCPCS / CPT®DRUG SCREEN
81000116HCPCS / CPT®URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, K
810011077HCPCS / CPT®URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN,
810021116HCPCS / CPT®URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN,
81003116HCPCS / CPT®URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN,
8102587HCPCS / CPT®Urinalysis Procedures
820031208HCPCS / CPT®acetaminophen
820091033HCPCS / CPT®KETONE BODY(S) (EG, ACETONE, ACETOACETIC ACID, BETA-HYDROXYBUTYRATE); QUALITATIV
82040128HCPCS / CPT®ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD
820551183HCPCS / CPT®ALCOHOL-BLOOD
82150191HCPCS / CPT®AMYLASE
82247149HCPCS / CPT®BILIRUBIN; TOTAL
822531140HCPCS / CPT®MB FRACTION
822701138HCPCS / CPT®BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE; FECES, CONSECUT
822721106HCPCS / CPT®BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE, FECES, 1-3 SIMU
82310144HCPCS / CPT®CALCIUM; TOTAL
825401062HCPCS / CPT®CREATINE
825411110HCPCS / CPT®Chemical analysis using chromatography technique
82550160HCPCS / CPT®CREATINE KINASE (CK), (CPK); TOTAL
82553239HCPCS / CPT®CREATINE KINASE (CK), (CPK); MB FRACTION ONLY
82565133HCPCS / CPT®CREATININE; BLOOD
826071065HCPCS / CPT®CYANOCOBALAMIN (VITAMIN B-12);
827841150HCPCS / CPT®IGC IMMUNOGLOBULIN
827851165HCPCS / CPT®GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE
828001118HCPCS / CPT®GASES, BLOOD, PH ONLY
82947100HCPCS / CPT®GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)
829481070HCPCS / CPT®GLUCOSE; BLOOD, REAGENT STRIP
829621063HCPCS / CPT®GLUCOSE FINGER STICK
8297770HCPCS / CPT®GLUTAMYLTRANSFERASE, GAMMA (GGT)
835201131HCPCS / CPT®IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT
835401093HCPCS / CPT®IRON- TOTAL
836151087HCPCS / CPT®LACTATE DEHYDROGENASE (LD), (LDH);
836901071HCPCS / CPT®LIPASE
838741156HCPCS / CPT®MYOGLOBIN
83880291HCPCS / CPT®NATRIURETIC PEPTIDE
84075128HCPCS / CPT®PHOSPHATASE, ALKALINE;
841530HCPCS / CPT®Assay of psa total
841540HCPCS / CPT®Assay of psa free
84155144HCPCS / CPT®PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD
841651001HCPCS / CPT®PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM
844361175HCPCS / CPT®THYROXINE; TOTAL
844391170HCPCS / CPT®THYROXINE; FREE
844431239HCPCS / CPT®THYROID STIMULATING HORMONE (TSH)
84450124HCPCS / CPT®TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)
84460142HCPCS / CPT®TRANSFERASE; ALANINE AMINO (ALT) (SGPT)
844791198HCPCS / CPT®THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)
84484239HCPCS / CPT®TROPONIN, QUANTITATIVE
845121140HCPCS / CPT®TROPONIN, QUALITATIVE
84520115HCPCS / CPT®UREA NITROGEN; QUANTITATIVE
84550137HCPCS / CPT®URIC ACID; BLOOD
845601125HCPCS / CPT®URIC ACID; OTHER SOURCE
847021190HCPCS / CPT®GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE
847031193HCPCS / CPT®GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE
850141093HCPCS / CPT®BLOOD COUNT; HEMATOCRIT (HCT)
850181093HCPCS / CPT®BLOOD COUNT; HEMOGLOBIN (HGB)
85025185HCPCS / CPT®BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT
85027135HCPCS / CPT®BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)
850321138HCPCS / CPT®BLOOD COUNT; MANUAL CELL COUNT (ERYTHROCYTE, LEUKOCYTE, OR PLATELET) EACH
853471032HCPCS / CPT®COAGULATION TIME; ACTIVATED
853781137HCPCS / CPT®FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUALITATIVE OR SEMIQUANTITATIVE
85379286HCPCS / CPT®FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE
85610156HCPCS / CPT®PROTHROMBIN TIME;
856511133HCPCS / CPT®SEDIMENTATION RATE, ERYTHROCYTE; NON-AUTOMATED
856521084HCPCS / CPT®SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED
857301147HCPCS / CPT®THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD
862561001HCPCS / CPT®FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACH ANTIBODY
863081097HCPCS / CPT®HETEROPHILE ANTIBODIES; SCREENING
863201001HCPCS / CPT®IMMUNOELECTROPHORESIS; SERUM
863601570HCPCS / CPT®T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO
864031122HCPCS / CPT®PARTICLE AGGLUTINATION; SCREEN, EACH ANTIBODY
864301067HCPCS / CPT®RHEUMATOID FACTOR; QUALITATIVE
865921070HCPCS / CPT®SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART)
86631118HCPCS / CPT®ANTIBODY; CHLAMYDIA
866641121HCPCS / CPT®ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN (EBNA)
866891196HCPCS / CPT®ANTIBODY; HTLV OR HIV ANTIBODY, CONFIRMATORY TEST (EG, WESTERN BLOT)
867011132HCPCS / CPT®ANTIBODY; HIV-1
867021149HCPCS / CPT®ANTIBODY; HIV-2
8670465HCPCS / CPT®Under Qualitative or Semiquantitative Immunoassays
8670665HCPCS / CPT®Under Qualitative or Semiquantitative Immunoassays
8670865HCPCS / CPT®Under Qualitative or Semiquantitative Immunoassays
867561130HCPCS / CPT®ANTIBODY; RESPIRATORY SYNCYTIAL VIRUS
8680365HCPCS / CPT®Under Qualitative or Semiquantitative Immunoassays
868501172HCPCS / CPT®ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE
869010HCPCS / CPT®BLOOD TYPING; RH (D)
869061078HCPCS / CPT®BLOOD TYPING; RH PHENOTYPING, COMPLETE
870401239HCPCS / CPT®CULTURE, BACTERIAL; BLOOD, AEROBIC, WITH ISOLATION AND PRESUMPTIVE
870701173HCPCS / CPT®CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC,
870751260HCPCS / CPT®CULTURE, BACTERIAL; ANY SOURCE, EXCEPT BLOOD, ANAEROBIC WITH ISOLATION AND
8708190HCPCS / CPT®CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY; GC Culture
870861090HCPCS / CPT®CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE
870881036HCPCS / CPT®CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF EACH ISOLAT
871061077HCPCS / CPT®CULTURE, FUNGI, DEFINITIVE IDENTIFICATION, EACH ORGANISM; YEAST
871101236HCPCS / CPT®CULTURE, CHLAMYDIA, ANY SOURCE
872071001HCPCS / CPT®SMEAR, PRIMARY SOURCE WITH INTERPRETATION; SPECIAL STAIN FOR INCLUSION BODIES
872101083HCPCS / CPT®SMEAR, PRIMARY SOURCE WITH INTERPRETATION; WET MOUNT FOR INFECTIOUS AGENTS (EG,
872751050HCPCS / CPT®INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B
874001158HCPCS / CPT®INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE
874301213HCPCS / CPT®INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE
87491279HCPCS / CPT®DNA PROBE CHLYMIDA
874931179HCPCS / CPT®Clostridium difficile, toxin gene(s), amplified probe technique
87804153HCPCS / CPT®INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL
878071038HCPCS / CPT®INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL
878471372HCPCS / CPT®NO DESCRIPTION
878501118HCPCS / CPT®INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION;
87880130HCPCS / CPT®INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION;
883051001HCPCS / CPT®Pathology examination of tissue using a microscope, intermediate complexity
890601001HCPCS / CPT®CRYSTAL IDENTIFICATION BY LIGHT MICROSCOPY WITH OR WITHOUT POLARIZING LENS ANALY
892201089HCPCS / CPT®SPUTUM, OBTAINING SPECIMEN, AEROSOL INDUCED TECHNIQUE (SEPARATE PROCEDURE)
9040888HCPCS / CPT®ALCOHOL?DRUG COUNSOLING
9047155HCPCS / CPT®IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS
9066064HCPCS / CPT®INFLUENZA VIRUS VACCINE, TRIVALENT, LIVE, FOR INTRANASAL USE
90703168HCPCS / CPT®TETANUS TOXOID ADSORBED, FOR INTRAMUSCULAR USE
90714168HCPCS / CPT®TETANUS AND DIPHTHERIA TOXOIDS (TD) ADSORBED, PRESERVATIVE FREE, WHEN ADMINISTER
90715155HCPCS / CPT®TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (TDAP), WHEN ADMINIS
90718168HCPCS / CPT®TETANUS & DIPTHERIA
911051542HCPCS / CPT®GASTRIC INTUBATION/ASPER
920021001HCPCS / CPT®OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION WITH INITIATION OF
920811001HCPCS / CPT®VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND
925521001HCPCS / CPT®PURE TONE AUDIOMETRY (THRESHOLD); AIR ONLY
929601990HCPCS / CPT®CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL
93000225HCPCS / CPT®ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND R
930051238HCPCS / CPT®ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT
930101137HCPCS / CPT®ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND
930411137HCPCS / CPT®RHYTHM ECG, ONE TO THREE LEADS; TRACING ONLY WITHOUT INTERPRETATION AND REPORT
93270325HCPCS / CPT®Cardiac Monitoring
940101424HCPCS / CPT®SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY
940601275HCPCS / CPT®Under Pulmonary Diagnostic Testing and Therapies
946401063HCPCS / CPT®PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION
946441143HCPCS / CPT®PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION
94760101HCPCS / CPT®NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; SINGLE DETERMINATION
947611216HCPCS / CPT®NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; MULTIPLE
94762101HCPCS / CPT®PULSE OXOMETER
96360228HCPCS / CPT®IV INFUSION HYDRATION- 31-60 MIN
96361212HCPCS / CPT®Intravenous infusion, hydration; each additional hour (List separately in additi
96365345HCPCS / CPT®intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance
96366215HCPCS / CPT®Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance
96367239HCPCS / CPT®INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS (SPECIFY SUBSTANCE
96368239HCPCS / CPT®Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance
96372175HCPCS / CPT®Therapeutic, prophylactic, or diagnostic injection (specify substance or drug);
963731207HCPCS / CPT®Therapeutic, prophylactic, or diagnostic injection (specify substance or drug);
96374273HCPCS / CPT®Therapeutic, prophylactic, or diagnostic injection (specify substance or drug);
96375255HCPCS / CPT®Injection of different drug or substance into a vein for therapy, diagnosis, or
96376210HCPCS / CPT®IV INFUSION – EACH ADD PUSH
9711636HCPCS / CPT®CRUTCH TRAINNING
97597100.51HCPCS / CPT®Active Wound Care Management.
990001016HCPCS / CPT®HANDLING AND/OR CONVEYANCE OF SPECIMEN FOR TRANSFER FROM THE OFFICE TO A LABORAT
990011037HCPCS / CPT®HANDLING AND/OR CONVEYANCE OF SPECIMEN FOR TRANSFER FROM THE PATIENT IN OTHER TH
9908050HCPCS / CPT®MEDICAL RECORDS
990971372HCPCS / CPT®IV NFS THER PROPH/DX 1ST
991431399HCPCS / CPT®Moderate sedation services by physician also performing a procedure, patient you
991441394HCPCS / CPT®Moderate sedation services by physician also performing a procedure, patient 5 y
991451153HCPCS / CPT®Moderate sedation services by physician or health care provider also performing
991491330HCPCS / CPT®MODERATE SEDATION SERVICES (OTHER THAN THOSE SERVICES DESCRIBED BY CODES 00100-0
99152103.79HCPCS / CPT®Moderate (conscious) sedation
99153103.79HCPCS / CPT®Moderate (conscious) Sedation
9917386HCPCS / CPT®SCREENING TEST OF VISUAL ACUITY, QUANTITATIVE, BILATERAL
992171575HCPCS / CPT®HOSPITAL OBSERVATION CARE DISCHARGE
992181700HCPCS / CPT®HOSPITAL OBSERVATION CARE TYPICALLY 30 MINUTES
992191960HCPCS / CPT®HOSPITAL OBSERVATION CARE TYPICALLY 50 MINUTES
992201678HCPCS / CPT®Initial observation care
992342150HCPCS / CPT®HOSPITAL OBSERVATION OR INPATIENT CARE LOW SEVERITY, 40 MINUTES PER DAY
992352450HCPCS / CPT®HOSPITAL OBSERVATION OR INPATIENT CARE MODERATE SEVERITY, 50 MINUTES PER DAY
992361725HCPCS / CPT®HOSPITAL OBSERVATION OR INPATIENT CARE HIGH SEVERITY, 55 MINUTES PER DAY
992391575HCPCS / CPT®Hospital discharge day
99282925HCPCS / CPT®EMERGENCY DEPARTMENT VISIT, LOW TO MODERATELY SEVERE PROBLEM
992831250HCPCS / CPT®EMERGENCY DEPARTMENT VISIT, MODERATELY SEVERE PROBLEM
992841975HCPCS / CPT®EMERGENCY DEPARTMENT VISIT, PROBLEM OF HIGH SEVERITY
992852360HCPCS / CPT®EMERGENCY DEPARTMENT VISIT, PROBLEM WITH SIGNIFICANT THREAT TO LIFE OR FUNCTION
992912575HCPCS / CPT®CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLY ILL OR CRITICALLY INJ
992921550HCPCS / CPT®CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLY ILL OR CRITICALLY
993541885HCPCS / CPT®PROLONGED SERVICE IN THE OFFICE OR OTHER OUTPATIENT SETTING REQUIRING DIRECT PAT
993551270.34HCPCS / CPT®PROLONGED SERVICE IN THE OFFICE OR OTHER OUTPATIENT SETTING REQUIRING DIRECT PAT
9940674HCPCS / CPT®SMOKING CESSATION 3-10
9940795HCPCS / CPT®smoking cessation 10 min
999990HCPCS / CPT®SELF PAY
A00210HCPCS / CPT®OUTSIDE STATE AMBULANCE SERV
A00800HCPCS / CPT®NONINTEREST ESCORT IN NON ER
A00900HCPCS / CPT®INTEREST ESCORT IN NON ER
A01000HCPCS / CPT®NONEMERGENCY TRANSPORT TAXI
A01100HCPCS / CPT®NONEMERGENCY TRANSPORT BUS
A01200HCPCS / CPT®NONER TRANSPORT MINI-BUS
A01300HCPCS / CPT®NONER TRANSPORT WHEELCH VAN
A01400HCPCS / CPT®NONEMERGENCY TRANSPORT AIR
A01600HCPCS / CPT®NONER TRANSPORT CASE WORKER
A01700HCPCS / CPT®TRANSPORT PARKING FEES/TOLLS
A01800HCPCS / CPT®NONER TRANSPORT LODGNG RECIP
A01900HCPCS / CPT®NONER TRANSPORT MEALS RECIP
A02000HCPCS / CPT®NONER TRANSPORT LODGNG ESCRT
A02100HCPCS / CPT®NONER TRANSPORT MEALS ESCORT
A02250HCPCS / CPT®NEONATAL EMERGENCY TRANSPORT
A03800HCPCS / CPT®BASIC LIFE SUPPORT MILEAGE
A03820HCPCS / CPT®BASIC SUPPORT ROUTINE SUPPLS
A03840HCPCS / CPT®BLS DEFIBRILLATION SUPPLIES
A03900HCPCS / CPT®ADVANCED LIFE SUPPORT MILEAG
A03920HCPCS / CPT®ALS DEFIBRILLATION SUPPLIES
A03941HCPCS / CPT®ALS IV DRUG THERAPY SUPPLIES
A039627HCPCS / CPT®ALS ESOPHAGEAL INTUB SUPPLS
A03980HCPCS / CPT®ALS ROUTINE DISPOSBLE SUPPLS
A04200HCPCS / CPT®AMBULANCE WAITING 1/2 HR
A04220HCPCS / CPT®AMBULANCE 02 LIFE SUSTAINING
A04240HCPCS / CPT®EXTRA AMBULANCE ATTENDANT
A04250HCPCS / CPT®GROUND MILEAGE
A04260HCPCS / CPT®ALS 1
A04270HCPCS / CPT®ALS1-EMERGENCY
A04280HCPCS / CPT®BLS
A04290HCPCS / CPT®BLS-EMERGENCY
A04300HCPCS / CPT®FIXED WING AIR TRANSPORT
A04310HCPCS / CPT®ROTARY WING AIR TRANSPORT
A04320HCPCS / CPT®PI VOLUNTEER AMBULANCE CO
A04330HCPCS / CPT®ALS 2
A04340HCPCS / CPT®SPECIALTY CARE TRANSPORT
A04350HCPCS / CPT®FIXED WING AIR MILEAGE
A04360HCPCS / CPT®ROTARY WING AIR MILEAGE
A08880HCPCS / CPT®NONCOVERED AMBULANCE MILEAGE
A09980HCPCS / CPT®AMBULANCE RESPONSE/TREATMENT
A09990HCPCS / CPT®UNLISTED AMBULANCE SERVICE
A42060HCPCS / CPT®1 CC STERILE SYRINGE&NEEDLE
A42070HCPCS / CPT®2 CC STERILE SYRINGE&NEEDLE
A420829HCPCS / CPT®3 CC STERILE SYRINGE&NEEDLE
A420932HCPCS / CPT®5+ CC STERILE SYRINGE&NEEDLE
A42100HCPCS / CPT®NONNEEDLE INJECTION DEVICE
A42110HCPCS / CPT®SUPP FOR SELF-ADM INJECTIONS
A42120HCPCS / CPT®NON CORING NEEDLE OR STYLET
A42136HCPCS / CPT®20+ CC SYRINGE ONLY
A421511HCPCS / CPT®STERILE NEEDLE
A42163HCPCS / CPT®STERILE WATER/SALINE, 10 ML
A421724HCPCS / CPT®STERILE WATER/SALINE, 500 ML
A421824HCPCS / CPT®STERILE SALINE OR WATER
A42200HCPCS / CPT®INFUSION PUMP REFILL KIT
A42210HCPCS / CPT®SUPP NON-INSULIN INF CATH/WK
A4222160HCPCS / CPT®INFUSION SUPPLIES WITH PUMP
A42230HCPCS / CPT®INFUSION SUPPLIES W/O PUMP
A42244HCPCS / CPT®SUPPLY INSULIN INF CATH/WK
A42250HCPCS / CPT®SUP/EXT INSULIN INF PUMP SYR
A42300HCPCS / CPT®INFUS INSULIN PUMP NON NEEDL
A42310HCPCS / CPT®INFUSION INSULIN PUMP NEEDLE
A423223HCPCS / CPT®SYRINGE W/NEEDLE INSULIN 3CC
A42330HCPCS / CPT®ALKALIN BATT FOR GLUCOSE MON
A42340HCPCS / CPT®J-CELL BATT FOR GLUCOSE MON
A42350HCPCS / CPT®LITHIUM BATT FOR GLUCOSE MON
A42360HCPCS / CPT®SILVR OXIDE BATT GLUCOSE MON
A42440HCPCS / CPT®ALCOHOL OR PEROXIDE PER PINT
A42450HCPCS / CPT®ALCOHOL WIPES PER BOX
A424623HCPCS / CPT®BETADINE/PHISOHEX SOLUTION
A424723HCPCS / CPT®BETADINE/IODINE SWABS/WIPES
A42480HCPCS / CPT®CHLORHEXIDINE ANTISEPT
A42500HCPCS / CPT®URINE REAGENT STRIPS/TABLETS
A42525HCPCS / CPT®BLOOD KETONE TEST OR STRIP
A42530HCPCS / CPT®BLOOD GLUCOSE/REAGENT STRIPS
A42550HCPCS / CPT®GLUCOSE MONITOR PLATFORMS
A42560HCPCS / CPT®CALIBRATOR SOLUTION/CHIPS
A42570HCPCS / CPT®REPLACE LENSSHIELD CARTRIDGE
A42580HCPCS / CPT®LANCET DEVICE EACH
A42590HCPCS / CPT®LANCETS PER BOX
A42610HCPCS / CPT®CERVICAL CAP CONTRACEPTIVE
A42620HCPCS / CPT®TEMPORARY TEAR DUCT PLUG
A42630HCPCS / CPT®PERMANENT TEAR DUCT PLUG
A42640HCPCS / CPT®INTRATUBAL OCCLUSION DEVICE
A42650HCPCS / CPT®PARAFFIN
A42660HCPCS / CPT®DIAPHRAGM
A42670HCPCS / CPT®MALE CONDOM
A42680HCPCS / CPT®FEMALE CONDOM
A42690HCPCS / CPT®SPERMICIDE
A427022HCPCS / CPT®DISPOSABLE ENDOSCOPE SHEATH
A42800HCPCS / CPT®BRST PRSTHS ADHSV ATTCHMNT
A42810HCPCS / CPT®REPLACEMENT BREASTPUMP TUBE
A42820HCPCS / CPT®REPLACEMENT BREASTPUMP ADPT
A42830HCPCS / CPT®REPLACEMENT BREASTPUMP CAP
A42840HCPCS / CPT®REPLCMNT BREAST PUMP SHIELD
A42850HCPCS / CPT®REPLCMNT BREAST PUMP BOTTLE
A42860HCPCS / CPT®REPLCMNT BREASTPUMP LOK RING
A42900HCPCS / CPT®SACRAL NERVE STIM TEST LEAD
A43000HCPCS / CPT®CATH IMPL VASC ACCESS PORTAL
A43010HCPCS / CPT®IMPLANTABLE ACCESS SYST PERC
A43050HCPCS / CPT®DRUG DELIVERY SYSTEM >=50 ML
A43060HCPCS / CPT®DRUG DELIVERY SYSTEM <=50 ML
A43100HCPCS / CPT®INSERT TRAY W/O BAG/CATH
A431132HCPCS / CPT®CATHETER W/O BAG 2-WAY LATEX
A43120HCPCS / CPT®CATH W/O BAG 2-WAY SILICONE
A43130HCPCS / CPT®CATHETER W/BAG 3-WAY
A431411HCPCS / CPT®CATH W/DRAINAGE 2-WAY LATEX
A43150HCPCS / CPT®CATH W/DRAINAGE 2-WAY SILCNE
A431682HCPCS / CPT®CATH W/DRAINAGE 3-WAY
A432038HCPCS / CPT®IRRIGATION TRAY
A43210HCPCS / CPT®CATH THERAPEUTIC IRRIG AGENT
A432214HCPCS / CPT®IRRIGATION SYRINGE
A43260HCPCS / CPT®MALE EXTERNAL CATHETER
A43273HCPCS / CPT®FEM URINARY COLLECT DEV CUP
A43280HCPCS / CPT®FEM URINARY COLLECT POUCH
A43300HCPCS / CPT®STOOL COLLECTION POUCH
A43310HCPCS / CPT®EXTENSION DRAINAGE TUBING
A43326HCPCS / CPT®LUBE STERILE PACKET
A43330HCPCS / CPT®URINARY CATH ANCHOR DEVICE
A43340HCPCS / CPT®URINARY CATH LEG STRAP
A43353HCPCS / CPT®INCONTINENCE SUPPLY
A43360HCPCS / CPT®URETHRAL INSERT
A43370HCPCS / CPT®INCONTINENT RECTAL INSERT
A433848HCPCS / CPT®INDWELLING CATHETER LATEX
A43400HCPCS / CPT®INDWELLING CATHETER SPECIAL
A434411HCPCS / CPT®CATH INDW FOLEY 2 WAY SILICN
A43460HCPCS / CPT®CATH INDW FOLEY 3 WAY
A43490HCPCS / CPT®DISPOSABLE MALE EXTERNAL CAT
A43510HCPCS / CPT®STRAIGHT TIP URINE CATHETER
A43520HCPCS / CPT®COUDE TIP URINARY CATHETER
A435322HCPCS / CPT®INTERMITTENT URINARY CATH
A43540HCPCS / CPT®CATH INSERTION TRAY W/BAG
A43550HCPCS / CPT®BLADDER IRRIGATION TUBING
A43560HCPCS / CPT®EXT URETH CLMP OR COMPR DVC
A435748HCPCS / CPT®BEDSIDE DRAINAGE BAG
A435813HCPCS / CPT®URINARY LEG OR ABDOMEN BAG
A43600HCPCS / CPT®DISPOSABLE EXT URETHRAL DEV
A43610HCPCS / CPT®OSTOMY FACE PLATE
A43620HCPCS / CPT®SOLID SKIN BARRIER
A43630HCPCS / CPT®OSTOMY CLAMP, REPLACEMENT
A436430HCPCS / CPT®ADHESIVE, LIQUID OR EQUAL
A43660HCPCS / CPT®OSTOMY VENT
A43670HCPCS / CPT®OSTOMY BELT
A43680HCPCS / CPT®OSTOMY FILTER
A43690HCPCS / CPT®SKIN BARRIER LIQUID PER OZ
A43710HCPCS / CPT®SKIN BARRIER POWDER PER OZ
A43720HCPCS / CPT®SKIN BARRIER SOLID 4X4 EQUIV
A43730HCPCS / CPT®SKIN BARRIER WITH FLANGE
A43750HCPCS / CPT®DRAINABLE PLASTIC PCH W FCPL
A43760HCPCS / CPT®DRAINABLE RUBBER PCH W FCPLT
A43770HCPCS / CPT®DRAINABLE PLSTIC PCH W/O FP
A43780HCPCS / CPT®DRAINABLE RUBBER PCH W/O FP
A43790HCPCS / CPT®URINARY PLASTIC POUCH W FCPL
A43800HCPCS / CPT®URINARY RUBBER POUCH W FCPLT
A43810HCPCS / CPT®URINARY PLASTIC POUCH W/O FP
A43820HCPCS / CPT®URINARY HVY PLSTC PCH W/O FP
A43830HCPCS / CPT®URINARY RUBBER POUCH W/O FP
A43840HCPCS / CPT®OSTOMY FACEPLT/SILICONE RING
A43850HCPCS / CPT®OST SKN BARRIER SLD EXT WEAR
A43870HCPCS / CPT®OST CLSD POUCH W ATT ST BARR
A43880HCPCS / CPT®DRAINABLE PCH W EX WEAR BARR
A43890HCPCS / CPT®DRAINABLE PCH W ST WEAR BARR
A43900HCPCS / CPT®DRAINABLE PCH EX WEAR CONVEX
A43910HCPCS / CPT®URINARY POUCH W EX WEAR BARR
A43920HCPCS / CPT®URINARY POUCH W ST WEAR BARR
A43930HCPCS / CPT®URINE PCH W EX WEAR BAR CONV
A43940HCPCS / CPT®OSTOMY POUCH LIQ DEODORANT
A43950HCPCS / CPT®OSTOMY POUCH SOLID DEODORANT
A43960HCPCS / CPT®PERISTOMAL HERNIA SUPPRT BLT
A43970HCPCS / CPT®IRRIGATION SUPPLY SLEEVE
A43980HCPCS / CPT®OSTOMY IRRIGATION BAG
A43990HCPCS / CPT®OSTOMY IRRIG CONE/CATH W BRS
A44000HCPCS / CPT®OSTOMY IRRIGATION SET
A44020HCPCS / CPT®LUBRICANT PER OUNCE
A44040HCPCS / CPT®OSTOMY RING EACH
A44050HCPCS / CPT®NONPECTIN BASED OSTOMY PASTE
A44060HCPCS / CPT®PECTIN BASED OSTOMY PASTE
A44070HCPCS / CPT®EXT WEAR OST SKN BARR <=4SQ
A44080HCPCS / CPT®EXT WEAR OST SKN BARR >4SQ
A44090HCPCS / CPT®OST SKN BARR CONVEX <=4 SQ I
A44100HCPCS / CPT®OST SKN BARR EXTND >4 SQ
A44110HCPCS / CPT®OST SKN BARR EXTND =4SQ
A44120HCPCS / CPT®OST POUCH DRAIN HIGH OUTPUT
A44130HCPCS / CPT®2 PC DRAINABLE OST POUCH
A44140HCPCS / CPT®OST SKNBAR W/O CONV<=4 SQ IN
A44150HCPCS / CPT®OST SKN BARR W/O CONV >4 SQI
A44160HCPCS / CPT®OST PCH CLSD W BARRIER/FILTR
A44170HCPCS / CPT®OST PCH W BAR/BLTINCONV/FLTR
A44180HCPCS / CPT®OST PCH CLSD W/O BAR W FILTR
A44190HCPCS / CPT®OST PCH FOR BAR W FLANGE/FLT
A44200HCPCS / CPT®OST PCH CLSD FOR BAR W LK FL
A44210HCPCS / CPT®OSTOMY SUPPLY MISC
A44220HCPCS / CPT®OST POUCH ABSORBENT MATERIAL
A44230HCPCS / CPT®OST PCH FOR BAR W LK FL/FLTR
A44240HCPCS / CPT®OST PCH DRAIN W BAR & FILTER
A44250HCPCS / CPT®OST PCH DRAIN FOR BARRIER FL
A44260HCPCS / CPT®OST PCH DRAIN 2 PIECE SYSTEM
A44270HCPCS / CPT®OST PCH DRAIN/BARR LK FLNG/F
A44280HCPCS / CPT®URINE OST POUCH W FAUCET/TAP
A44290HCPCS / CPT®URINE OST POUCH W BLTINCONV
A44300HCPCS / CPT®OST URINE PCH W B/BLTIN CONV
A44310HCPCS / CPT®OST PCH URINE W BARRIER/TAPV
A44320HCPCS / CPT®OS PCH URINE W BAR/FANGE/TAP
A44330HCPCS / CPT®URINE OST PCH BAR W LOCK FLN
A44340HCPCS / CPT®OST PCH URINE W LOCK FLNG/FT
A44350HCPCS / CPT®1PC OST PCH DRAIN HGH OUTPUT
A44509HCPCS / CPT®NON-WATERPROOF TAPE
A44529HCPCS / CPT®WATERPROOF TAPE
A44557HCPCS / CPT®ADHESIVE REMOVER PER OUNCE
A44567HCPCS / CPT®ADHESIVE REMOVER, WIPES
A44580HCPCS / CPT®REUSABLE ENEMA BAG
A44590HCPCS / CPT®MANUAL PUMP ENEMA, REUSABLE
A44610HCPCS / CPT®SURGICL DRESS HOLD NON-REUSE
A44630HCPCS / CPT®SURGICAL DRESS HOLDER REUSE
A44650HCPCS / CPT®NON-ELASTIC EXTREMITY BINDER
A44670HCPCS / CPT®BELT STRAP SLEEV GRMNT COVER
A44700HCPCS / CPT®GRAVLEE JET WASHER
A44800HCPCS / CPT®VABRA ASPIRATOR
A44810HCPCS / CPT®TRACHEOSTOMA FILTER
A44830HCPCS / CPT®MOISTURE EXCHANGER
A44900HCPCS / CPT®ABOVE KNEE SURGICAL STOCKING
A44950HCPCS / CPT®THIGH LENGTH SURG STOCKING
A45000HCPCS / CPT®BELOW KNEE SURGICAL STOCKING
A45100HCPCS / CPT®FULL LENGTH SURG STOCKING
A45200HCPCS / CPT®INCONTINENCE GARMENT ANYTYPE
A4550372HCPCS / CPT®SURGICAL TRAYS
A45530HCPCS / CPT®NONDISP UNDERPADS, ALL SIZES
A455427HCPCS / CPT®DISPOSABLE UNDERPADS
A45550HCPCS / CPT®CA TX E-STIM ELECTR/TRANSDUC
A455612HCPCS / CPT®ELECTRODES, PAIR
A455719HCPCS / CPT®LEAD WIRES, PAIR
A45587HCPCS / CPT®CONDUCTIVE GEL OR PASTE
A45590HCPCS / CPT®COUPLING GEL OR PASTE
A45610HCPCS / CPT®PESSARY RUBBER, ANY TYPE
A45620HCPCS / CPT®PESSARY, NON RUBBER,ANY TYPE
A4565133HCPCS / CPT®SLINGS
A456679HCPCS / CPT®SHOULD SLING/VEST/ABRESTRAIN
A4570114HCPCS / CPT®SPLINT
A45750HCPCS / CPT®HYPERBARIC O2 CHAMBER DISPS
A45800HCPCS / CPT®CAST SUPPLIES (PLASTER)
A459076HCPCS / CPT®SPECIAL CASTING MATERIAL
A459542HCPCS / CPT®TENS SUPPL 2 LEAD PER MONTH
A46000HCPCS / CPT®SLEEVE, INTER LIMB COMP DEV
A46010HCPCS / CPT®LITH ION NON PROSTH RECHARGE
A46020HCPCS / CPT®REPLACE LITHIUM BATTERY 1.5V
A46040HCPCS / CPT®TUBING WITH HEATING ELEMENT
A46050HCPCS / CPT®TRACH SUCTION CATH CLOSE SYS
A4606115HCPCS / CPT®OXYGEN PROBE USED W OXIMETER
A46080HCPCS / CPT®TRANSTRACHEAL OXYGEN CATH
A46110HCPCS / CPT®HEAVY DUTY BATTERY
A46120HCPCS / CPT®BATTERY CABLES
A46130HCPCS / CPT®BATTERY CHARGER
A461445HCPCS / CPT®HAND-HELD PEFR METER
A46157HCPCS / CPT®CANNULA NASAL
A46167HCPCS / CPT®TUBING (OXYGEN) PER FOOT
A461750HCPCS / CPT®MOUTH PIECE
A46180HCPCS / CPT®BREATHING CIRCUITS
A46190HCPCS / CPT®FACE TENT
A46200HCPCS / CPT®VARIABLE CONCENTRATION MASK
A46230HCPCS / CPT®TRACHEOSTOMY INNER CANNULA
A46240HCPCS / CPT®TRACHEAL SUCTION TUBE
A46250HCPCS / CPT®TRACH CARE KIT FOR NEW TRACH
A46260HCPCS / CPT®TRACHEOSTOMY CLEANING BRUSH
A46270HCPCS / CPT®SPACER BAG/RESERVOIR
A46280HCPCS / CPT®OROPHARYNGEAL SUCTION CATH
A46290HCPCS / CPT®TRACHEOSTOMY CARE KIT
A46300HCPCS / CPT®REPL BAT T.E.N.S. OWN BY PT
A46330HCPCS / CPT®UVL REPLACEMENT BULB
A46340HCPCS / CPT®REPLACEMENT BULB TH LIGHTBOX
A463522HCPCS / CPT®UNDERARM CRUTCH PAD
A46360HCPCS / CPT®HANDGRIP FOR CANE ETC
A46370HCPCS / CPT®REPL TIP CANE/CRUTCH/WALKER
A46380HCPCS / CPT®REPL BATT PULSE GEN SYS
A46390HCPCS / CPT®INFRARED HT SYS REPLCMNT PAD
A46400HCPCS / CPT®ALTERNATING PRESSURE PAD
A46410HCPCS / CPT®RADIOPHARM DX AGENT NOC
A46420HCPCS / CPT®IN111 SATUMOMAB
A46480HCPCS / CPT®IMPLANTABLE TISSUE MARKER
A4649121HCPCS / CPT®SURGICAL SUPPLIES
A46500HCPCS / CPT®IMPLANT RADIATION DOSIMETER
A46510HCPCS / CPT®CALIBRATED MICROCAP TUBE
A46520HCPCS / CPT®MICROCAPILLARY TUBE SEALANT
A46530HCPCS / CPT®PD CATHETER ANCHOR BELT
A46576HCPCS / CPT®SYRINGE W/WO NEEDLE
A46600HCPCS / CPT®SPHYG/BP APP W CUFF AND STET
A46630HCPCS / CPT®DIALYSIS BLOOD PRESSURE CUFF
A467033HCPCS / CPT®AUTOMATIC BP MONITOR, DIAL
A46710HCPCS / CPT®DISPOSABLE CYCLER SET
A46720HCPCS / CPT®DRAINAGE EXT LINE, DIALYSIS
A467312HCPCS / CPT®EXT LINE W EASY LOCK CONNECT
A46740HCPCS / CPT®CHEM/ANTISEPT SOLUTION, 8OZ
A46800HCPCS / CPT®ACTIVATED CARBON FILTER, EA
A46900HCPCS / CPT®DIALYZER, EACH
A47060HCPCS / CPT®BICARBONATE CONC SOL PER GAL
A47070HCPCS / CPT®BICARBONATE CONC POW PER PAC
A47080HCPCS / CPT®ACETATE CONC SOL PER GALLON
A47090HCPCS / CPT®ACID CONC SOL PER GALLON
A47140HCPCS / CPT®TREATED WATER PER GALLON
A47190HCPCS / CPT®Y SET TUBING
A47200HCPCS / CPT®DIALYSAT SOL FLD VOL > 249CC
A47210HCPCS / CPT®DIALYSAT SOL FLD VOL > 999CC
A47220HCPCS / CPT®DIALYS SOL FLD VOL > 1999CC
A47230HCPCS / CPT®DIALYS SOL FLD VOL > 2999CC
A47240HCPCS / CPT®DIALYS SOL FLD VOL > 3999CC
A47250HCPCS / CPT®DIALYS SOL FLD VOL > 4999CC
A47260HCPCS / CPT®DIALYS SOL FLD VOL > 5999CC
A47280HCPCS / CPT®DIALYSATE SOLUTION, NON-DEX
A47300HCPCS / CPT®FISTULA CANNULATION SET, EA
A47369HCPCS / CPT®TOPICAL ANESTHETIC, PER GRAM
A47370HCPCS / CPT®INJ ANESTHETIC PER 10 ML
A47400HCPCS / CPT®SHUNT ACCESSORY
A47500HCPCS / CPT®ART OR VENOUS BLOOD TUBING
A47550HCPCS / CPT®COMB ART/VENOUS BLOOD TUBING
A47600HCPCS / CPT®DIALYSATE SOL TEST KIT, EACH
A47650HCPCS / CPT®DIALYSATE CONC POW PER PACK
A47660HCPCS / CPT®DIALYSATE CONC SOL ADD 10 ML
A47700HCPCS / CPT®BLOOD COLLECTION TUBE/VACUUM
A47710HCPCS / CPT®SERUM CLOTTING TIME TUBE
A47727HCPCS / CPT®BLOOD GLUCOSE TEST STRIPS
A47737HCPCS / CPT®OCCULT BLOOD TEST STRIPS
A47740HCPCS / CPT®AMMONIA TEST STRIPS
A48020HCPCS / CPT®PROTAMINE SULFATE PER 50 MG
A48600HCPCS / CPT®DISPOSABLE CATHETER TIPS
A48700HCPCS / CPT®PLUMB/ELEC WK HM HEMO EQUIP
A48900HCPCS / CPT®REPAIR/MAINT CONT HEMO EQUIP
A49110HCPCS / CPT®DRAIN BAG/BOTTLE
A49130HCPCS / CPT®MISC DIALYSIS SUPPLIES NOC
A49180HCPCS / CPT®VENOUS PRESSURE CLAMP
A49271HCPCS / CPT®NON-STERILE GLOVES
A49280HCPCS / CPT®SURGICAL MASK
A49290HCPCS / CPT®TOURNIQUET FOR DIALYSIS, EA
A49303HCPCS / CPT®STERILE, GLOVES PER PAIR
A49310HCPCS / CPT®REUSABLE ORAL THERMOMETER
A49320HCPCS / CPT®REUSABLE RECTAL THERMOMETER
A50510HCPCS / CPT®POUCH CLSD W BARR ATTACHED
A50520HCPCS / CPT®CLSD OSTOMY POUCH W/O BARR
A50530HCPCS / CPT®CLSD OSTOMY POUCH FACEPLATE
A50540HCPCS / CPT®CLSD OSTOMY POUCH W/FLANGE
A50550HCPCS / CPT®STOMA CAP
A50560HCPCS / CPT®1 PC OST POUCH W FILTER
A50570HCPCS / CPT®1 PC OST POU W BUILT-IN CONV
A50610HCPCS / CPT®POUCH DRAINABLE W BARRIER AT
A50620HCPCS / CPT®DRNBLE OSTOMY POUCH W/O BARR
A50630HCPCS / CPT®DRAIN OSTOMY POUCH W/FLANGE
A50710HCPCS / CPT®URINARY POUCH W/BARRIER
A50720HCPCS / CPT®URINARY POUCH W/O BARRIER
A50730HCPCS / CPT®URINARY POUCH ON BARR W/FLNG
A50810HCPCS / CPT®STOMA PLUG OR SEAL, ANY TYPE
A50820HCPCS / CPT®CONTINENT STOMA CATHETER
A50830HCPCS / CPT®STOMA ABSORPTIVE COVER
A50930HCPCS / CPT®OSTOMY ACCESSORY CONVEX INSE
A51020HCPCS / CPT®BEDSIDE DRAIN BTL W/WO TUBE
A51050HCPCS / CPT®URINARY SUSPENSORY
A511212HCPCS / CPT®URINARY LEG BAG
A51137HCPCS / CPT®LATEX LEG STRAP
A51147HCPCS / CPT®FOAM/FABRIC LEG STRAP
A51205HCPCS / CPT®SKIN BARRIER, WIPE OR SWAB
A51210HCPCS / CPT®SOLID SKIN BARRIER 6X6
A51220HCPCS / CPT®SOLID SKIN BARRIER 8X8
A51260HCPCS / CPT®DISK/FOAM PAD +OR- ADHESIVE
A51310HCPCS / CPT®APPLIANCE CLEANER
A52000HCPCS / CPT®PERCUTANEOUS CATHETER ANCHOR
A55000HCPCS / CPT®DIAB SHOE FOR DENSITY INSERT
A55010HCPCS / CPT®DIABETIC CUSTOM MOLDED SHOE
A55030HCPCS / CPT®DIABETIC SHOE W/ROLLER/ROCKR
A55040HCPCS / CPT®DIABETIC SHOE WITH WEDGE
A55050HCPCS / CPT®DIAB SHOE W/METATARSAL BAR
A55060HCPCS / CPT®DIABETIC SHOE W/OFF SET HEEL
A55070HCPCS / CPT®MODIFICATION DIABETIC SHOE
A55080HCPCS / CPT®DIABETIC DELUXE SHOE
A55100HCPCS / CPT®COMPRESSION FORM SHOE INSERT
A55120HCPCS / CPT®MULTI DEN INSERT DIRECT FORM
A55130HCPCS / CPT®MULTI DEN INSERT CUSTOM MOLD
A60000HCPCS / CPT®WOUND WARMING WOUND COVER
A60100HCPCS / CPT®COLLAGEN BASED WOUND FILLER
A60110HCPCS / CPT®COLLAGEN GEL/PASTE WOUND FIL
A602115HCPCS / CPT®COLLAGEN DRESSING <=16 SQ IN
A60220HCPCS / CPT®COLLAGEN DRSG>16<=48 SQ IN
A60230HCPCS / CPT®COLLAGEN DRESSING >48 SQ IN
A60240HCPCS / CPT®COLLAGEN DSG WOUND FILLER
A60250HCPCS / CPT®SILICONE GEL SHEET, EACH
A61540HCPCS / CPT®WOUND POUCH EACH
A61960HCPCS / CPT®ALGINATE DRESSING <=16 SQ IN
A61970HCPCS / CPT®ALGINATE DRSG >16 <=48 SQ IN
A61980HCPCS / CPT®ALGINATE DRESSING > 48 SQ IN
A61990HCPCS / CPT®ALGINATE DRSG WOUND FILLER
A62030HCPCS / CPT®COMPOSITE DRSG <= 16 SQ IN
A62040HCPCS / CPT®COMPOSITE DRSG >16<=48 SQ IN
A620520HCPCS / CPT®COMPOSITE DRSG > 48 SQ IN
A62060HCPCS / CPT®CONTACT LAYER <= 16 SQ IN
A62070HCPCS / CPT®CONTACT LAYER >16<= 48 SQ IN
A62080HCPCS / CPT®CONTACT LAYER > 48 SQ IN
A62090HCPCS / CPT®FOAM DRSG <=16 SQ IN W/O BDR
A621089HCPCS / CPT®FOAM DRG >16<=48 SQ IN W/O B
A621128HCPCS / CPT®FOAM DRG > 48 SQ IN W/O BRDR
A62120HCPCS / CPT®FOAM DRG <=16 SQ IN W/BORDER
A62130HCPCS / CPT®FOAM DRG >16<=48 SQ IN W/BDR
A62140HCPCS / CPT®FOAM DRG > 48 SQ IN W/BORDER
A62150HCPCS / CPT®FOAM DRESSING WOUND FILLER
A621612HCPCS / CPT®NON-STERILE GAUZE<=16 SQ IN
A621712HCPCS / CPT®NON-STERILE GAUZE>16<=48 SQ
A62180HCPCS / CPT®NON-STERILE GAUZE > 48 SQ IN
A621917HCPCS / CPT®GAUZE <= 16 SQ IN W/BORDER
A62200HCPCS / CPT®GAUZE >16 <=48 SQ IN W/BORDR
A62210HCPCS / CPT®GAUZE > 48 SQ IN W/BORDER
A62220HCPCS / CPT®GAUZE <=16 IN NO W/SAL W/O B
A62230HCPCS / CPT®GAUZE >16<=48 NO W/SAL W/O B
A62240HCPCS / CPT®GAUZE > 48 IN NO W/SAL W/O B
A62280HCPCS / CPT®GAUZE <= 16 SQ IN WATER/SAL
A62290HCPCS / CPT®GAUZE >16<=48 SQ IN WATR/SAL
A62300HCPCS / CPT®GAUZE > 48 SQ IN WATER/SALNE
A62310HCPCS / CPT®HYDROGEL DSG<=16 SQ IN
A62320HCPCS / CPT®HYDROGEL DSG>16<=48 SQ IN
A62330HCPCS / CPT®HYDROGEL DRESSING >48 SQ IN
A62340HCPCS / CPT®HYDROCOLLD DRG <=16 W/O BDR
A62350HCPCS / CPT®HYDROCOLLD DRG >16<=48 W/O B
A62360HCPCS / CPT®HYDROCOLLD DRG > 48 IN W/O B
A62370HCPCS / CPT®HYDROCOLLD DRG <=16 IN W/BDR
A62380HCPCS / CPT®HYDROCOLLD DRG >16<=48 W/BDR
A62390HCPCS / CPT®HYDROCOLLD DRG > 48 IN W/BDR
A62400HCPCS / CPT®HYDROCOLLD DRG FILLER PASTE
A62410HCPCS / CPT®HYDROCOLLOID DRG FILLER DRY
A62420HCPCS / CPT®HYDROGEL DRG <=16 IN W/O BDR
A62430HCPCS / CPT®HYDROGEL DRG >16<=48 W/O BDR
A62440HCPCS / CPT®HYDROGEL DRG >48 IN W/O BDR
A62450HCPCS / CPT®HYDROGEL DRG <= 16 IN W/BDR
A62460HCPCS / CPT®HYDROGEL DRG >16<=48 IN W/B
A62470HCPCS / CPT®HYDROGEL DRG > 48 SQ IN W/B
A62480HCPCS / CPT®HYDROGEL DRSG GEL FILLER
A625031HCPCS / CPT®SKIN SEAL PROTECT MOISTURIZR
A62510HCPCS / CPT®ABSORPT DRG <=16 SQ IN W/O B
A62520HCPCS / CPT®ABSORPT DRG >16 <=48 W/O BDR
A62530HCPCS / CPT®ABSORPT DRG > 48 SQ IN W/O B
A62540HCPCS / CPT®ABSORPT DRG <=16 SQ IN W/BDR
A62550HCPCS / CPT®ABSORPT DRG >16<=48 IN W/BDR
A62560HCPCS / CPT®ABSORPT DRG > 48 SQ IN W/BDR
A62570HCPCS / CPT®TRANSPARENT FILM <= 16 SQ IN
A62580HCPCS / CPT®TRANSPARENT FILM >16<=48 IN
A62590HCPCS / CPT®TRANSPARENT FILM > 48 SQ IN
A626091HCPCS / CPT®WOUND CLEANSER ANY TYPE/SIZE
A626191HCPCS / CPT®WOUND FILLER GEL/PASTE /OZ
A62620HCPCS / CPT®WOUND FILLER DRY FORM / GRAM
A62660HCPCS / CPT®IMPREG GAUZE NO H20/SAL/YARD
A64020HCPCS / CPT®STERILE GAUZE <= 16 SQ IN
A64030HCPCS / CPT®STERILE GAUZE>16 <= 48 SQ IN
A64040HCPCS / CPT®STERILE GAUZE > 48 SQ IN
A64070HCPCS / CPT®PACKING STRIPS, NON-IMPREG
A641015HCPCS / CPT®STERILE EYE PAD
A64110HCPCS / CPT®NON-STERILE EYE PAD
A641227HCPCS / CPT®OCCLUSIVE EYE PATCH
A64136HCPCS / CPT®ADHESIVE BANDAGE, FIRST-AID
A64410HCPCS / CPT®PAD BAND W>=3 <5/YD
A64420HCPCS / CPT®CONFORM BAND N/S W<3/YD
A64430HCPCS / CPT®CONFORM BAND N/S W>=3<5/YD
A64440HCPCS / CPT®CONFORM BAND N/S W>=5/YD
A64450HCPCS / CPT®CONFORM BAND S W <3/YD
A64460HCPCS / CPT®CONFORM BAND S W>=3 <5/YD
A64470HCPCS / CPT®CONFORM BAND S W >=5/YD
A644810HCPCS / CPT®LT COMPRES BAND <3/YD
A644916HCPCS / CPT®LT COMPRES BAND >=3 <5/YD
A645015HCPCS / CPT®LT COMPRES BAND >=5/YD elastic
A64510HCPCS / CPT®MOD COMPRES BAND W>=3<5/YD
A64520HCPCS / CPT®HIGH COMPRES BAND W>=3<5YD
A64532HCPCS / CPT®SELF-ADHER BAND W <3/YD
A645410HCPCS / CPT®SELF-ADHER BAND W>=3 <5/YD
A64550HCPCS / CPT®SELF-ADHER BAND >=5/YD
A64560HCPCS / CPT®ZINC PASTE BAND W >=3<5/YD
A64570HCPCS / CPT®TUBULAR DRESSING
A65010HCPCS / CPT®COMPRES BURNGARMENT BODYSUIT
A65020HCPCS / CPT®COMPRES BURNGARMENT CHINSTRP
A65030HCPCS / CPT®COMPRES BURNGARMENT FACEHOOD
A65040HCPCS / CPT®CMPRSBURNGARMENT GLOVE-WRIST
A65050HCPCS / CPT®CMPRSBURNGARMENT GLOVE-ELBOW
A65060HCPCS / CPT®CMPRSBURNGRMNT GLOVE-AXILLA
A65070HCPCS / CPT®CMPRS BURNGARMENT FOOT-KNEE
A65080HCPCS / CPT®CMPRS BURNGARMENT FOOT-THIGH
A65090HCPCS / CPT®COMPRES BURN GARMENT JACKET
A65100HCPCS / CPT®COMPRES BURN GARMENT LEOTARD
A65110HCPCS / CPT®COMPRES BURN GARMENT PANTY
A65120HCPCS / CPT®COMPRES BURN GARMENT, NOC