Code |
Price |
Type |
Description |
0 |
$0.00 |
HCPCS / CPT® |
COURTESY – MEDICARE |
1 |
$0.00 |
HCPCS / CPT® |
COURTESY – MEDICAID |
2 |
$0.00 |
HCPCS / CPT® |
COURTESY – TRICARE |
10101 |
$0.00 |
HCPCS / CPT® |
INTEREST |
10021 |
$759.00 |
HCPCS / CPT® |
FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE |
10060 |
$994.92 |
HCPCS / CPT® |
INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE |
10061 |
$1306.68 |
HCPCS / CPT® |
INCISION&DRAINAGE ABSCESS COMPLICATED/MULTIPLE |
10080 |
$574.38 |
HCPCS / CPT® |
INCISION & DRAINAGE PILONIDAL CYST SIMPLE |
10081 |
$772.98 |
HCPCS / CPT® |
INCISION & DRAINAGE PILONIDAL CYST COMPLICATED |
10120 |
$263.27 |
HCPCS / CPT® |
INCISION&REMOVAL FOREIGN BODY SUBQ TISS SMPL |
10121 |
$765.32 |
HCPCS / CPT® |
INCISION&REMOVAL FOREIGN BODY SUBQ TISS COMP |
10140 |
$750.00 |
HCPCS / CPT® |
I&D HEMATOMA SEROMA/FLUID COLLECTION |
10160 |
$810.00 |
HCPCS / CPT® |
PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST |
11000 |
$1000.00 |
HCPCS / CPT® |
DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN UP TO 10 OF BODY SURFACE |
11011 |
$344.40 |
HCPCS / CPT® |
DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC |
11040 |
$269.40 |
HCPCS / CPT® |
DEBRIDEMENT SKIN PARTIAL THICKNESS |
11042 |
$336.74 |
HCPCS / CPT® |
REMOVAL DAMAGED SKIN AND UNDERLYING TISSUE |
11200 |
$384.19 |
HCPCS / CPT® |
REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA UP&W/15< |
11400 |
$1134.36 |
HCPCS / CPT® |
Exc tr-ext b9+marg 0.5 cm< |
11404 |
$1092.88 |
HCPCS / CPT® |
EXC B9 LES MRGN XCP SK TG T/A/L 3.1-4.0 CM |
11730 |
$381.13 |
HCPCS / CPT® |
AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 |
11740 |
$396.83 |
HCPCS / CPT® |
EVACUATION SUBUNGUAL HEMATOMA |
11750 |
$700.92 |
HCPCS / CPT® |
EXCISION NAIL MATRIX PERMANENT REMOVAL |
11760 |
$244.79 |
HCPCS / CPT® |
REPAIR NAIL BED |
11762 |
$1150.00 |
HCPCS / CPT® |
Reconstruction of nail bed with graft |
11765 |
$385.44 |
HCPCS / CPT® |
WEDGE EXCISION SKIN NAIL FOLD |
11771 |
$335.28 |
HCPCS / CPT® |
EXCISION PILONIDAL CYST/SINUS EXTENSIVE |
12001 |
$480.48 |
HCPCS / CPT® |
SIMPLE REPAIR SCALPNECKAXGENITTRUNK 2 5CM |
12002 |
$487.08 |
HCPCS / CPT® |
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM |
12004 |
$561.00 |
HCPCS / CPT® |
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM |
12005 |
$744.48 |
HCPCS / CPT® |
SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM |
12011 |
$724.88 |
HCPCS / CPT® |
SIMPLE REPAIR FACE/EAR/EYE/NOSE/LIP/MOUTH 2.5CM OR LESS |
12013 |
$757.90 |
HCPCS / CPT® |
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0CM |
12014 |
$887.12 |
HCPCS / CPT® |
SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5CM |
12015 |
$471.63 |
HCPCS / CPT® |
Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm |
12020 |
$363.00 |
HCPCS / CPT® |
TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE |
12031 |
$570.24 |
HCPCS / CPT® |
REPAIR INTERMEDIATE SCALP/AXILLA/TRUNK/EXTREMITY 2.5 CM OR LESS |
12032 |
$861.17 |
HCPCS / CPT® |
LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK/OR EXTREMITIES (EXCLUDING HANDS AND FEET);2.6CM TO 7.5 CM |
12034 |
$799.92 |
HCPCS / CPT® |
REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM |
12036 |
$2702.11 |
HCPCS / CPT® |
Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm |
12041 |
$592.68 |
HCPCS / CPT® |
REPAIR INTERMEDIATE N/H/F/XTRNL GENT LESS THAN 2.5CM |
12042 |
$861.17 |
HCPCS / CPT® |
REPAIR (LACERATION)INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM |
12044 |
$861.96 |
HCPCS / CPT® |
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM |
12051 |
$671.88 |
HCPCS / CPT® |
REPAIR INTERMEDIATE FACE/EAR/EYE/NOSE/LIP/MOUTH&/MUC 2.5 CM OR LESS |
12052 |
$801.24 |
HCPCS / CPT® |
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.6-5.0 CM |
12053 |
$1082.40 |
HCPCS / CPT® |
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 5.1-7.5 CM |
12054 |
$471.63 |
HCPCS / CPT® |
Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm |
13101 |
$1398.28 |
HCPCS / CPT® |
REPAIR COMPLEX TRUNK 2.6 CM-7.5 CM |
13120 |
$859.32 |
HCPCS / CPT® |
REPAIR COMPLEX SCALP/ARM/LEG 1.1 CM-2.5 CM |
13121 |
$1398.28 |
HCPCS / CPT® |
REPAIR COMPLEX SCALP/ARM/LEG 2.6 CM-7.5 CM |
13122 |
$601.00 |
HCPCS / CPT® |
REPAIR COMPLEX SCALP-ARM-LEG EA 5 CM |
13131 |
$574.92 |
HCPCS / CPT® |
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1 CM-2.5 CM |
13132 |
$1652.64 |
HCPCS / CPT® |
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6 CM-7.5 CM |
13133 |
$2800.00 |
HCPCS / CPT® |
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA 5 CM |
13151 |
$1193.28 |
HCPCS / CPT® |
REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM |
13152 |
$2071.08 |
HCPCS / CPT® |
REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM |
13153 |
$756.36 |
HCPCS / CPT® |
REPAIR COMPLEX EYELID/NOSE/EAR/LIP EA 5 CM/< |
16000 |
$310.20 |
HCPCS / CPT® |
INITIAL TX 1ST DEGREE BURN LOCAL TX |
16020 |
$304.92 |
HCPCS / CPT® |
DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL |
16025 |
$850.00 |
HCPCS / CPT® |
DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM |
17999 |
$196.88 |
HCPCS / CPT® |
UNLISTED PX SKIN MUC MEMBRANE &SUBQ TISSUE |
19020 |
$11019.68 |
HCPCS / CPT® |
MASTOTOMY W/EXPL/DRAINAGE ABSCESS DEEP |
20520 |
$1386.00 |
HCPCS / CPT® |
REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE |
20552 |
$1406.52 |
HCPCS / CPT® |
INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES |
20600 |
$826.55 |
HCPCS / CPT® |
ARTHROCENTESIS ASPIR&/INJECTION SMALL JT/BURSA |
20605 |
$269.40 |
HCPCS / CPT® |
ARTHROCENTESIS ASPIR&/INJECTION INTERM JT/BURSA |
20610 |
$950.00 |
HCPCS / CPT® |
ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA |
20612 |
$175.00 |
HCPCS / CPT® |
ASPIRATE/INJ GANGLION CYST |
21310 |
$653.59 |
HCPCS / CPT® |
CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION |
21315 |
$3500.00 |
HCPCS / CPT® |
CLOSED TX NASAL FRACTURE W/O STABILIZATION |
21480 |
$573.76 |
HCPCS / CPT® |
RESET DISLOCATED JAW |
21501 |
$858.00 |
HCPCS / CPT® |
I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX |
21705 |
$765.32 |
HCPCS / CPT® |
DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB |
21800 |
$480.48 |
HCPCS / CPT® |
CLOSED TX RIB FRACTURE UNCOMPLICATED EACH |
21812 |
$502.32 |
HCPCS / CPT® |
CLOSED TX RIB FRACTURE UNCOMPLICATED EACH |
21820 |
$735.08 |
HCPCS / CPT® |
TREAT STERNUM FRACTURE |
23500 |
$1066.87 |
HCPCS / CPT® |
CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION |
23540 |
$900.00 |
HCPCS / CPT® |
Closed treatment of acromioclavicular dislocation; without manipulation |
23625 |
$2253.73 |
HCPCS / CPT® |
CLTX GREATER HUMERAL TUBEROSITY FX W/ MNP |
23650 |
$1224.52 |
HCPCS / CPT® |
CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES |
23655 |
$1738.82 |
HCPCS / CPT® |
CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES |
23665 |
$2500.00 |
HCPCS / CPT® |
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER HUMERAL TUBEROSITY |
23931 |
$1834.80 |
HCPCS / CPT® |
INCISION&DRAINAGE UPPER ARM/ELBOW BURSA |
24201 |
$7859.21 |
HCPCS / CPT® |
REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP |
24500 |
$427.68 |
HCPCS / CPT® |
CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION |
24530 |
$1824.53 |
HCPCS / CPT® |
CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX+-MNPJ |
24600 |
$882.09 |
HCPCS / CPT® |
TREATMENT OF CLOSED ELBOW DISLOCATION WITHOUT ANESTHESIA |
24605 |
$7146.58 |
HCPCS / CPT® |
TREATMENT ELBOW DISLOCATION |
24640 |
$1200.00 |
HCPCS / CPT® |
CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MNPJ |
24650 |
$1258.19 |
HCPCS / CPT® |
CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION |
24655 |
$2500.00 |
HCPCS / CPT® |
CLOSED TX RADIAL HEAD/NECK FX W MANIPULATION |
24670 |
$1500.00 |
HCPCS / CPT® |
CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MNPJ |
25505 |
$2500.00 |
HCPCS / CPT® |
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE WITH MANIPULATION |
25565 |
$1740.35 |
HCPCS / CPT® |
CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MNPJ |
25600 |
$1300.00 |
HCPCS / CPT® |
CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ |
25605 |
$2612.82 |
HCPCS / CPT® |
CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ |
25622 |
$2712.30 |
HCPCS / CPT® |
CLOSED TX CARPAL SCAPHOID FRACTURE W/O MNPJ |
25635 |
$1421.98 |
HCPCS / CPT® |
CLTX CARPL B1 FX W/MNPJ EA B1 |
25675 |
$1836.78 |
HCPCS / CPT® |
CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION WITH MANIPULATION |
26010 |
$390.32 |
HCPCS / CPT® |
DRAINAGE FINGER ABSCESS SIMPLE |
26011 |
$3212.50 |
HCPCS / CPT® |
DRAINAGE OF FINGER ABCESS |
26600 |
$1192.38 |
HCPCS / CPT® |
CLTX MTCRPL FX 1 W/O MNPJ EA B1 |
26605 |
$1380.64 |
HCPCS / CPT® |
CLTX MTCRPL FX 1 W/MNPJ EA B1 |
26607 |
$2190.36 |
HCPCS / CPT® |
CLTX MTCRPL FX W/MNPJ W/XTRNL FIXJ EA B1 |
26700 |
$805.03 |
HCPCS / CPT® |
CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; WITHOUT ANESTHESIA |
26705 |
$845.34 |
HCPCS / CPT® |
TREAT KNUCKLE DISLOCATION |
26720 |
$823.49 |
HCPCS / CPT® |
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB; WITHOUT MANIPULATION, EACH |
26725 |
$1348.50 |
HCPCS / CPT® |
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB; WITH MANIPULATION, EACH |
26750 |
$805.03 |
HCPCS / CPT® |
CLTX DSTL PHLNGL FX FNGR/THMB W/O MNPJ EA |
26755 |
$811.24 |
HCPCS / CPT® |
CLTX DSTL PHLNGL FX FNGR/THMB W/MNPJ EA |
26770 |
$734.71 |
HCPCS / CPT® |
CLTX IPHAL JT DISLC 1 W/MNPJ W/O ANES |
26775 |
$6572.12 |
HCPCS / CPT® |
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIOPULATION; REQUIRING ANESTHESIA |
27372 |
$459.20 |
HCPCS / CPT® |
REMOVAL FOREIGN BODY DEEP THIGH/KNEE |
27520 |
$1579.63 |
HCPCS / CPT® |
CLOSED TX PATELLAR FRACTURE W/O MANIPULATION |
27550 |
$1792.39 |
HCPCS / CPT® |
CLOSED TX KNEE DISLOCATION W/O ANESTHESIA |
27560 |
$804.28 |
HCPCS / CPT® |
CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA |
27750 |
$1424.77 |
HCPCS / CPT® |
CLTX TIBL SHFT FX W/O MNPJ |
27752 |
$2580.68 |
HCPCS / CPT® |
CLTX TIBL SHFT FX W/MNPJ +-SKEL TRACJ |
27760 |
$1510.75 |
HCPCS / CPT® |
CLTX MEDIAL MALLS FX W/O MNPJ |
27780 |
$1750.00 |
HCPCS / CPT® |
CLOSED TREATMENT OF PROXIMAL FIBULA SHAFT FRACTURE WITHOUT MANIPULATION |
27786 |
$1800.00 |
HCPCS / CPT® |
CLOSED TXT DISTAL FIBULAR FX LATERAL MALLEOLUS W/O MANIPULATION |
27788 |
$2400.00 |
HCPCS / CPT® |
CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE LATERAL MALLEOLUS WITH MANIPULATION |
27808 |
$1350.00 |
HCPCS / CPT® |
Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation |
27810 |
$845.34 |
HCPCS / CPT® |
TREATMENT OF ANKLE FRACTURE |
27818 |
$2500.00 |
HCPCS / CPT® |
Closed treatment of trimalleolar ankle fracture; with manipulation |
27824 |
$845.34 |
HCPCS / CPT® |
CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MNPJ |
27840 |
$499.28 |
HCPCS / CPT® |
CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA |
28190 |
$976.56 |
HCPCS / CPT® |
REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS |
28192 |
$5182.47 |
HCPCS / CPT® |
REMOVAL OF FOOT FOREIGN BODY |
28400 |
$1250.00 |
HCPCS / CPT® |
CLOSED TREATMENT OF CALCANEAL FRACTURE WITHOUT MANIPULATION |
28430 |
$853.02 |
HCPCS / CPT® |
CLOSED TX TALUS FRACTURE W/O MANIPULATION |
28450 |
$800.00 |
HCPCS / CPT® |
Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each |
28470 |
$1102.07 |
HCPCS / CPT® |
CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION |
28490 |
$495.93 |
HCPCS / CPT® |
CLTX FX GRT TOE PHLX/PHLG W/O MNPJ |
28495 |
$750.00 |
HCPCS / CPT® |
CLOSED TXT FX OF GREAT TOE PHLX/PHLG W/MANIPULATION |
28510 |
$685.73 |
HCPCS / CPT® |
CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MNPJ |
28515 |
$815.83 |
HCPCS / CPT® |
CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MNPJ |
28660 |
$805.03 |
HCPCS / CPT® |
CLTX IPHAL JT DISLC W/O ANES |
29049 |
$1425.00 |
HCPCS / CPT® |
APPLICATION OF FIGURE EIGHT SLING AND SWATHE |
29085 |
$229.60 |
HCPCS / CPT® |
CAST HAND&LOWER FOREARM GAUNTLET |
29105 |
$840.00 |
HCPCS / CPT® |
LONG ARM SPLINT SHOULDER HAND |
29125 |
$229.60 |
HCPCS / CPT® |
SHORT ARM SPLINT FOREARM-HAND STATIC |
29126 |
$229.60 |
HCPCS / CPT® |
SHORT ARM SPLINT DYNAMIC |
29130 |
$229.60 |
HCPCS / CPT® |
FINGER SPLINT STATIC |
29240 |
$507.63 |
HCPCS / CPT® |
STRAPPING; SHOULDER |
29260 |
$341.11 |
HCPCS / CPT® |
STRAPPING; ELBOW OR WRIST |
29280 |
$313.79 |
HCPCS / CPT® |
STRAPPING HAND/FINGER |
29505 |
$229.60 |
HCPCS / CPT® |
LONG LEG SPLINT THIGH ANKLE/TOES |
29515 |
$229.60 |
HCPCS / CPT® |
SHORT LEG SPLINT CALF FOOT |
29530 |
$431.43 |
HCPCS / CPT® |
STRAPPING; KNEE |
29540 |
$287.76 |
HCPCS / CPT® |
STRAPPING ANKLE &/FOOT |
29550 |
$287.76 |
HCPCS / CPT® |
STRAPPING TOES |
29580 |
$287.76 |
HCPCS / CPT® |
STRAPPING UNNA BOOT |
29700 |
$166.84 |
HCPCS / CPT® |
REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST |
30300 |
$650.53 |
HCPCS / CPT® |
REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE |
30901 |
$375.00 |
HCPCS / CPT® |
CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE |
30903 |
$238.91 |
HCPCS / CPT® |
CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX |
30905 |
$650.00 |
HCPCS / CPT® |
CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD, INITIAL |
31500 |
$1075.00 |
HCPCS / CPT® |
INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE |
31502 |
$1167.33 |
HCPCS / CPT® |
TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT |
31505 |
$198.60 |
HCPCS / CPT® |
LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX |
31515 |
$9863.77 |
HCPCS / CPT® |
LARYNGOSCOPY +-TRACHEOSCOPY ASPIRATION |
31525 |
$7689.00 |
HCPCS / CPT® |
LARYNGOSCOPY +-TRACHEOSCOPY DX EXCEPT NEWBORN |
31530 |
$1995.14 |
HCPCS / CPT® |
LARYNGOSCOPY W/FOREIGN BODY REMOVAL |
32421 |
$1518.00 |
HCPCS / CPT® |
THORACENTESIS PUNCTURE PLEURAL CAVITY ASPIRATION |
32551 |
$2951.39 |
HCPCS / CPT® |
TUBE THORACOSTOMY INCLUDES WATER SEAL |
32554 |
$1360.89 |
HCPCS / CPT® |
Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance |
33415 |
$1285.75 |
HCPCS / CPT® |
RESCJ/INC SUBVALVULAR TISSUE |
36000 |
$321.44 |
HCPCS / CPT® |
INTRO NDL/INTRACATH VEIN |
36415 |
$350.00 |
HCPCS / CPT® |
VENIPUNCTURE |
36416 |
$53.58 |
HCPCS / CPT® |
CAPILLARY COLLECTION BLOOD SPECIMEN (FINGERSTICK) |
36556 |
$5850.00 |
HCPCS / CPT® |
INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER; AGE 5 YEARS OR OLDER |
36558 |
$2828.74 |
HCPCS / CPT® |
INSERT TUNNELED CV CATH – INSJ TUN CTR CVC W/O SUBQ PORT/PMP AGE 5 YR/> |
36571 |
$2439.43 |
HCPCS / CPT® |
INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/> |
36591 |
$191.34 |
HCPCS / CPT® |
COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE |
36880 |
$713.84 |
HCPCS / CPT® |
INTRAOSSEOUS LINE PLACEMENT |
37195 |
$1500.00 |
HCPCS / CPT® |
Thrombolysis, cerebral, by intravenous infusion |
38300 |
$396.83 |
HCPCS / CPT® |
DRAINAGE LYMPH NODE ABSC/LYMPHADENITIS SMPL |
40650 |
$3921.14 |
HCPCS / CPT® |
REPAIR LIP, FULL THICKNESS; VERMILLION ONLY |
41250 |
$360.51 |
HCPCS / CPT® |
REPAIR TONGUE LACERATION |
41251 |
$858.00 |
HCPCS / CPT® |
RPR LAC 2.5 CM/< PST ONE-3RD TONGUE |
41800 |
$975.00 |
HCPCS / CPT® |
Drainage of abscess, cyst, hematoma from dentoalveolar structures |
42700 |
$1758.80 |
HCPCS / CPT® |
I&D ABSC PRITONSILLAR |
42809 |
$675.00 |
HCPCS / CPT® |
REMOVAL OF FB FROM PHARYNX |
43753 |
$522.56 |
HCPCS / CPT® |
GASTRIC TUBE PLMT W/ASPIR & LAVAGE |
46040 |
$1513.81 |
HCPCS / CPT® |
I&D ISCHIORCT&/PRIRCT ABSC SPX |
46050 |
$2778.89 |
HCPCS / CPT® |
I&D PRIANAL ABSC SUPFC |
46083 |
$1044.67 |
HCPCS / CPT® |
INC THROMBOSED HEMORRHOID XTRNL |
46320 |
$802.06 |
HCPCS / CPT® |
ENCL/EXC XTRNL THROMBOTIC HEMORRHOID |
51700 |
$126.74 |
HCPCS / CPT® |
BLDR IRRIGATION SMPL LVG&/INSTLJ |
51701 |
$303.07 |
HCPCS / CPT® |
CATHETERIZATION, BLADDER |
51702 |
$472.97 |
HCPCS / CPT® |
INSJ TEMP NDWELLG BLDR CATH SMPL |
51703 |
$745.43 |
HCPCS / CPT® |
INSJ TEMP NDWELLG BLDR CATH COMP |
54220 |
$840.13 |
HCPCS / CPT® |
Irrigation of corpora cavernosa for priapism |
54450 |
$1533.31 |
HCPCS / CPT® |
FORESKN MNPJ W/LSS PREPUTIAL ADS&STRETCHING |
56405 |
$786.15 |
HCPCS / CPT® |
I&D VULVA/PRNL ABSC |
56420 |
$130.11 |
HCPCS / CPT® |
I&D OF BARTHOLIN’S GLAND ABSC |
57180 |
$450.00 |
HCPCS / CPT® |
TREAT VAGINAL BLEEDING |
58301 |
$652.08 |
HCPCS / CPT® |
Removal of intrauterine device (IUD) |
59025 |
$750.00 |
HCPCS / CPT® |
FETAL NON-STRESS TEST |
59409 |
$4478.89 |
HCPCS / CPT® |
VAG DLVR ONLY |
62270 |
$3275.00 |
HCPCS / CPT® |
SPINAL TAP FLUID |
64400 |
$1400.00 |
HCPCS / CPT® |
NJX ANES TRIGEMINAL NRV ANY DIV/BRANCH |
64402 |
$1350.00 |
HCPCS / CPT® |
NERVE BLOCK – ANESTHESIA FACIAL NERVE |
64450 |
$750.00 |
HCPCS / CPT® |
NERVE BLOCK ANES OTHER PRPH NRV/BRANCH |
64640 |
$1600.65 |
HCPCS / CPT® |
DSTRJ NULYT OTH PRPH NRV/BRANCH |
65205 |
$321.44 |
HCPCS / CPT® |
RMVL FB XTRNL EYE |
65210 |
$488.80 |
HCPCS / CPT® |
Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating |
65220 |
$497.47 |
HCPCS / CPT® |
RMVL FB XTRNL EYE CRNL W/O SLIT LAMP |
65222 |
$587.77 |
HCPCS / CPT® |
RMVL FB XTRNL EYE CRNL W/SLIT LAMP |
65435 |
$726.00 |
HCPCS / CPT® |
RMVL CRNL EPITHE +-CHEMOCAUT |
67700 |
$1014.82 |
HCPCS / CPT® |
BLEPHAROTOMY DRG ABSC EYELID |
69000 |
$793.48 |
HCPCS / CPT® |
DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; SIMPLE |
69200 |
$499.00 |
HCPCS / CPT® |
REMOVAL OF FOREIGN BODY OF EAR XTRNL AUD CANAL W/O ANES |
69205 |
$535.73 |
HCPCS / CPT® |
RMVL FB XTRNL AUD CANAL ANES |
69209 |
$150.00 |
HCPCS / CPT® |
REMOVE IMPACTED EAR WAX UNILATERAL |
69210 |
$257.15 |
HCPCS / CPT® |
REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION; UNILATERAL |
69399 |
$500.00 |
HCPCS / CPT® |
Procedure performed on external ear |
70030 |
$345.00 |
HCPCS / CPT® |
RADEX EYE DETCJ FB |
70100 |
$460.34 |
HCPCS / CPT® |
XRAY MANDIBLE LESS THAN 4 VIEWS |
70110 |
$460.34 |
HCPCS / CPT® |
XRAY MANDIBLE 4 OR MORE VIEWS |
70150 |
$655.12 |
HCPCS / CPT® |
RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS |
70160 |
$307.21 |
HCPCS / CPT® |
XRAY NASAL BONE MINIMUM OF 3 VIEWS |
70200 |
$471.09 |
HCPCS / CPT® |
X-RAY EXAM OF EYE SOCKETS, MINIMUM OF 4 VIEWS |
70210 |
$365.70 |
HCPCS / CPT® |
XRAY SINUSES PARANSL LESS THAN 3 VIEWS |
70220 |
$645.93 |
HCPCS / CPT® |
XRAY SINUSES PARANASAL COMPLETE MINIMUM OF 3 VIEWS |
70250 |
$496.66 |
HCPCS / CPT® |
XRAY SKULL LESS THAN 4 VIEWS |
70260 |
$657.50 |
HCPCS / CPT® |
RADEX SKL COMPL MINIMUM 4 VIEWS |
70328 |
$460.34 |
HCPCS / CPT® |
RADEX TMPRMAND JT OPN&CLSD MOUTH UNI |
70330 |
$460.34 |
HCPCS / CPT® |
X-RAY EXAM OF JAW JOINT |
70350 |
$336.74 |
HCPCS / CPT® |
CEPHALOGRAM ORTHODONTIC |
70360 |
$895.13 |
HCPCS / CPT® |
RADEX OF NECK SOFT TISSUE |
70380 |
$178.35 |
HCPCS / CPT® |
RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS |
70450 |
$4986.50 |
HCPCS / CPT® |
CT HEAD-BRAIN WITHOUT CONTRAST |
70460 |
$7356.03 |
HCPCS / CPT® |
CT HEAD-BRAIN WITH CONTRAST |
70470 |
$11942.53 |
HCPCS / CPT® |
CT HEAD-BRAIN WITH & WITHOUT CONTRAST |
70480 |
$1530.65 |
HCPCS / CPT® |
CT ORBIT SELLA/POST FOSSA/EAR C-MATRL |
70481 |
$3116.56 |
HCPCS / CPT® |
CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL |
70486 |
$2519.04 |
HCPCS / CPT® |
CT SCAN MAXLFCL AREA C-MATRL – SINUS AREA |
70487 |
$2142.91 |
HCPCS / CPT® |
CT MAXLFCL AREA C+ MATRL |
70488 |
$2546.24 |
HCPCS / CPT® |
CT MAXLFCL AREA C-/C+ |
70490 |
$1200.00 |
HCPCS / CPT® |
CT SOFT TISSUE NECK WITHOUT CONTRAST |
70491 |
$2537.00 |
HCPCS / CPT® |
CT SOFT TISSUE NECK WITH CONTRAST |
70492 |
$2600.00 |
HCPCS / CPT® |
CT SOFT TISSUE NECK WITH AND WITHOUT CONTRAST |
70496 |
$6498.38 |
HCPCS / CPT® |
CTA HEAD WITH AND WITHOUT CONTRAST |
70498 |
$2145.69 |
HCPCS / CPT® |
CTA NECK WITH AND WITHOUT CONTRAST |
70544 |
$4132.75 |
HCPCS / CPT® |
MRA HEAD C-MATRL |
70547 |
$3635.84 |
HCPCS / CPT® |
MRA NCK C-MATRL |
70551 |
$3635.84 |
HCPCS / CPT® |
MRI BRN BRN STEM C-MATRL |
70553 |
$4285.82 |
HCPCS / CPT® |
MRI BRN BRN STEM C-/C+ |
71010 |
$391.71 |
HCPCS / CPT® |
XRAY CHEST ONE VIEW |
71020 |
$609.62 |
HCPCS / CPT® |
XRAY CHEST 2 VIEW FRONTAL AND LATERAL |
71030 |
$687.26 |
HCPCS / CPT® |
RADEX CH COMPL MINIMUM 4 VIEWS |
71045 |
$665.91 |
HCPCS / CPT® |
XRAY CHEST ONE VIEW |
71046 |
$786.65 |
HCPCS / CPT® |
XRAY CHEST 2 VIEW FRONTAL AND LATERAL |
71100 |
$345.77 |
HCPCS / CPT® |
RADEX RIBS UNI 2 VIEWS |
71101 |
$1175.95 |
HCPCS / CPT® |
RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS |
71110 |
$668.90 |
HCPCS / CPT® |
RADEX RIBS BI 3 VIEWS |
71111 |
$804.06 |
HCPCS / CPT® |
RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS |
71120 |
$334.45 |
HCPCS / CPT® |
RADEX STERNUM MINIMUM 2 VIEWS |
71250 |
$6893.53 |
HCPCS / CPT® |
CT THORAX C-MATRL |
71260 |
$7794.08 |
HCPCS / CPT® |
CT THORAX C+ MATRL |
71270 |
$7579.40 |
HCPCS / CPT® |
CT THORAX C-/C+ |
71275 |
$9006.53 |
HCPCS / CPT® |
CTA CHEST WITH AND WITHOUT CONTRAST |
71550 |
$3635.30 |
HCPCS / CPT® |
MRI CH C-MATRL |
72020 |
$412.25 |
HCPCS / CPT® |
XRAY SPINE 1 VIEW SPECIFY LEVEL |
72040 |
$879.98 |
HCPCS / CPT® |
XRAY CERVICAL 2 OR 3 VIEWS |
72050 |
$642.87 |
HCPCS / CPT® |
XRAY CERVICAL 4 VIEWS |
72052 |
$1102.07 |
HCPCS / CPT® |
XRAY CERVICAL 6 OR MORE VIEWS |
72069 |
$962.31 |
HCPCS / CPT® |
XRAY SPINE THORACOLUMBAR STANDING SCOLIOSIS |
72070 |
$898.07 |
HCPCS / CPT® |
XRAY THORACIC 2 VIEWS |
72072 |
$1308.71 |
HCPCS / CPT® |
XRAY THORACIC 3 VIEWS |
72074 |
$701.71 |
HCPCS / CPT® |
XRAY THORACIC 4 VIEWS |
72080 |
$290.64 |
HCPCS / CPT® |
X RAY EXAM TRUNK SPINE 2VWS |
72100 |
$1107.64 |
HCPCS / CPT® |
XRAY LUMBAR 2 OR 3 VIEWS |
72110 |
$1040.84 |
HCPCS / CPT® |
XRAY LUMBAR 4 VIEWS |
72114 |
$612.26 |
HCPCS / CPT® |
XRAY LUMBAR 6 OR MORE VIEWS |
72120 |
$727.06 |
HCPCS / CPT® |
XRAY SPINE LUMBOSACRAL BENDING MINIMUM 4 VIEWS |
72125 |
$5568.78 |
HCPCS / CPT® |
CT CERVICAL SPINE WITHOUT CONTRAST |
72126 |
$7735.34 |
HCPCS / CPT® |
CT CERVICAL SPINE WITH CONTRAST |
72127 |
$13268.78 |
HCPCS / CPT® |
CT CERVICAL SPINE W & WITHOUT CONTRAST |
72128 |
$5152.70 |
HCPCS / CPT® |
CT THORACIC SPINE WITHOUT CONTRAST |
72129 |
$7306.70 |
HCPCS / CPT® |
CT THORACIC SPINE WITH CONTRAST |
72131 |
$6820.25 |
HCPCS / CPT® |
CT LUMBAR SPINE WITHOUT CONTRAST |
72132 |
$8716.24 |
HCPCS / CPT® |
CT LUMBAR SPINE WITH CONTRAST |
72133 |
$15524.87 |
HCPCS / CPT® |
CT LUMBAR SPINE WITH AND WITHOUT CONTRAST |
72141 |
$2449.04 |
HCPCS / CPT® |
MRI SPI CANAL&CNTS CRV C-MATRL |
72146 |
$3635.84 |
HCPCS / CPT® |
MRI SPI CANAL&CNTS THRC C-MATRL |
72148 |
$3635.84 |
HCPCS / CPT® |
MRI SPI CANAL&CNTS LMBR C-MATRL |
72156 |
$4285.82 |
HCPCS / CPT® |
MRI SPI CANAL&CNTS C-/C+ CRV |
72157 |
$3635.84 |
HCPCS / CPT® |
MRI SPI CANAL&CNTS C-/C+ |
72158 |
$3673.56 |
HCPCS / CPT® |
MRI SPI CANAL&CNTS C-/C+ LMBR |
72170 |
$497.47 |
HCPCS / CPT® |
XRAY PELVIS 1 OR 2 VIEWS |
72190 |
$569.55 |
HCPCS / CPT® |
XRAY PELVIS COMPLETE MINIMUM 3 VIEWS |
72191 |
$1980.28 |
HCPCS / CPT® |
CTA PELVIS WITH & WITHOUT CONTRAST |
72192 |
$3644.48 |
HCPCS / CPT® |
CT PELVIS WITHOUT CONTRAST |
72193 |
$2404.50 |
HCPCS / CPT® |
CT PELVIS WITH CONTRAST |
72194 |
$6622.05 |
HCPCS / CPT® |
CT PELVIS WITH & WITHOUT CONTRAST |
72195 |
$3635.84 |
HCPCS / CPT® |
MRI PELVIS C-MATRL |
72196 |
$4898.08 |
HCPCS / CPT® |
MRI PELVIS C+ MATRL |
72220 |
$372.25 |
HCPCS / CPT® |
XRAY SACRUM & COCCYX MINIMUM 2 VIEWS |
73000 |
$366.13 |
HCPCS / CPT® |
XRAY CLAVICLE COMPLETE |
73010 |
$423.02 |
HCPCS / CPT® |
XRAY SCAPULA COMPLETE |
73020 |
$303.29 |
HCPCS / CPT® |
XRAY SHOULDER 1 VIEW |
73030 |
$911.18 |
HCPCS / CPT® |
XRAY SHOULDER 2 OR MORE VIEWS |
73040 |
$2205.64 |
HCPCS / CPT® |
CONTRAST X RAY OF SHOULDER |
73050 |
$486.75 |
HCPCS / CPT® |
RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ |
73060 |
$845.35 |
HCPCS / CPT® |
XRAY HUMERUS MINIMUM 2 VIEWS |
73070 |
$843.21 |
HCPCS / CPT® |
XRAY ELBOW 2 VIEWS |
73080 |
$1327.08 |
HCPCS / CPT® |
XRAY ELBOW COMPLETE MINIMUM 3 VIEWS |
73090 |
$749.87 |
HCPCS / CPT® |
XRAY FOREARM 2 VIEWS |
73100 |
$495.63 |
HCPCS / CPT® |
RADEX WRST 2 VIEWS |
73110 |
$945.53 |
HCPCS / CPT® |
XRAY WRIST MINIMUM 3 VIEWS |
73120 |
$422.12 |
HCPCS / CPT® |
RADEX HAND 2 VIEWS |
73130 |
$1030.54 |
HCPCS / CPT® |
XRAY HAND MINIMUM 3 VIEWS |
73140 |
$466.85 |
HCPCS / CPT® |
XRAY FINGER MINIMUM 2 VIEWS |
73200 |
$1917.90 |
HCPCS / CPT® |
CT UPPER EXTREMITY WITHOUT MATERIAL |
73201 |
$1188.00 |
HCPCS / CPT® |
CT UPPER EXTREMITY WITH CONTRAST |
73220 |
$4285.82 |
HCPCS / CPT® |
MRI UXTR OTH/THN JT C-/C+ |
73221 |
$3635.84 |
HCPCS / CPT® |
MRI ANY JT UXTR C-MATRL |
73501 |
$250.00 |
HCPCS / CPT® |
Radiologic examination, hip, unilateral, with pelvis when performed; 1 view |
73502 |
$764.56 |
HCPCS / CPT® |
XRAY HIP UNILATERAL 2-3 VIEWS |
73510 |
$624.24 |
HCPCS / CPT® |
XRAY HIP UNILATERAL COMPLETE MINIMUM 2 VIEWS |
73520 |
$813.12 |
HCPCS / CPT® |
XRAY HIP BILATERAL 2 VIEWS ANTEROPOSTERIOR PELVIS |
73521 |
$316.80 |
HCPCS / CPT® |
XRAY HIPS BILATERAL 2 VIEWS ANTEROPOSTERIOR PELVIS |
73522 |
$421.54 |
HCPCS / CPT® |
XRAY HIPS BILATERAL 3-4 VIEWS ANTEROPOSTERIOR PELVIS |
73552 |
$827.90 |
HCPCS / CPT® |
XRAY FEMUR 2 VIEWS |
73560 |
$864.77 |
HCPCS / CPT® |
XRAY KNEE 1-2 VIEWS |
73562 |
$997.35 |
HCPCS / CPT® |
XRAY KNEE 3 VIEWS |
73564 |
$515.76 |
HCPCS / CPT® |
XRAY KNEE COMPLETE 4 OR MORE VIEWS |
73590 |
$983.26 |
HCPCS / CPT® |
RADEX TIBFIB 2 VIEWS |
73592 |
$391.47 |
HCPCS / CPT® |
RADEX LXTR INFT MINIMUM 2 VIEWS |
73600 |
$307.21 |
HCPCS / CPT® |
RADEX ANKLE 2 VIEWS |
73610 |
$964.53 |
HCPCS / CPT® |
RADEX ANKLE COMPL MINIMUM 3 VIEWS |
73620 |
$775.35 |
HCPCS / CPT® |
RADEX FOOT 2 VIEWS |
73630 |
$901.87 |
HCPCS / CPT® |
RADEX FOOT COMPL MINIMUM 3 VIEWS |
73650 |
$420.93 |
HCPCS / CPT® |
RADEX CALCANEUS MINIMUM 2 VIEWS |
73652 |
$294.49 |
HCPCS / CPT® |
RADEX KNE 3 VIEWS |
73660 |
$306.13 |
HCPCS / CPT® |
RADEX TOE MINIMUM 2 VIEWS |
73700 |
$1110.00 |
HCPCS / CPT® |
CT LOWER EXTREMITY WITHOUT CONTRAST |
73701 |
$1500.00 |
HCPCS / CPT® |
CT LOWER EXTREMITY WITH CONTRAST |
73702 |
$1750.00 |
HCPCS / CPT® |
CT LOWER EXTREMITY WITH & WITHOUT CONTRAST |
73721 |
$3635.84 |
HCPCS / CPT® |
MRI ANY JT LXTR C-MATRL |
73722 |
$4034.04 |
HCPCS / CPT® |
MRI ANY JT LXTR C+ MATRL |
73723 |
$6622.05 |
HCPCS / CPT® |
MRI ANY JT LXTR C-/C+ |
73725 |
$4898.08 |
HCPCS / CPT® |
MRA LXTR C+-MATRL |
74000 |
$994.92 |
HCPCS / CPT® |
XRAY ABDOMEN – KUB 1 ANTEROPOSTERIOR VIEW |
74010 |
$558.69 |
HCPCS / CPT® |
XRAY ABDOMEN AP, OBLIQUE & CONE VIEWS |
74018 |
$450.00 |
HCPCS / CPT® |
XRAY ABDOMEN – 1 VIEW |
74019 |
$725.00 |
HCPCS / CPT® |
XRAY ABDOMEN – 2 VIEWS |
74020 |
$595.42 |
HCPCS / CPT® |
XRAY ABDOMEN COMPLETE WITH DECUBITUS & ERECT VIEWS |
74021 |
$725.00 |
HCPCS / CPT® |
XRAY ABDOMEN – 3 VIEWS |
74022 |
$747.59 |
HCPCS / CPT® |
XRAY ABDOMEN COMPLETE AAS WITH 1 VIEW CHEST |
74150 |
$5711.02 |
HCPCS / CPT® |
CT ABD C-MATRL |
74160 |
$3357.54 |
HCPCS / CPT® |
CT ABD C+ MATRL |
74170 |
$3955.60 |
HCPCS / CPT® |
CT ABD C-/C+ |
74174 |
$3916.22 |
HCPCS / CPT® |
CTA ABDOMEN PELVIS WITH AND WITHOUT CONTRAST |
74175 |
$4239.61 |
HCPCS / CPT® |
CTA ABDOMEN WITH AND WITHOUT CONTRAST |
74176 |
$5554.73 |
HCPCS / CPT® |
CT ABDOMEN & PELVIS W/O CONTRAST |
74177 |
$7653.97 |
HCPCS / CPT® |
CT ABDOMEN & PELVIS WITH CONTRAST |
74178 |
$12445.08 |
HCPCS / CPT® |
CT ABDOMEN & PELVIS WITH AND WITHOUT CONTRAST |
74181 |
$3635.84 |
HCPCS / CPT® |
MRI ABD C-MATRL |
74183 |
$4285.82 |
HCPCS / CPT® |
MRI ABD C-/C+ |
74241 |
$1308.79 |
HCPCS / CPT® |
RADEX GI TRC UPR +-DLYD FLMS W/KUB |
74247 |
$1323.71 |
HCPCS / CPT® |
RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB |
76010 |
$342.86 |
HCPCS / CPT® |
RADEX FROM NOSE RECTUM FB 1 VIEW CHLD |
76376 |
$841.86 |
HCPCS / CPT® |
3D RNDR I&R CT MRI US/OTH X REQ POSTPCX |
76510 |
$1120.47 |
HCPCS / CPT® |
Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter |
76536 |
$1308.79 |
HCPCS / CPT® |
US SOFT TISSUE OF HEAD AND NECK |
76641 |
$943.48 |
HCPCS / CPT® |
Ultrasound breast complete |
76642 |
$3219.23 |
HCPCS / CPT® |
ULTRASOUND BREAST LIMITED |
76645 |
$943.48 |
HCPCS / CPT® |
US BREAST R-T W/IMAGE DOCUMENTATION |
76700 |
$1516.14 |
HCPCS / CPT® |
US ABDOMINAL COMPLETE |
76705 |
$1347.51 |
HCPCS / CPT® |
US ABDOMINAL LIMITED |
76706 |
$750.00 |
HCPCS / CPT® |
ULTRASOUND, ABDOMINAL AORTA, REAL TIME WITH IMAGE DOCUMENTATION, SCREENING STUDY FOR ABDOMINAL AORTIC ANEURYSM (AAA) |
76770 |
$1093.06 |
HCPCS / CPT® |
US RETROPERITONEAL COMPLETE |
76775 |
$983.77 |
HCPCS / CPT® |
US RETROPERITONEAL LIMITED |
76801 |
$952.06 |
HCPCS / CPT® |
ULTRASOUND 14 WK TABDL 1/1ST GESTATION |
76805 |
$1084.47 |
HCPCS / CPT® |
US PG UTER F&MAT AFTER 1ST TRI 1/1ST GESTATION |
76813 |
$245.52 |
HCPCS / CPT® |
US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION |
76815 |
$750.00 |
HCPCS / CPT® |
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED 1 OR MORE FETUSES |
76816 |
$468.22 |
HCPCS / CPT® |
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION |
76817 |
$789.51 |
HCPCS / CPT® |
US PG UTER R-T IMG TRVG |
76818 |
$356.00 |
HCPCS / CPT® |
FTL BIOPHYSICAL PROFILE NON-STRS TSTG |
76825 |
$1629.36 |
HCPCS / CPT® |
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; |
76830 |
$947.61 |
HCPCS / CPT® |
US TRVG |
76856 |
$1100.54 |
HCPCS / CPT® |
US PELVIC NONOB REAL-TIME IMG COMPLETE |
76857 |
$574.00 |
HCPCS / CPT® |
US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97 |
76870 |
$1000.01 |
HCPCS / CPT® |
US SCROTUM&CNTS |
76880 |
$1197.22 |
HCPCS / CPT® |
US EXTREMITY NON-VASC REAL-TIME IMG |
76881 |
$636.17 |
HCPCS / CPT® |
US EXTREMITY NON-VASC REAL-TIME IMG COMPL |
76882 |
$410.85 |
HCPCS / CPT® |
US EXTREMITY NON-VASC REAL-TIME IMG LMTD |
76942 |
$375.00 |
HCPCS / CPT® |
Ultrasonic guidance for needle placement |
77072 |
$409.64 |
HCPCS / CPT® |
X RAYS FOR BONE AGE |
77074 |
$750.00 |
HCPCS / CPT® |
X-RAY BONE SURVEY limited |
77079 |
$535.73 |
HCPCS / CPT® |
CT BONE MINERAL DENSITY STUDY 1+ SITS APPND |
78075 |
$4745.02 |
HCPCS / CPT® |
ADRNL IMG CORTEX&/MEDULLA |
78223 |
$3290.90 |
HCPCS / CPT® |
HIDA SCAN – HEPATBL DUX SYS IMG GLBLDR |
78306 |
$1888.82 |
HCPCS / CPT® |
B1&/JT IMG WHBDY |
78315 |
$1888.62 |
HCPCS / CPT® |
B1&/JT IMG 3 PHASE STD |
78320 |
$1211.05 |
HCPCS / CPT® |
B1&/JT IMG TOMOG SPECT |
78472 |
$2674.74 |
HCPCS / CPT® |
CARD BPI GTD =BRM PLNR 1 STD REST/STRS |
80047 |
$334.45 |
HCPCS / CPT® |
BASIC METABOLIC PANEL CALCIUM IONIZED |
80048 |
$353.58 |
HCPCS / CPT® |
BASIC METABOLIC PANEL CALCIUM TOTAL |
80051 |
$364.75 |
HCPCS / CPT® |
ELECTROLYTE PANEL |
80053 |
$1276.00 |
HCPCS / CPT® |
COMPRE METAB PANEL |
80061 |
$363.54 |
HCPCS / CPT® |
LIPID PANEL |
80074 |
$722.46 |
HCPCS / CPT® |
HEPATITIS PANEL |
80076 |
$372.34 |
HCPCS / CPT® |
HEPATC FUNCJ PANEL |
80100 |
$301.53 |
HCPCS / CPT® |
DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX |
80104 |
$482.16 |
HCPCS / CPT® |
DRUG SCREEN, QUALITATIVE MULTIPLE DRUG CLASSES OTHER THAN CHROMATOGRAPHIC METHOD |
80158 |
$243.52 |
HCPCS / CPT® |
Cyclosporine A Trough, Blood |
80164 |
$202.84 |
HCPCS / CPT® |
DIPROPYLACETIC ACID |
80178 |
$77.45 |
HCPCS / CPT® |
LITHIUM |
80185 |
$115.44 |
HCPCS / CPT® |
PHENYTOIN TOT |
80197 |
$459.20 |
HCPCS / CPT® |
TACROLIMUS |
80202 |
$300.01 |
HCPCS / CPT® |
VANCOMYCIN |
80305 |
$260.00 |
HCPCS / CPT® |
Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only |
80306 |
$275.00 |
HCPCS / CPT® |
UDS – DRUG SCREEN, PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; READ BY INSTRUMENT ASSISTED DIRECT OPTICAL OBSERVATION (i.e. DIPSTICKS) |
80307 |
$366.13 |
HCPCS / CPT® |
UDS – URINE DRUG SCREEN QUAL 1 DRUG CLASS METH EA DRUG CLASS |
80320 |
$264.80 |
HCPCS / CPT® |
ALCOHOL, ETHYL SERUM OR PLASMA |
80329 |
$289.29 |
HCPCS / CPT® |
ANALGESICS NON-OPIOID 1 OR 2 |
80435 |
$585.00 |
HCPCS / CPT® |
Insulin tolerance panel; for growth hormone deficiency |
81000 |
$168.37 |
HCPCS / CPT® |
URNLS DIP STICK/TABLET RGNT NON-AUTO MIC |
81001 |
$111.73 |
HCPCS / CPT® |
URINALYSIS – URNLS DIP STICK/TABLET RGNT AUTO MIC |
81002 |
$168.37 |
HCPCS / CPT® |
URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC |
81003 |
$301.00 |
HCPCS / CPT® |
URINALYSIS DIP STICK/TABLET REAGENT AUTO W/O MIC |
81005 |
$12.08 |
HCPCS / CPT® |
URNLS QUAL/SEMIQUAN XCPT IAS |
81020 |
$20.55 |
HCPCS / CPT® |
URNLS 2/3 GLASS TST |
81025 |
$124.12 |
HCPCS / CPT® |
URINE PREGNANCY TST VIS COLOR CMPRSN METHS |
81240 |
$315.00 |
HCPCS / CPT® |
F2 (PROTHROMBIN, COAGULATION FACTOR II) GENE ANALYSIS, 20210G A VARIANT |
81241 |
$380.00 |
HCPCS / CPT® |
F5 (COAGULATION FACTOR V) GENE ANALYSIS, LEIDEN VARIANT |
81291 |
$250.00 |
HCPCS / CPT® |
MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) |
82009 |
$34.16 |
HCPCS / CPT® |
Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative |
82010 |
$162.89 |
HCPCS / CPT® |
ACETONE/OTH KETONE BODIES SERUM QUAN |
82040 |
$42.88 |
HCPCS / CPT® |
ASSAY OF SERUM ALBUMIN |
82075 |
$132.09 |
HCPCS / CPT® |
ALCOHOL BRTH |
82103 |
$250.00 |
HCPCS / CPT® |
Alpha-1-antitrypsin; total |
82105 |
$131.67 |
HCPCS / CPT® |
ALPHA-FETOPROTEIN SERUM |
82140 |
$275.00 |
HCPCS / CPT® |
AMMONIA ASSAY |
82150 |
$275.52 |
HCPCS / CPT® |
AMYLASE |
82164 |
$79.20 |
HCPCS / CPT® |
ANGIOTENSIN I-CONVERTING ENZYME |
82247 |
$102.17 |
HCPCS / CPT® |
BILIRUBIN TOTAL |
82270 |
$265.32 |
HCPCS / CPT® |
BLD OCLT PROXIDASE ACTV QUAL FECES 1 DETER |
82271 |
$25.76 |
HCPCS / CPT® |
BLOOD, OCCULT, BY PEROXIDASE ACTIVITY EG, GUAIAC, QUALITATIVE OTHER SOURCES |
82272 |
$153.06 |
HCPCS / CPT® |
BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC |
82274 |
$102.80 |
HCPCS / CPT® |
BLD OCLT FECAL HGB DETER IA QUAL FECES 1-3 |
82306 |
$36.63 |
HCPCS / CPT® |
Vitamin D 25 Hydroxy |
82310 |
$116.13 |
HCPCS / CPT® |
ASSAY OF CALCIUM |
82330 |
$125.00 |
HCPCS / CPT® |
IONIZED CALCIUM |
82374 |
$550.84 |
HCPCS / CPT® |
ASSAY BLOOD CARBON DIOXIDE |
82376 |
$33.40 |
HCPCS / CPT® |
CARBOXYHEMOGLOBIN QUALITATIVE |
82435 |
$127.95 |
HCPCS / CPT® |
ASSAY OF BLOOD CHLORIDE |
82465 |
$139.05 |
HCPCS / CPT® |
CHOLESTEROL SERUM/WHL BLD TOT |
82491 |
$65.14 |
HCPCS / CPT® |
CHROM QUAN COLUMN 1 ANAL NES |
82533 |
$150.00 |
HCPCS / CPT® |
CORTISOL; TOTAL |
82540 |
$89.55 |
HCPCS / CPT® |
CREATINE |
82541 |
$158.33 |
HCPCS / CPT® |
COL-CHR/MS QUAL 1 STATIONARY&MOBILE PHASE |
82550 |
$410.98 |
HCPCS / CPT® |
CREATINE KINASE TOT |
82553 |
$603.75 |
HCPCS / CPT® |
CKMB – CREATINE KINASE MB FXJ ONLY |
82554 |
$267.72 |
HCPCS / CPT® |
CREATINE KINASE ISOFORMS |
82565 |
$191.34 |
HCPCS / CPT® |
CREATININE BLD |
82608 |
$250.47 |
HCPCS / CPT® |
CYANOCOBALAMIN UNSAT BNDNG CAP |
82652 |
$285.00 |
HCPCS / CPT® |
VIT D 1 25-DIHYDROXY |
82705 |
$48.11 |
HCPCS / CPT® |
FAT/LIPIDS FECES QUAL |
82784 |
$112.20 |
HCPCS / CPT® |
GAMMAGLOBULIN IGA IGD IGG IGM EACH |
82787 |
$91.87 |
HCPCS / CPT® |
GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES |
82800 |
$170.67 |
HCPCS / CPT® |
GASES BLD PH ONLY |
82803 |
$501.68 |
HCPCS / CPT® |
GASES BLD PH CALCULATED O2 SATURATION |
82805 |
$257.47 |
HCPCS / CPT® |
GASES BLD PH DIR MEAS XCPT PLS OXIMTRY |
82810 |
$47.52 |
HCPCS / CPT® |
GASES BLD O2 SATURATION ONLY DIR MEAS |
82945 |
$105.00 |
HCPCS / CPT® |
Glucose, body fluid, other than blood |
82947 |
$144.23 |
HCPCS / CPT® |
GLUC QUAN BLD |
82948 |
$101.27 |
HCPCS / CPT® |
GLUCOSE BLOOD REAGENT STRIP |
82962 |
$90.31 |
HCPCS / CPT® |
GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE |
82969 |
$165.83 |
HCPCS / CPT® |
Etiocholanolone |
82977 |
$101.27 |
HCPCS / CPT® |
GGT – GLUTAMYLTRASE GAMMA |
82985 |
$85.00 |
HCPCS / CPT® |
Glycated protein |
83036 |
$84.38 |
HCPCS / CPT® |
HEMOGLOBIN GLYCOSYLATED (A1C) |
83090 |
$125.00 |
HCPCS / CPT® |
HOMOCYSTEINE |
83516 |
$65.00 |
HCPCS / CPT® |
Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method |
83520 |
$188.12 |
HCPCS / CPT® |
IMMUNOASSAY ANALYTE QUANTITATIVE NOS |
83540 |
$165.00 |
HCPCS / CPT® |
ASSAY OF IRON |
83550 |
$165.00 |
HCPCS / CPT® |
IRON BINDING TEST |
83605 |
$116.13 |
HCPCS / CPT® |
LACTATE |
83615 |
$53.95 |
HCPCS / CPT® |
LACTATE DEHYDROGENASE LD ISOENZYME PANEL |
83690 |
$191.34 |
HCPCS / CPT® |
LIPASE |
83721 |
$150.00 |
HCPCS / CPT® |
Lipoprotein, direct measurement; LDL cholesterol |
83735 |
$206.64 |
HCPCS / CPT® |
MAGNESIUM |
83872 |
$225.01 |
HCPCS / CPT® |
ASSAY SYNOVIAL FLUID MUCIN |
83874 |
$414.00 |
HCPCS / CPT® |
MYOGLOBIN |
83880 |
$420.93 |
HCPCS / CPT® |
BNP – B TYPE NATRIURETIC PEPTIDE |
84075 |
$44.60 |
HCPCS / CPT® |
ASSAY ALKALINE PHOSPHATASE |
84132 |
$170.74 |
HCPCS / CPT® |
POTASSIUM SERUM PLASMA/WHOLE BLOOD |
84144 |
$199.32 |
HCPCS / CPT® |
PROGST |
84152 |
$102.52 |
HCPCS / CPT® |
PRST8 SPEC AG CPLXED DIR MEAS |
84153 |
$140.00 |
HCPCS / CPT® |
ASSAY OF PSA TOTAL |
84155 |
$38.25 |
HCPCS / CPT® |
ASSAY OF PROTEIN SERUM |
84157 |
$34.06 |
HCPCS / CPT® |
PROTEIN TOT XCPT REFRACTOMETRY OTH SRC |
84166 |
$80.00 |
HCPCS / CPT® |
PROTEIN E-PHORESIS-URINE-CSF |
84295 |
$133.80 |
HCPCS / CPT® |
ASSAY OF SERUM SODIUM |
84402 |
$190.00 |
HCPCS / CPT® |
TESTOSTERONE FREE |
84403 |
$195.00 |
HCPCS / CPT® |
TESTOSTERONE; TOTAL |
84410 |
$395.00 |
HCPCS / CPT® |
TESTOSTERONE BIOAVAILABLE |
84436 |
$220.00 |
HCPCS / CPT® |
THYROXINE TOT |
84439 |
$210.00 |
HCPCS / CPT® |
THYROXINE FR |
84442 |
$153.78 |
HCPCS / CPT® |
THYROXINE BINDING GLOBULIN TBG |
84443 |
$345.00 |
HCPCS / CPT® |
TSH – THYR STIMULATING HORM |
84445 |
$225.00 |
HCPCS / CPT® |
THYROID STIMULATING IMMUNE GLOBULINS TSI |
84450 |
$195.82 |
HCPCS / CPT® |
TRANSFERASE (AST) (SGOT) |
84460 |
$195.82 |
HCPCS / CPT® |
ALANINE AMINO (ALT) (SGPT) |
84479 |
$285.64 |
HCPCS / CPT® |
THYR HORM UPTK/THYR HORM BNDNG RATIO |
84481 |
$267.87 |
HCPCS / CPT® |
Triiodothyronine T3 |
84482 |
$175.00 |
HCPCS / CPT® |
TRIIODOTHYRONINE T3 REVERSE |
84484 |
$593.40 |
HCPCS / CPT® |
TROPONIN QUAN |
84512 |
$202.43 |
HCPCS / CPT® |
TROPONIN QUAL |
84520 |
$166.86 |
HCPCS / CPT® |
UREA N QUAN |
84550 |
$197.45 |
HCPCS / CPT® |
URIC ACID BLD |
84560 |
$179.54 |
HCPCS / CPT® |
URIC ACID OTH SRC |
84702 |
$273.76 |
HCPCS / CPT® |
GONAD CHORNC QUAN |
84703 |
$278.58 |
HCPCS / CPT® |
SERUM HCG – QUALITATIVE |
84704 |
$130.35 |
HCPCS / CPT® |
GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN |
85014 |
$133.62 |
HCPCS / CPT® |
BLD# HEMATOCRIT |
85018 |
$133.62 |
HCPCS / CPT® |
BLD# HGB |
85025 |
$503.25 |
HCPCS / CPT® |
CBC BLOOD COMPLETE AUTO WITH AUTO DIFFERENTIAL |
85027 |
$194.40 |
HCPCS / CPT® |
BLD# COMPL AUTO HHRWP |
85032 |
$199.84 |
HCPCS / CPT® |
BLD# MNL C-CNT RBC WBC/PLTLT EA |
85044 |
$131.18 |
HCPCS / CPT® |
BLD# RETICULOCYTE MNL |
85046 |
$42.19 |
HCPCS / CPT® |
Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [CHr], immature reticulocyte fraction [IRF] |
85060 |
$91.08 |
HCPCS / CPT® |
BLD SMR PRPH INTERPJ PHYS WRTTN REPRT |
85347 |
$46.31 |
HCPCS / CPT® |
COAGJ TM ACTIVATED |
85378 |
$197.16 |
HCPCS / CPT® |
D-DIMER – FIBRIN DGRADJ PRODUXS D-DIMER QUAL/SEMIQUAN |
85379 |
$413.72 |
HCPCS / CPT® |
FIBRIN DGRADJ PRODUXS D-DIMER QUAN |
85380 |
$427.52 |
HCPCS / CPT® |
FIBRIN DGRADJ PRODUXS D-DIMER ULTRSENS |
85415 |
$91.08 |
HCPCS / CPT® |
FIBRINOLYTIC FACTORS AND INHIBITORS PLASMINOGEN ACTIVATOR |
85610 |
$225.01 |
HCPCS / CPT® |
PT – PROTHROMBIN TIME |
85651 |
$191.34 |
HCPCS / CPT® |
SEDIMENTATION RATE RBC NON-AUTO |
85652 |
$122.39 |
HCPCS / CPT® |
SEDIMENTATION RATE RBC AUTO |
85730 |
$212.29 |
HCPCS / CPT® |
THROMBOPLASTIN TM PRTL PLSM/WHL BLD |
86003 |
$285.20 |
HCPCS / CPT® |
ALLERGEN SPECIFIC IGE |
86038 |
$125.00 |
HCPCS / CPT® |
ANTINUCLEAR ANTIBODIES |
86039 |
$75.15 |
HCPCS / CPT® |
ANA TITER |
86140 |
$28.98 |
HCPCS / CPT® |
C-REACTIVE PROTEIN |
86148 |
$135.00 |
HCPCS / CPT® |
ANTI-PHOSPHOLIPID ANTIBODY |
86304 |
$212.96 |
HCPCS / CPT® |
IMMUNOASSAY TUMOR CA 125 |
86308 |
$139.06 |
HCPCS / CPT® |
MONO – HTROPHL ANTIBODIES SCR |
86325 |
$244.90 |
HCPCS / CPT® |
IMMUNOELECTROPHORESIS OTH FLUS CONCENTRATION |
86376 |
$250.00 |
HCPCS / CPT® |
Microsomal antibodies (eg, thyroid or liver-kidney), each |
86403 |
$174.85 |
HCPCS / CPT® |
PART AGGLUJ SCR EA ANTB |
86430 |
$96.82 |
HCPCS / CPT® |
RHEUMATOID FACTOR QUAL |
86431 |
$175.00 |
HCPCS / CPT® |
LUPUS PANEL |
86480 |
$208.17 |
HCPCS / CPT® |
TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFER |
86486 |
$19.80 |
HCPCS / CPT® |
SKIN TEST UNLISTED ANTIGEN EACH |
86580 |
$22.97 |
HCPCS / CPT® |
SKN TST TUBERCULOSIS ID |
86592 |
$50.00 |
HCPCS / CPT® |
RPR SYPHILIS TEST QUAL |
86593 |
$90.00 |
HCPCS / CPT® |
SYPHILLIS TEST,NON-TREPONEMAL ANTIBODY, QUANTITATIVE |
86611 |
$43.56 |
HCPCS / CPT® |
ANTB BARTONELLA |
86617 |
$98.20 |
HCPCS / CPT® |
Lyme Disease Ab with Reflex to Blot |
86625 |
$225.00 |
HCPCS / CPT® |
CAMPYLOBACTER ANTIBODY |
86631 |
$170.75 |
HCPCS / CPT® |
ANTB CHLAMYDIA |
86641 |
$225.00 |
HCPCS / CPT® |
Cryptococcus AG |
86663 |
$322.12 |
HCPCS / CPT® |
ANTB EPSTEIN-BARR EB VIRUS EARLY AG EA |
86666 |
$125.00 |
HCPCS / CPT® |
EHRLICHIA ANTIBODY |
86677 |
$126.19 |
HCPCS / CPT® |
Antibody; Helicobacter pylori |
86689 |
$281.64 |
HCPCS / CPT® |
ANTB HTLV/HIV ANTB CONFIRMATORY TST |
86694 |
$82.80 |
HCPCS / CPT® |
ANTB HERPES SMPLX NON-SPEC TYP TST |
86695 |
$150.00 |
HCPCS / CPT® |
ANTIBODY; HERPES SIMPLEX, TYPE 1 |
86696 |
$150.00 |
HCPCS / CPT® |
ANTIBODY; HERPES SIMPLEX, TYPE 2 |
86701 |
$189.80 |
HCPCS / CPT® |
ANTB HIV-1 |
86702 |
$231.00 |
HCPCS / CPT® |
ANTB HIV-2 |
86703 |
$75.24 |
HCPCS / CPT® |
ANTB HIV-1&HIV-2 1 ASSAY |
86710 |
$187.51 |
HCPCS / CPT® |
ANTB INF VIRUS |
86747 |
$175.00 |
HCPCS / CPT® |
PARVOVIRUS B19 |
86756 |
$187.51 |
HCPCS / CPT® |
RSV ANTB |
86757 |
$125.00 |
HCPCS / CPT® |
Antibody; Rickettsia |
86759 |
$264.92 |
HCPCS / CPT® |
ANTB ROTAVIRUS |
86780 |
$180.00 |
HCPCS / CPT® |
ANTIBODY; TREPONEMA PALLIDUM |
86787 |
$172.90 |
HCPCS / CPT® |
ANTB VARICELLA-ZOSTER |
86789 |
$134.57 |
HCPCS / CPT® |
ANTIBODY WEST NILE VIRUS |
86794 |
$225.00 |
HCPCS / CPT® |
ZIKA VIRUS ANTIBODY (IGM) |
86800 |
$225.00 |
HCPCS / CPT® |
THYROGLOBULIN ANTIBODY |
86803 |
$140.69 |
HCPCS / CPT® |
Hepatitis C antibody |
86812 |
$165.00 |
HCPCS / CPT® |
HLA B27 TYPING A B OR C |
86850 |
$248.73 |
HCPCS / CPT® |
ANTB SCR RBC EA SERUM TQ |
86900 |
$186.14 |
HCPCS / CPT® |
BLD TYPING ABO |
86901 |
$112.96 |
HCPCS / CPT® |
BLD TYPING RH D |
86906 |
$112.96 |
HCPCS / CPT® |
BLD TYPING RH PHEXYPING COMPL |
87040 |
$345.00 |
HCPCS / CPT® |
BLOOD CULTURE – CUL BACT BLD AERC ISOL |
87045 |
$336.74 |
HCPCS / CPT® |
CUL BACT STL AERC ISOL SALMONELLA&SHIGELLA |
87046 |
$184.14 |
HCPCS / CPT® |
CUL BACT STL AERC ADDL PATHOGENS&ID EA |
87070 |
$250.00 |
HCPCS / CPT® |
WOUND CULTURE – CULTURE BACTERIAL EXCPT URINE, BLOOD, STOOL AEROBIC ISOLATED |
87075 |
$375.02 |
HCPCS / CPT® |
CUL BACT BLD ANAERC ISOL |
87077 |
$73.33 |
HCPCS / CPT® |
CULTURE AEROBIC IDENTIFY |
87081 |
$265.25 |
HCPCS / CPT® |
STREP CULTURE PRESUMPTIVE PATHOGENIC ORGANISMS SCREENING |
87086 |
$265.00 |
HCPCS / CPT® |
CUL BACT QUAN COLONY CNT URINE |
87088 |
$52.35 |
HCPCS / CPT® |
CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE |
87106 |
$207.97 |
HCPCS / CPT® |
CUL FNGI DEFINITIVE ID EA ORGANISM YEAST |
87110 |
$350.00 |
HCPCS / CPT® |
CUL CHLAMYDIA ANY SRC |
87177 |
$120.00 |
HCPCS / CPT® |
OVA PARASITES DIRECT SMEARS CONCENTRATION&ID |
87205 |
$191.40 |
HCPCS / CPT® |
SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL |
87207 |
$191.43 |
HCPCS / CPT® |
SMR PRIM SRC SPEC STAIN BODIES/PARASITS |
87209 |
$150.00 |
HCPCS / CPT® |
Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites |
87210 |
$120.62 |
HCPCS / CPT® |
SMR PRIM SRC WET MOUNT NFCT AGT |
87230 |
$175.00 |
HCPCS / CPT® |
TOXIN OR ANTITOXIN ASSAY, TISSUE CULTURE EG, CLOSTRIDIUM DIFFICILE TOXIN |
87252 |
$86.57 |
HCPCS / CPT® |
Herpes simplex/Varicella |
87273 |
$99.56 |
HCPCS / CPT® |
HERPES SIMPLEX 2 AG |
87274 |
$99.56 |
HCPCS / CPT® |
Infectious agent antigen detection by |
87324 |
$310.50 |
HCPCS / CPT® |
IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN |
87329 |
$180.00 |
HCPCS / CPT® |
IAA DETECTION BY IMMUNOASSAY,QUAL OR SEMIQUAL, GIARDIA |
87332 |
$192.06 |
HCPCS / CPT® |
IAAD EIA CMV |
87389 |
$270.00 |
HCPCS / CPT® |
Infectious agent antigen detection by enzyme immunoassay technique, HIV 1-2, multiple-step method; |
87390 |
$163.88 |
HCPCS / CPT® |
IAAD EIA HIV-1 |
87400 |
$228.07 |
HCPCS / CPT® |
INFLUENZA A OR B – IAAD EIA INF/B EA |
87420 |
$129.18 |
HCPCS / CPT® |
IAAD EIA RSV |
87425 |
$264.92 |
HCPCS / CPT® |
IAAD EIA ROTAVIRUS |
87430 |
$307.21 |
HCPCS / CPT® |
IAAD EIA STREPTOCOCCUS GROUP A |
87491 |
$240.00 |
HCPCS / CPT® |
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID DNA OR RNA CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECHNIQUE |
87493 |
$258.68 |
HCPCS / CPT® |
INF AGENT DET NUC ACID CLOSTRIDIUM AMP PROBE |
87507 |
$3500.00 |
HCPCS / CPT® |
IA DETECT BY NUCLEIC ACID GI PATHOGEN – DNA/RNA PROBE TQ 12-25 |
87528 |
$315.09 |
HCPCS / CPT® |
IADNA HERPES SMPLX VIRUS DIR PRB |
87530 |
$322.22 |
HCPCS / CPT® |
IADNA HERPES SOMPLX VIRUS QUANTIFICATION |
87591 |
$240.00 |
HCPCS / CPT® |
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE. AMPLIFIED PROBE TECHNIQUE |
87635 |
$389.00 |
HCPCS / CPT® |
Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique |
87798 |
$534.96 |
HCPCS / CPT® |
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified, Norovirus |
87804 |
$225.00 |
HCPCS / CPT® |
INFLUENZA TEST; EACH A AND B |
87807 |
$55.11 |
HCPCS / CPT® |
IAADIADOO RSV |
87808 |
$47.52 |
HCPCS / CPT® |
Infectious agent antigen detection by immunoassay with direct optical observation; Trichomonas vaginalis |
87850 |
$175.00 |
HCPCS / CPT® |
IAADIADOO NEISSERIA GONORRHOEAE |
87880 |
$190.00 |
HCPCS / CPT® |
STREP TEST; RAPID |
89050 |
$50.00 |
HCPCS / CPT® |
BODY FLUID CELL COUNT |
89051 |
$51.15 |
HCPCS / CPT® |
C-CNT MISC BDY FLUS XCPT BLD DIFFIAL CNT |
89055 |
$40.00 |
HCPCS / CPT® |
WBC ASSMT FECAL QUAL/SEMIQUAN |
89060 |
$75.32 |
HCPCS / CPT® |
CRYSTAL ID LIGHT MIC ALYS TISSUE/ANY FLU |
89220 |
$127.81 |
HCPCS / CPT® |
SPTM OBTG SPEC AERSL INDUCED SPX |
90470 |
$79.20 |
HCPCS / CPT® |
H1N1 IMMUNIZATION ADMINISTRATION (INTRAMUSCULAR, INTRANASAL), INCLUDING COUNSELING WHEN PERFORMED |
90471 |
$110.00 |
HCPCS / CPT® |
Immunization administration; 1 vaccine |
90472 |
$5.75 |
HCPCS / CPT® |
IMADM PRQ ID SUBQ/IM NJXS EA VACC |
90658 |
$177.10 |
HCPCS / CPT® |
INFLUENZA VIRUS VACCINE SPLIT VIRUS 3 YEARS + IM |
90660 |
$91.84 |
HCPCS / CPT® |
INFLUENZA VIRUS VACCINE LIVE INTRANASAL |
90662 |
$79.20 |
HCPCS / CPT® |
INFLUENZA VACCINE SPLT PRSRV FREE INC ANTIGEN IM |
90665 |
$158.40 |
HCPCS / CPT® |
LYME DISEASE VACCINE ADULT IM |
90675 |
$254.30 |
HCPCS / CPT® |
RABIES VACCINE INTRAMUSCULAR |
90703 |
$198.93 |
HCPCS / CPT® |
TETANUS TOXOID ADSORBED INTRAMUSCULAR |
90707 |
$249.11 |
HCPCS / CPT® |
MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ |
90714 |
$188.48 |
HCPCS / CPT® |
TD VACCINE NO PRSV 7 IM |
90715 |
$193.33 |
HCPCS / CPT® |
TDAP VACCINE 7 YR + IM |
90716 |
$85.80 |
HCPCS / CPT® |
VARICELLA VIRUS VACCINE LIVE SUBQ |
90718 |
$198.93 |
HCPCS / CPT® |
TD – TETANUS & DIPHTHERIA TOXOIDS ADSORBED 7 YR + IM |
90746 |
$104.06 |
HCPCS / CPT® |
HEPATITIS B VACCINE ADULT DOSAGE INTRAMUSCULAR |
90885 |
$580.00 |
HCPCS / CPT® |
Psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes |
90997 |
$535.73 |
HCPCS / CPT® |
HEMOPERFUSION |
92950 |
$1280.09 |
HCPCS / CPT® |
CARDIOPULM RESUSCITATION |
92960 |
$1427.56 |
HCPCS / CPT® |
CARDIOVERSION ELECTIVE ARRHYT XTRNL |
93000 |
$324.50 |
HCPCS / CPT® |
ECG ROUTINE ECG W/LEAST 12 LDS W/I&R |
93005 |
$343.56 |
HCPCS / CPT® |
Electrocardiogram, routine ECG with at least 12 leads |
93010 |
$197.16 |
HCPCS / CPT® |
ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY EKG |
93041 |
$191.34 |
HCPCS / CPT® |
Rhythm ECG, 1-3 leads |
93042 |
$164.40 |
HCPCS / CPT® |
RHYTHM ECG, 1-3 LEADS; INTERPRETATION AND REPORT ONLY |
93224 |
$194.55 |
HCPCS / CPT® |
WEARABLE ECG 24 HR W/VIS SUPIMPOS SCAN PHYS R&I |
93303 |
$2076.26 |
HCPCS / CPT® |
COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY |
93306 |
$2969.08 |
HCPCS / CPT® |
ECHO TTHRC R-T 2D SPEC&COLOR DOP |
93307 |
$1400.52 |
HCPCS / CPT® |
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography |
93308 |
$1401.31 |
HCPCS / CPT® |
TTHRC R-T IMG 2D +-M-MODE REC F-UP/LMTD |
93312 |
$1334.32 |
HCPCS / CPT® |
TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R |
93313 |
$3442.89 |
HCPCS / CPT® |
TEE R-T IMG 2D W/PROBE PLMT ONLY |
93320 |
$449.33 |
HCPCS / CPT® |
DOPPLER ECHO COMPLETE |
93351 |
$2046.33 |
HCPCS / CPT® |
ECHO TTHRC R-T 2D -+M-MODE REST&STRS CONT ECG |
93875 |
$1102.07 |
HCPCS / CPT® |
N-INVAS PHYSIOLOGIC STD XTRC ART COMPL BI STD |
93880 |
$1275.00 |
HCPCS / CPT® |
ULTRASOUND CAROTID DUPLEX SCAN COMPLETE BILATERAL STUDY |
93882 |
$1184.72 |
HCPCS / CPT® |
DUP-SCAN XTRC ART UNI/LMTD STD |
93926 |
$1151.05 |
HCPCS / CPT® |
DOPPLER – DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD |
93931 |
$612.26 |
HCPCS / CPT® |
DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STD |
93965 |
$2369.45 |
HCPCS / CPT® |
N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD |
93970 |
$1639.32 |
HCPCS / CPT® |
DUP-SCAN XTR VEINS COMPL BI STD |
93971 |
$844.92 |
HCPCS / CPT® |
ULTRASOUND VENOUS DOPPLER UNILATERAL LIMITED STUDY DUPLEX SCAN |
93976 |
$1100.00 |
HCPCS / CPT® |
ULTRASOUND PELVIC SCROTALCONTENTS AND OR RETROPERITONEAL; LIMITED STUDY |
93980 |
$1021.28 |
HCPCS / CPT® |
PENILE VASCULAR STUDY |
94010 |
$1387.50 |
HCPCS / CPT® |
SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY |
94150 |
$158.40 |
HCPCS / CPT® |
VC TOT SPX |
94621 |
$1349.73 |
HCPCS / CPT® |
PULM STRS TSTG CPLX |
94640 |
$765.60 |
HCPCS / CPT® |
NEBULIZER TREATMENT AIRWAY INHALATION TREATMENT – PRESS/N-PRESS INHLJ TX F/AAO/SPTM INDCTJ |
94644 |
$207.15 |
HCPCS / CPT® |
INHALATION TREATMENT – CONTINUOUS 1ST HR |
94645 |
$125.00 |
HCPCS / CPT® |
Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour |
94660 |
$1125.00 |
HCPCS / CPT® |
CONTINUOUS POSITIVE AIRWAY PRESSURE VENTILATION CPAP, INITIATION AND MANAGEMENT |
94760 |
$150.00 |
HCPCS / CPT® |
PULSE OXIMETRY – O2 SATURATION LEVELS – SINGLE |
94761 |
$315.00 |
HCPCS / CPT® |
PULSE OXIMETRY – O2 SATURATION LEVELS – MULTIPLE |
96360 |
$1050.00 |
HCPCS / CPT® |
IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR |
96361 |
$306.13 |
HCPCS / CPT® |
IV INFUSION HYDRATION EACH ADDITIONAL HOUR |
96365 |
$1050.00 |
HCPCS / CPT® |
IV INFUSION THERAPY 1ST HOUR |
96366 |
$304.60 |
HCPCS / CPT® |
IV INFUSION THERAPY, EACH ADDL HOUR |
96367 |
$344.40 |
HCPCS / CPT® |
IV INFUSION THERAPY, ADDL SEQUENTIAL INFUSION OF NEW MED 1ST HR |
96368 |
$329.10 |
HCPCS / CPT® |
IV INFUSION THERAPY, CONCURRENT IV INFUSION OF DIFFERENT MED |
96372 |
$217.29 |
HCPCS / CPT® |
INJECTION, INTRAMUSCULAR OR SUBCUTANEOUS |
96373 |
$298.83 |
HCPCS / CPT® |
INJECTION, INTRA-ARTERIAL |
96374 |
$1050.00 |
HCPCS / CPT® |
IV PUSH 1ST DRUG, THERAPEUTIC, DIAGNOSITIC MEDICATION |
96375 |
$266.33 |
HCPCS / CPT® |
IV PUSH EACH ADD’L DRUG, THERAPEUTIC, DIAGNOSITIC, PROPHYLACTIC |
96376 |
$289.29 |
HCPCS / CPT® |
IV PUSH EACH OF SAME DRUG, THERAPEUTIC, DIAGNOSITIC, PROPHYLACTIC |
96379 |
$279.04 |
HCPCS / CPT® |
INJECTION – UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS |
97116 |
$186.42 |
HCPCS / CPT® |
THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING) |
97597 |
$150.00 |
HCPCS / CPT® |
REMOVAL DEVITALIZED TISSUE 20 CM OR LESS |
97760 |
$250.00 |
HCPCS / CPT® |
ORTHOTIC TRAINING |
99000 |
$25.74 |
HCPCS / CPT® |
HANDLING OR CONVEYANCE OF SPECIMEN FOR TRNSFR FROM OFFICE TO LAB |
99001 |
$60.00 |
HCPCS / CPT® |
HANDLING OR CONVEYANCE OF SPECIMEN FOR TRNSFR FROM PT TO LAB |
99024 |
$100.00 |
HCPCS / CPT® |
FOLLOW-UP VISIT |
99053 |
$200.00 |
HCPCS / CPT® |
SERVICES PROVIDED BETWEEN 10 PM AND 8 AM AT A 24 HR FACILITY |
99070 |
$69.18 |
HCPCS / CPT® |
SUPPLIES&MATERIALS PRV BY PHYS >&ABOVE |
99143 |
$575.53 |
HCPCS / CPT® |
M-SEDATJ BY SM PHYS PERFRMG SVC < 5 YR |
99144 |
$569.40 |
HCPCS / CPT® |
ANESTHESIA – M-SEDAJ BY SM PHYS PERFRMG SVC 5+ YR |
99145 |
$221.95 |
HCPCS / CPT® |
M-SEDAJ BY SM PHYS PERFRMG SVC EA 15 MIN |
99148 |
$191.27 |
HCPCS / CPT® |
M-SEDATION BY PHYS OTH/THN HC PROF PERFRMG < 5 |
99149 |
$476.03 |
HCPCS / CPT® |
M-SEDATION BY PHYS OTH/THN HC PROF PERFRMG 5+ |
99150 |
$413.94 |
HCPCS / CPT® |
MOD SED DIFF PHYS/QHP ADD ON |
99152 |
$475.80 |
HCPCS / CPT® |
MOD SED SAME PHYS/QHP OVER 5 YRS OF AGE |
99153 |
$563.49 |
HCPCS / CPT® |
MOD SED SAME PHYS/QHP EA |
99173 |
$382.66 |
HCPCS / CPT® |
VISUAL ACUITY SCREENING |
99235 |
$2226.40 |
HCPCS / CPT® |
EMERGENCY ROOM GENERAL CLASSIFICATION |
99244 |
$401.28 |
HCPCS / CPT® |
OFFICE CONSLTJ 60 MIN |
99281 |
$422.88 |
HCPCS / CPT® |
EVALUATION AND MANAGEMENT – LEVEL 1 |
99282 |
$825.00 |
HCPCS / CPT® |
EVALUATION AND MANAGEMENT – LEVEL 2 |
99283 |
$1336.04 |
HCPCS / CPT® |
EVALUATION AND MANAGEMENT – LEVEL 3 |
99284 |
$2000.00 |
HCPCS / CPT® |
EVALUATION AND MANAGEMENT – LEVEL 4 |
99285 |
$3500.00 |
HCPCS / CPT® |
EVALUATION AND MANAGEMENT – LEVEL 5 |
99291 |
$4278.65 |
HCPCS / CPT® |
CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN |
99292 |
$1023.04 |
HCPCS / CPT® |
CC E/M CRITICALLY ILL/INJURED EA 30 MIN |
99354 |
$500.00 |
HCPCS / CPT® |
Prolonged E/M (beyond the typical service time of the primary procedure) in an outpatient setting requiring direct patient contact beyond the usual service; first hour |
99406 |
$106.43 |
HCPCS / CPT® |
TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES |
999999 |
$61.23 |
HCPCS / CPT® |
RETURN CHECK FEE |
A0021 |
$0.00 |
HCPCS / CPT® |
OUTSIDE STATE AMBULANCE SERV |
A0080 |
$0.00 |
HCPCS / CPT® |
NONINTEREST ESCORT IN NON ER |
A0090 |
$0.00 |
HCPCS / CPT® |
INTEREST ESCORT IN NON ER |
A0100 |
$0.00 |
HCPCS / CPT® |
NONEMERGENCY TRANSPORT TAXI |
A0110 |
$0.00 |
HCPCS / CPT® |
NONEMERGENCY TRANSPORT BUS |
A0120 |
$0.00 |
HCPCS / CPT® |
NONER TRANSPORT MINI-BUS |
A0130 |
$0.00 |
HCPCS / CPT® |
NONER TRANSPORT WHEELCH VAN |
A0140 |
$0.00 |
HCPCS / CPT® |
NONEMERGENCY TRANSPORT AIR |
A0160 |
$0.00 |
HCPCS / CPT® |
NONER TRANSPORT CASE WORKER |
A0170 |
$0.00 |
HCPCS / CPT® |
TRANSPORT PARKING FEES/TOLLS |
A0180 |
$0.00 |
HCPCS / CPT® |
NONER TRANSPORT LODGNG RECIP |
A0190 |
$0.00 |
HCPCS / CPT® |
NONER TRANSPORT MEALS RECIP |
A0200 |
$0.00 |
HCPCS / CPT® |
NONER TRANSPORT LODGNG ESCRT |
A0210 |
$0.00 |
HCPCS / CPT® |
NONER TRANSPORT MEALS ESCORT |
A0225 |
$0.00 |
HCPCS / CPT® |
NEONATAL EMERGENCY TRANSPORT |
A0380 |
$0.00 |
HCPCS / CPT® |
BASIC LIFE SUPPORT MILEAGE |
A0382 |
$0.00 |
HCPCS / CPT® |
BASIC SUPPORT ROUTINE SUPPLS |
A0384 |
$0.00 |
HCPCS / CPT® |
BLS DEFIBRILLATION SUPPLIES |
A0390 |
$0.00 |
HCPCS / CPT® |
ADVANCED LIFE SUPPORT MILEAG |
A0392 |
$0.00 |
HCPCS / CPT® |
ALS DEFIBRILLATION SUPPLIES |
A0394 |
$3.45 |
HCPCS / CPT® |
ALS IV DRUG THERAPY SUPPLIES |
A0396 |
$38.27 |
HCPCS / CPT® |
ALS ESOPHAGEAL INTUB SUPPLS |
A0398 |
$0.00 |
HCPCS / CPT® |
ALS ROUTINE DISPOSBLE SUPPLS |
A0420 |
$0.00 |
HCPCS / CPT® |
AMBULANCE WAITING 1/2 HR |
A0422 |
$0.00 |
HCPCS / CPT® |
AMBULANCE 02 LIFE SUSTAINING |
A0424 |
$0.00 |
HCPCS / CPT® |
EXTRA AMBULANCE ATTENDANT |
A0425 |
$0.00 |
HCPCS / CPT® |
GROUND MILEAGE |
A0426 |
$0.00 |
HCPCS / CPT® |
ALS 1 |
A0427 |
$0.00 |
HCPCS / CPT® |
ALS1-EMERGENCY |
A0428 |
$0.00 |
HCPCS / CPT® |
BLS |
A0429 |
$0.00 |
HCPCS / CPT® |
BLS-EMERGENCY |
A0430 |
$0.00 |
HCPCS / CPT® |
FIXED WING AIR TRANSPORT |
A0431 |
$0.00 |
HCPCS / CPT® |
ROTARY WING AIR TRANSPORT |
A0432 |
$0.00 |
HCPCS / CPT® |
PI VOLUNTEER AMBULANCE CO |
A0433 |
$0.00 |
HCPCS / CPT® |
ALS 2 |
A0434 |
$0.00 |
HCPCS / CPT® |
SPECIALTY CARE TRANSPORT |
A0435 |
$0.00 |
HCPCS / CPT® |
FIXED WING AIR MILEAGE |
A0436 |
$0.00 |
HCPCS / CPT® |
ROTARY WING AIR MILEAGE |
A0888 |
$0.00 |
HCPCS / CPT® |
NONCOVERED AMBULANCE MILEAGE |
A0998 |
$0.00 |
HCPCS / CPT® |
AMBULANCE RESPONSE/TREATMENT |
A0999 |
$0.00 |
HCPCS / CPT® |
UNLISTED AMBULANCE SERVICE |
A4206 |
$24.31 |
HCPCS / CPT® |
Syringe with needle, sterile, 1 cc or less, each |
A4207 |
$0.00 |
HCPCS / CPT® |
2 CC STERILE SYRINGE&NEEDLE |
A4208 |
$41.18 |
HCPCS / CPT® |
3 CC STERILE SYRINGE&NEEDLE |
A4209 |
$45.92 |
HCPCS / CPT® |
5+ CC STERILE SYRINGE&NEEDLE |
A4210 |
$0.00 |
HCPCS / CPT® |
NONNEEDLE INJECTION DEVICE |
A4211 |
$0.00 |
HCPCS / CPT® |
SUPP FOR SELF-ADM INJECTIONS |
A4212 |
$0.00 |
HCPCS / CPT® |
NON CORING NEEDLE OR STYLET |
A4213 |
$9.15 |
HCPCS / CPT® |
20+ CC SYRINGE ONLY |
A4215 |
$16.46 |
HCPCS / CPT® |
NEEDLE STERILE, ANY SIZE, EACH |
A4216 |
$4.59 |
HCPCS / CPT® |
STERILE WATER/SALINE, FLUSH 10 ML |
A4217 |
$34.90 |
HCPCS / CPT® |
STERILE WATER/SALINE, 500 ML |
A4218 |
$0.00 |
HCPCS / CPT® |
STERILE SALINE OR WATER |
A4220 |
$0.00 |
HCPCS / CPT® |
INFUSION PUMP REFILL KIT |
A4221 |
$185.08 |
HCPCS / CPT® |
MAINT DRUG INFUS CATH PER WK |
A4222 |
$367.39 |
HCPCS / CPT® |
INFUSION SUPPLIES WITH PUMP |
A4223 |
$0.00 |
HCPCS / CPT® |
INFUSION SUPPLIES W/O PUMP |
A4224 |
$0.00 |
HCPCS / CPT® |
SUPPLY INSULIN INF CATH/WK |
A4225 |
$0.00 |
HCPCS / CPT® |
SUP/EXT INSULIN INF PUMP SYR |
A4230 |
$0.00 |
HCPCS / CPT® |
INFUS INSULIN PUMP NON NEEDL |
A4231 |
$0.00 |
HCPCS / CPT® |
INFUSION INSULIN PUMP NEEDLE |
A4232 |
$0.00 |
HCPCS / CPT® |
SYRINGE W/NEEDLE INSULIN 3CC |
A4233 |
$0.00 |
HCPCS / CPT® |
ALKALIN BATT FOR GLUCOSE MON |
A4234 |
$0.00 |
HCPCS / CPT® |
J-CELL BATT FOR GLUCOSE MON |
A4235 |
$0.00 |
HCPCS / CPT® |
LITHIUM BATT FOR GLUCOSE MON |
A4236 |
$0.00 |
HCPCS / CPT® |
SILVR OXIDE BATT GLUCOSE MON |
A4244 |
$6.12 |
HCPCS / CPT® |
ALCOHOL OR PEROXIDE PER PINT |
A4245 |
$19.99 |
HCPCS / CPT® |
ALCOHOL WIPE |
A4246 |
$33.03 |
HCPCS / CPT® |
BETADINE/PHISOHEX SOLUTION |
A4247 |
$33.03 |
HCPCS / CPT® |
BETADINE/IODINE SWABS/WIPES |
A4248 |
$156.18 |
HCPCS / CPT® |
CHLORHEXIDINE ANTISEPT |
A4250 |
$10.00 |
HCPCS / CPT® |
URINE REAGENT STRIPS/TABLETS |
A4252 |
$10.00 |
HCPCS / CPT® |
GLUCOSE TEST STRIP – BLOOD KETONE TEST OR STRIP |
A4253 |
$0.00 |
HCPCS / CPT® |
BLOOD GLUCOSE/REAGENT STRIPS |
A4255 |
$0.00 |
HCPCS / CPT® |
GLUCOSE MONITOR PLATFORMS |
A4256 |
$0.00 |
HCPCS / CPT® |
CALIBRATOR SOLUTION/CHIPS |
A4257 |
$0.00 |
HCPCS / CPT® |
REPLACE LENSSHIELD CARTRIDGE |
A4258 |
$0.00 |
HCPCS / CPT® |
LANCET DEVICE EACH |
A4259 |
$0.00 |
HCPCS / CPT® |
LANCETS PER BOX |
A4260 |
$0.00 |
HCPCS / CPT® |
LEVONORGESTREL IMPLANT |
A4261 |
$0.00 |
HCPCS / CPT® |
CERVICAL CAP CONTRACEPTIVE |
A4262 |
$0.00 |
HCPCS / CPT® |
TEMPORARY TEAR DUCT PLUG |
A4263 |
$0.00 |
HCPCS / CPT® |
PERMANENT TEAR DUCT PLUG |
A4264 |
$0.00 |
HCPCS / CPT® |
INTRATUBAL OCCLUSION DEVICE |
A4265 |
$0.00 |
HCPCS / CPT® |
PARAFFIN |
A4266 |
$0.00 |
HCPCS / CPT® |
DIAPHRAGM |
A4267 |
$0.00 |
HCPCS / CPT® |
MALE CONDOM |
A4268 |
$0.00 |
HCPCS / CPT® |
FEMALE CONDOM |
A4269 |
$0.00 |
HCPCS / CPT® |
SPERMICIDE |
A4270 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE ENDOSCOPE SHEATH |
A4280 |
$0.00 |
HCPCS / CPT® |
BRST PRSTHS ADHSV ATTCHMNT |
A4281 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT BREASTPUMP TUBE |
A4282 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT BREASTPUMP ADPT |
A4283 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT BREASTPUMP CAP |
A4284 |
$0.00 |
HCPCS / CPT® |
REPLCMNT BREAST PUMP SHIELD |
A4285 |
$0.00 |
HCPCS / CPT® |
REPLCMNT BREAST PUMP BOTTLE |
A4286 |
$0.00 |
HCPCS / CPT® |
REPLCMNT BREASTPUMP LOK RING |
A4290 |
$0.00 |
HCPCS / CPT® |
SACRAL NERVE STIM TEST LEAD |
A4300 |
$55.83 |
HCPCS / CPT® |
IMPLANTABLE ACCESS CATHETER |
A4301 |
$0.00 |
HCPCS / CPT® |
IMPLANTABLE ACCESS SYST PERC |
A4305 |
$0.00 |
HCPCS / CPT® |
DRUG DELIVERY SYSTEM >=50 ML |
A4306 |
$0.00 |
HCPCS / CPT® |
DRUG DELIVERY SYSTEM <=50 ML |
A4310 |
$0.00 |
HCPCS / CPT® |
INSERT TRAY W/O BAG/CATH |
A4311 |
$45.92 |
HCPCS / CPT® |
CATHETER W/O BAG 2-WAY LATEX |
A4312 |
$0.00 |
HCPCS / CPT® |
CATH W/O BAG 2-WAY SILICONE |
A4313 |
$36.73 |
HCPCS / CPT® |
CATHETER W/BAG 3-WAY |
A4314 |
$16.84 |
HCPCS / CPT® |
CATH W/DRAINAGE 2-WAY LATEX |
A4315 |
$0.00 |
HCPCS / CPT® |
CATH W/DRAINAGE 2-WAY SILCNE |
A4316 |
$0.00 |
HCPCS / CPT® |
CATH W/DRAINAGE 3-WAY |
A4320 |
$20.29 |
HCPCS / CPT® |
IRRIGATION TRAY |
A4321 |
$0.00 |
HCPCS / CPT® |
CATH THERAPEUTIC IRRIG AGENT |
A4322 |
$20.29 |
HCPCS / CPT® |
IRRIGATION SYRINGE |
A4326 |
$11.49 |
HCPCS / CPT® |
MALE EXTERNAL CATHETER WITH INTEGRAL COLLECTION CHAMBER, ANY TYPE, EACH |
A4327 |
$4.59 |
HCPCS / CPT® |
URINE CUP FEMALE COLLECT DEV CUP |
A4328 |
$4.99 |
HCPCS / CPT® |
FEMALE EXTERNAL URINARY COLLECTION DEVICE; POUCH, EACH |
A4330 |
$10.00 |
HCPCS / CPT® |
STOOL COLLECTION POUCH |
A4331 |
$0.00 |
HCPCS / CPT® |
EXTENSION DRAINAGE TUBING |
A4332 |
$9.19 |
HCPCS / CPT® |
LUBE STERILE PACKET |
A4333 |
$0.00 |
HCPCS / CPT® |
URINARY CATH ANCHOR DEVICE |
A4334 |
$0.00 |
HCPCS / CPT® |
URINARY CATH LEG STRAP |
A4335 |
$4.59 |
HCPCS / CPT® |
INCONTINENCE SUPPLY MISCELLANEOUS |
A4336 |
$0.00 |
HCPCS / CPT® |
URETHRAL INSERT |
A4337 |
$0.00 |
HCPCS / CPT® |
INCONTINENT RECTAL INSERT |
A4338 |
$15.31 |
HCPCS / CPT® |
INDWELLING CATHETER LATEX |
A4340 |
$0.00 |
HCPCS / CPT® |
INDWELLING CATHETER SPECIAL |
A4344 |
$16.84 |
HCPCS / CPT® |
CATHETER – FOLEY 2 WAY SILICN |
A4346 |
$0.00 |
HCPCS / CPT® |
CATH INDW FOLEY 3 WAY |
A4349 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE MALE EXTERNAL CAT |
A4351 |
$14.92 |
HCPCS / CPT® |
STRAIGHT TIP URINE CATHETER |
A4352 |
$30.81 |
HCPCS / CPT® |
COUDE TIP URINARY CATHETER |
A4353 |
$30.61 |
HCPCS / CPT® |
INTERMITTENT URINARY CATH |
A4354 |
$81.71 |
HCPCS / CPT® |
CATH INSERTION TRAY W/BAG |
A4355 |
$0.00 |
HCPCS / CPT® |
BLADDER IRRIGATION TUBING |
A4356 |
$357.43 |
HCPCS / CPT® |
EXT URETH CLMP OR COMPR DVC |
A4357 |
$0.00 |
HCPCS / CPT® |
BEDSIDE DRAINAGE BAG |
A4358 |
$19.14 |
HCPCS / CPT® |
BAG – URINARY LEG OR ABDOMEN BAG |
A4360 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE EXT URETHRAL DEV |
A4361 |
$0.00 |
HCPCS / CPT® |
OSTOMY FACE PLATE |
A4362 |
$0.00 |
HCPCS / CPT® |
SOLID SKIN BARRIER |
A4363 |
$0.00 |
HCPCS / CPT® |
OSTOMY CLAMP, REPLACEMENT |
A4364 |
$43.73 |
HCPCS / CPT® |
DERMABOND – ADHESIVE, LIQUID OR EQUAL PER OZ. |
A4366 |
$0.00 |
HCPCS / CPT® |
OSTOMY VENT |
A4367 |
$0.00 |
HCPCS / CPT® |
OSTOMY BELT |
A4368 |
$0.00 |
HCPCS / CPT® |
OSTOMY FILTER |
A4369 |
$0.00 |
HCPCS / CPT® |
SKIN BARRIER LIQUID PER OZ |
A4371 |
$0.00 |
HCPCS / CPT® |
SKIN BARRIER POWDER PER OZ |
A4372 |
$0.00 |
HCPCS / CPT® |
SKIN BARRIER SOLID 4X4 EQUIV |
A4373 |
$0.00 |
HCPCS / CPT® |
SKIN BARRIER WITH FLANGE |
A4375 |
$0.00 |
HCPCS / CPT® |
DRAINABLE PLASTIC PCH W FCPL |
A4376 |
$0.00 |
HCPCS / CPT® |
DRAINABLE RUBBER PCH W FCPLT |
A4377 |
$0.00 |
HCPCS / CPT® |
DRAINABLE PLSTIC PCH W/O FP |
A4378 |
$0.00 |
HCPCS / CPT® |
DRAINABLE RUBBER PCH W/O FP |
A4379 |
$0.00 |
HCPCS / CPT® |
URINARY PLASTIC POUCH W FCPL |
A4380 |
$0.00 |
HCPCS / CPT® |
URINARY RUBBER POUCH W FCPLT |
A4381 |
$0.00 |
HCPCS / CPT® |
URINARY PLASTIC POUCH W/O FP |
A4382 |
$0.00 |
HCPCS / CPT® |
URINARY HVY PLSTC PCH W/O FP |
A4383 |
$0.00 |
HCPCS / CPT® |
URINARY RUBBER POUCH W/O FP |
A4384 |
$0.00 |
HCPCS / CPT® |
OSTOMY FACEPLT/SILICONE RING |
A4385 |
$0.00 |
HCPCS / CPT® |
OST SKN BARRIER SLD EXT WEAR |
A4387 |
$0.00 |
HCPCS / CPT® |
OST CLSD POUCH W ATT ST BARR |
A4388 |
$0.00 |
HCPCS / CPT® |
DRAINABLE PCH W EX WEAR BARR |
A4389 |
$0.00 |
HCPCS / CPT® |
DRAINABLE PCH W ST WEAR BARR |
A4390 |
$0.00 |
HCPCS / CPT® |
DRAINABLE PCH EX WEAR CONVEX |
A4391 |
$0.00 |
HCPCS / CPT® |
URINARY POUCH W EX WEAR BARR |
A4392 |
$0.00 |
HCPCS / CPT® |
URINARY POUCH W ST WEAR BARR |
A4393 |
$0.00 |
HCPCS / CPT® |
URINE PCH W EX WEAR BAR CONV |
A4394 |
$0.00 |
HCPCS / CPT® |
OSTOMY POUCH LIQ DEODORANT |
A4395 |
$0.00 |
HCPCS / CPT® |
OSTOMY POUCH SOLID DEODORANT |
A4396 |
$0.00 |
HCPCS / CPT® |
PERISTOMAL HERNIA SUPPRT BLT |
A4397 |
$0.00 |
HCPCS / CPT® |
IRRIGATION SUPPLY SLEEVE |
A4398 |
$0.00 |
HCPCS / CPT® |
OSTOMY IRRIGATION BAG |
A4399 |
$0.00 |
HCPCS / CPT® |
OSTOMY IRRIG CONE/CATH W BRS |
A4400 |
$0.00 |
HCPCS / CPT® |
OSTOMY IRRIGATION SET |
A4402 |
$12.50 |
HCPCS / CPT® |
LUBRICANT PER OUNCE |
A4404 |
$0.00 |
HCPCS / CPT® |
OSTOMY RING EACH |
A4405 |
$0.00 |
HCPCS / CPT® |
NONPECTIN BASED OSTOMY PASTE |
A4406 |
$0.00 |
HCPCS / CPT® |
PECTIN BASED OSTOMY PASTE |
A4407 |
$0.00 |
HCPCS / CPT® |
EXT WEAR OST SKN BARR <=4SQ |
A4408 |
$0.00 |
HCPCS / CPT® |
EXT WEAR OST SKN BARR >4SQ |
A4409 |
$0.00 |
HCPCS / CPT® |
OST SKN BARR CONVEX <=4 SQ I |
A4410 |
$0.00 |
HCPCS / CPT® |
OST SKN BARR EXTND >4 SQ |
A4411 |
$0.00 |
HCPCS / CPT® |
OST SKN BARR EXTND =4SQ |
A4412 |
$0.00 |
HCPCS / CPT® |
OST POUCH DRAIN HIGH OUTPUT |
A4413 |
$0.00 |
HCPCS / CPT® |
2 PC DRAINABLE OST POUCH |
A4414 |
$0.00 |
HCPCS / CPT® |
OST SKNBAR W/O CONV<=4 SQ IN |
A4415 |
$0.00 |
HCPCS / CPT® |
OST SKN BARR W/O CONV >4 SQI |
A4416 |
$0.00 |
HCPCS / CPT® |
OST PCH CLSD W BARRIER/FILTR |
A4417 |
$0.00 |
HCPCS / CPT® |
OST PCH W BAR/BLTINCONV/FLTR |
A4418 |
$0.00 |
HCPCS / CPT® |
OST PCH CLSD W/O BAR W FILTR |
A4419 |
$0.00 |
HCPCS / CPT® |
OST PCH FOR BAR W FLANGE/FLT |
A4420 |
$0.00 |
HCPCS / CPT® |
OST PCH CLSD FOR BAR W LK FL |
A4421 |
$0.00 |
HCPCS / CPT® |
OSTOMY SUPPLY MISC |
A4422 |
$0.00 |
HCPCS / CPT® |
OST POUCH ABSORBENT MATERIAL |
A4423 |
$0.00 |
HCPCS / CPT® |
OST PCH FOR BAR W LK FL/FLTR |
A4424 |
$0.00 |
HCPCS / CPT® |
OST PCH DRAIN W BAR & FILTER |
A4425 |
$0.00 |
HCPCS / CPT® |
OST PCH DRAIN FOR BARRIER FL |
A4426 |
$0.00 |
HCPCS / CPT® |
OST PCH DRAIN 2 PIECE SYSTEM |
A4427 |
$0.00 |
HCPCS / CPT® |
OST PCH DRAIN/BARR LK FLNG/F |
A4428 |
$0.00 |
HCPCS / CPT® |
URINE OST POUCH W FAUCET/TAP |
A4429 |
$0.00 |
HCPCS / CPT® |
URINE OST POUCH W BLTINCONV |
A4430 |
$0.00 |
HCPCS / CPT® |
OST URINE PCH W B/BLTIN CONV |
A4431 |
$0.00 |
HCPCS / CPT® |
OST PCH URINE W BARRIER/TAPV |
A4432 |
$0.00 |
HCPCS / CPT® |
OS PCH URINE W BAR/FANGE/TAP |
A4433 |
$0.00 |
HCPCS / CPT® |
URINE OST PCH BAR W LOCK FLN |
A4434 |
$0.00 |
HCPCS / CPT® |
OST PCH URINE W LOCK FLNG/FT |
A4435 |
$0.00 |
HCPCS / CPT® |
1PC OST PCH DRAIN HGH OUTPUT |
A4450 |
$13.73 |
HCPCS / CPT® |
TAPE NON-WATERPROOF |
A4452 |
$13.73 |
HCPCS / CPT® |
TAPE WATERPROOF |
A4455 |
$0.00 |
HCPCS / CPT® |
ADHESIVE REMOVER PER OUNCE |
A4456 |
$0.00 |
HCPCS / CPT® |
ADHESIVE REMOVER, WIPES |
A4458 |
$0.00 |
HCPCS / CPT® |
REUSABLE ENEMA BAG |
A4459 |
$0.00 |
HCPCS / CPT® |
MANUAL PUMP ENEMA, REUSABLE |
A4461 |
$150.00 |
HCPCS / CPT® |
SURGICL DRESS HOLD NON-REUSE |
A4463 |
$0.00 |
HCPCS / CPT® |
SURGICAL DRESS HOLDER REUSE |
A4465 |
$0.00 |
HCPCS / CPT® |
NON-ELASTIC EXTREMITY BINDER |
A4467 |
$0.00 |
HCPCS / CPT® |
BELT STRAP SLEEV GRMNT COVER |
A4470 |
$0.00 |
HCPCS / CPT® |
GRAVLEE JET WASHER |
A4480 |
$0.00 |
HCPCS / CPT® |
VABRA ASPIRATOR |
A4481 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMA FILTER |
A4483 |
$0.00 |
HCPCS / CPT® |
MOISTURE EXCHANGER |
A4490 |
$0.00 |
HCPCS / CPT® |
ABOVE KNEE SURGICAL STOCKING |
A4495 |
$0.00 |
HCPCS / CPT® |
THIGH LENGTH SURG STOCKING |
A4500 |
$0.00 |
HCPCS / CPT® |
BELOW KNEE SURGICAL STOCKING |
A4510 |
$0.00 |
HCPCS / CPT® |
FULL LENGTH SURG STOCKING |
A4520 |
$0.00 |
HCPCS / CPT® |
INCONTINENCE GARMENT ANYTYPE |
A4550 |
$535.73 |
HCPCS / CPT® |
PROCEDURE SUPPLY TRAY |
A4550DRESS |
$125.00 |
HCPCS / CPT® |
DRESSING TRAY |
A4550SRKIT |
$125.00 |
HCPCS / CPT® |
SUTURE REMOVAL KIT |
A4553 |
$0.00 |
HCPCS / CPT® |
NONDISP UNDERPADS, ALL SIZES |
A4554 |
$38.20 |
HCPCS / CPT® |
DISPOSABLE UNDERPADS – CHUCKS PAD – CHUX |
A4555 |
$0.00 |
HCPCS / CPT® |
CA TX E-STIM ELECTR/TRANSDUC |
A4556 |
$97.51 |
HCPCS / CPT® |
ELECTRODES PAIR |
A4557 |
$0.00 |
HCPCS / CPT® |
LEAD WIRES, PAIR |
A4558 |
$0.00 |
HCPCS / CPT® |
CONDUCTIVE GEL OR PASTE |
A4559 |
$0.00 |
HCPCS / CPT® |
COUPLING GEL OR PASTE |
A4561 |
$0.00 |
HCPCS / CPT® |
PESSARY RUBBER, ANY TYPE |
A4562 |
$0.00 |
HCPCS / CPT® |
PESSARY, NON RUBBER,ANY TYPE |
A4565 |
$191.34 |
HCPCS / CPT® |
SLINGS |
A4566 |
$201.77 |
HCPCS / CPT® |
SHOULD SLING/VEST/ABRESTRAIN |
A4570 |
$164.55 |
HCPCS / CPT® |
SPLINT |
A4575 |
$0.00 |
HCPCS / CPT® |
HYPERBARIC O2 CHAMBER DISPS |
A4580 |
$109.31 |
HCPCS / CPT® |
CAST SUPPLIES (PLASTER) |
A4590 |
$164.55 |
HCPCS / CPT® |
ORTHO GLASS 4″ SPECIAL CASTING MATERIAL |
A4590 3 |
$110.22 |
HCPCS / CPT® |
ORTHO GLASS 3″ SPECIAL CASTING MATERIAL |
A4595 |
$0.00 |
HCPCS / CPT® |
TENS SUPPL 2 LEAD PER MONTH |
A4600 |
$0.00 |
HCPCS / CPT® |
SLEEVE, INTER LIMB COMP DEV |
A4601 |
$0.00 |
HCPCS / CPT® |
LITH ION NON PROSTH RECHARGE |
A4602 |
$0.00 |
HCPCS / CPT® |
REPLACE LITHIUM BATTERY 1.5V |
A4604 |
$0.00 |
HCPCS / CPT® |
TUBING WITH HEATING ELEMENT |
A4605 |
$0.00 |
HCPCS / CPT® |
TRACH SUCTION CATH CLOSE SYS |
A4606 |
$166.84 |
HCPCS / CPT® |
OXYGEN PROBE USED W OXIMETER |
A4608 |
$0.00 |
HCPCS / CPT® |
TRANSTRACHEAL OXYGEN CATH |
A4611 |
$0.00 |
HCPCS / CPT® |
HEAVY DUTY BATTERY |
A4612 |
$0.00 |
HCPCS / CPT® |
BATTERY CABLES |
A4613 |
$0.00 |
HCPCS / CPT® |
BATTERY CHARGER |
A4614 |
$0.00 |
HCPCS / CPT® |
HAND-HELD PEFR METER |
A4615 |
$7.66 |
HCPCS / CPT® |
CANNULA NASAL O2 |
A4616 |
$3.45 |
HCPCS / CPT® |
TUBING (OXYGEN) PER FOOT |
A4617 |
$0.00 |
HCPCS / CPT® |
MOUTH PIECE |
A4618 |
$0.00 |
HCPCS / CPT® |
BREATHING CIRCUITS |
A4619 |
$0.00 |
HCPCS / CPT® |
FACE TENT |
A4620 |
$72.19 |
HCPCS / CPT® |
MASK – VARIABLE CONCENTRATION MASK – NON-REBREATHER MASK |
A4623 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMY INNER CANNULA |
A4624 |
$0.00 |
HCPCS / CPT® |
TRACHEAL SUCTION TUBE |
A4625 |
$0.00 |
HCPCS / CPT® |
TRACH CARE KIT FOR NEW TRACH |
A4626 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMY CLEANING BRUSH |
A4627 |
$0.00 |
HCPCS / CPT® |
SPACER BAG/RESERVOIR |
A4628 |
$0.00 |
HCPCS / CPT® |
OROPHARYNGEAL SUCTION CATH |
A4629 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMY CARE KIT |
A4630 |
$0.00 |
HCPCS / CPT® |
REPL BAT T.E.N.S. OWN BY PT |
A4633 |
$0.00 |
HCPCS / CPT® |
UVL REPLACEMENT BULB |
A4634 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT BULB TH LIGHTBOX |
A4635 |
$0.00 |
HCPCS / CPT® |
UNDERARM CRUTCH PAD |
A4636 |
$0.00 |
HCPCS / CPT® |
HANDGRIP FOR CANE ETC |
A4637 |
$0.00 |
HCPCS / CPT® |
REPL TIP CANE/CRUTCH/WALKER |
A4638 |
$0.00 |
HCPCS / CPT® |
REPL BATT PULSE GEN SYS |
A4639 |
$0.00 |
HCPCS / CPT® |
INFRARED HT SYS REPLCMNT PAD |
A4640 |
$0.00 |
HCPCS / CPT® |
ALTERNATING PRESSURE PAD |
A4641 |
$0.00 |
HCPCS / CPT® |
RADIOPHARM DX AGENT NOC |
A4642 |
$0.00 |
HCPCS / CPT® |
IN111 SATUMOMAB |
A4648 |
$0.00 |
HCPCS / CPT® |
IMPLANTABLE TISSUE MARKER |
A4649 |
$10.10 |
HCPCS / CPT® |
SURGICAL MISC |
A4649 BAG |
$28.84 |
HCPCS / CPT® |
BAG – NORMAL SALINE 100ML BAG |
A4649 BAND |
$1.27 |
HCPCS / CPT® |
BANDAID |
A4649 BLAD |
$6.32 |
HCPCS / CPT® |
SCAPLEL BLADE 11 |
A4649 BOTT |
$15.84 |
HCPCS / CPT® |
HYDROGEN PEROXIDE BOTTLE |
A4649 BUDD |
$11.34 |
HCPCS / CPT® |
BUDDY TAPE |
A4649 CAT |
$206.64 |
HCPCS / CPT® |
IV CATH ANY SIZE |
A4649 CAU |
$43.64 |
HCPCS / CPT® |
ELECTROCAUTERY MISC |
A4649 CUP |
$3.79 |
HCPCS / CPT® |
URINE SPEC CUP |
A4649 DEC |
$20.24 |
HCPCS / CPT® |
CO2 DETECTOR |
A4649 ENEM |
$41.78 |
HCPCS / CPT® |
FLEETS ENEMA |
A4649 ICE |
$6.32 |
HCPCS / CPT® |
ICE PACK |
A4649 IRR |
$16.77 |
HCPCS / CPT® |
IRRIGATION BOTTLE |
A4649 IV |
$16.08 |
HCPCS / CPT® |
IV START KIT |
A4649 KATZ |
$40.00 |
HCPCS / CPT® |
KATZ EXTRACTOR |
A4649 LAMP |
$225.01 |
HCPCS / CPT® |
WOODS LAMP |
A4649 LITE |
$46.31 |
HCPCS / CPT® |
LIGHT SOURCE |
A4649 MASK |
$12.65 |
HCPCS / CPT® |
ABUTER MASK |
A4649 MON |
$378.84 |
HCPCS / CPT® |
CARDIAC MONITOR |
A4649 NACL |
$13.20 |
HCPCS / CPT® |
SODIUM CHLORIDE BOTTLE 1000 ML |
A4649 NIT |
$52.82 |
HCPCS / CPT® |
SILVER NITRATE STICKS EACH |
A4649 OXY |
$28.16 |
HCPCS / CPT® |
OXYGEN MASK |
A4649 SPEC |
$231.60 |
HCPCS / CPT® |
SPECULUM |
A4649 STAP |
$76.53 |
HCPCS / CPT® |
STAPLE REPAIR KIT |
A4649 TAM |
$67.66 |
HCPCS / CPT® |
RAPID RHINO NASAL PACKING OR NASAL TAMPON |
A4649 TON |
$3.45 |
HCPCS / CPT® |
TONGUE DEPRESSOR |
A4649 TOUR |
$38.27 |
HCPCS / CPT® |
TOURNIQUETS |
A4649 TU |
$58.62 |
HCPCS / CPT® |
IV TUBING |
A4649 VAG |
$231.60 |
HCPCS / CPT® |
VAGINAL SPECULUM |
A4649BASIN |
$10.00 |
HCPCS / CPT® |
BASIN – EMESIS BASIN STERILE |
A4649CAT |
$206.64 |
HCPCS / CPT® |
IV CATH ANY SIZE |
A4649FLUID |
$10.00 |
HCPCS / CPT® |
PO FLUIDS MISCELLANEOUS |
A4649FORCE |
$25.00 |
HCPCS / CPT® |
FORCEPS |
A4649STAPL |
$236.89 |
HCPCS / CPT® |
SKIN STAPLER |
A4649STR |
$18.52 |
HCPCS / CPT® |
FLUOR-I-STRIP |
A4649STRAI |
$10.00 |
HCPCS / CPT® |
URINE STRAINER |
A4649SURGI |
$50.00 |
HCPCS / CPT® |
SURGICEL GEL FOAM |
A4649SUTUR |
$25.00 |
HCPCS / CPT® |
SUTURES |
A4649SWAB |
$5.00 |
HCPCS / CPT® |
SPECIMEN SWAB |
A4649VBAG |
$8.43 |
HCPCS / CPT® |
VOMIT BAG |
A4649WICK |
$40.00 |
HCPCS / CPT® |
EAR WICK |
A4650 |
$0.00 |
HCPCS / CPT® |
IMPLANT RADIATION DOSIMETER |
A4651 |
$0.00 |
HCPCS / CPT® |
CALIBRATED MICROCAP TUBE |
A4652 |
$0.00 |
HCPCS / CPT® |
MICROCAPILLARY TUBE SEALANT |
A4653 |
$0.00 |
HCPCS / CPT® |
PD CATHETER ANCHOR BELT |
A4657 |
$9.15 |
HCPCS / CPT® |
SYRINGE WITH OR WITHOUT NEEDLE |
A4660 |
$40.39 |
HCPCS / CPT® |
SPHYG/BP APP W CUFF AND STET |
A4663 |
$0.00 |
HCPCS / CPT® |
DIALYSIS BLOOD PRESSURE CUFF |
A4670 |
$46.84 |
HCPCS / CPT® |
AUTOMATIC BP MONITOR, DIAL |
A4671 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE CYCLER SET |
A4672 |
$0.00 |
HCPCS / CPT® |
DRAINAGE EXT LINE, DIALYSIS |
A4673 |
$18.37 |
HCPCS / CPT® |
SALINE LOCK |
A4674 |
$0.00 |
HCPCS / CPT® |
CHEM/ANTISEPT SOLUTION, 8OZ |
A4680 |
$0.00 |
HCPCS / CPT® |
ACTIVATED CARBON FILTER, EA |
A4690 |
$0.00 |
HCPCS / CPT® |
DIALYZER, EACH |
A4706 |
$0.00 |
HCPCS / CPT® |
BICARBONATE CONC SOL PER GAL |
A4707 |
$0.00 |
HCPCS / CPT® |
BICARBONATE CONC POW PER PAC |
A4708 |
$0.00 |
HCPCS / CPT® |
ACETATE CONC SOL PER GALLON |
A4709 |
$0.00 |
HCPCS / CPT® |
ACID CONC SOL PER GALLON |
A4714 |
$0.00 |
HCPCS / CPT® |
TREATED WATER PER GALLON |
A4719 |
$0.00 |
HCPCS / CPT® |
Y SET TUBING |
A4720 |
$0.00 |
HCPCS / CPT® |
DIALYSAT SOL FLD VOL > 249CC |
A4721 |
$0.00 |
HCPCS / CPT® |
DIALYSAT SOL FLD VOL > 999CC |
A4722 |
$0.00 |
HCPCS / CPT® |
DIALYS SOL FLD VOL > 1999CC |
A4723 |
$0.00 |
HCPCS / CPT® |
DIALYS SOL FLD VOL > 2999CC |
A4724 |
$0.00 |
HCPCS / CPT® |
DIALYS SOL FLD VOL > 3999CC |
A4725 |
$0.00 |
HCPCS / CPT® |
DIALYS SOL FLD VOL > 4999CC |
A4726 |
$0.00 |
HCPCS / CPT® |
DIALYS SOL FLD VOL > 5999CC |
A4728 |
$0.00 |
HCPCS / CPT® |
DIALYSATE SOLUTION, NON-DEX |
A4730 |
$0.00 |
HCPCS / CPT® |
FISTULA CANNULATION SET, EA |
A4736 |
$0.00 |
HCPCS / CPT® |
TOPICAL ANESTHETIC, PER GRAM |
A4737 |
$0.00 |
HCPCS / CPT® |
INJ ANESTHETIC PER 10 ML |
A4740 |
$0.00 |
HCPCS / CPT® |
SHUNT ACCESSORY |
A4750 |
$0.00 |
HCPCS / CPT® |
ART OR VENOUS BLOOD TUBING |
A4755 |
$0.00 |
HCPCS / CPT® |
COMB ART/VENOUS BLOOD TUBING |
A4760 |
$0.00 |
HCPCS / CPT® |
DIALYSATE SOL TEST KIT, EACH |
A4765 |
$0.00 |
HCPCS / CPT® |
DIALYSATE CONC POW PER PACK |
A4766 |
$0.00 |
HCPCS / CPT® |
DIALYSATE CONC SOL ADD 10 ML |
A4770 |
$7.83 |
HCPCS / CPT® |
BLOOD COLLECTION TUBE/VACUUM |
A4771 |
$0.00 |
HCPCS / CPT® |
SERUM CLOTTING TIME TUBE |
A4772 |
$0.00 |
HCPCS / CPT® |
BLOOD GLUCOSE TEST STRIPS |
A4773 |
$0.00 |
HCPCS / CPT® |
OCCULT BLOOD TEST STRIPS |
A4774 |
$0.00 |
HCPCS / CPT® |
AMMONIA TEST STRIPS |
A4802 |
$0.00 |
HCPCS / CPT® |
PROTAMINE SULFATE PER 50 MG |
A4860 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE CATHETER TIPS |
A4870 |
$0.00 |
HCPCS / CPT® |
PLUMB/ELEC WK HM HEMO EQUIP |
A4890 |
$0.00 |
HCPCS / CPT® |
REPAIR/MAINT CONT HEMO EQUIP |
A4911 |
$0.00 |
HCPCS / CPT® |
DRAIN BAG/BOTTLE |
A4913 |
$0.00 |
HCPCS / CPT® |
MISC DIALYSIS SUPPLIES NOC |
A4918 |
$0.00 |
HCPCS / CPT® |
VENOUS PRESSURE CLAMP |
A4927 |
$3.45 |
HCPCS / CPT® |
GLOVES NON-STERILE |
A4928 |
$0.00 |
HCPCS / CPT® |
SURGICAL MASK |
A4929 |
$9.81 |
HCPCS / CPT® |
TOURNIQUET FOR DIALYSIS, EA |
A4930 |
$4.59 |
HCPCS / CPT® |
GLOVES STERILE, PER PAIR |
A4931 |
$0.00 |
HCPCS / CPT® |
REUSABLE ORAL THERMOMETER |
A4932 |
$0.00 |
HCPCS / CPT® |
REUSABLE RECTAL THERMOMETER |
A5051 |
$0.00 |
HCPCS / CPT® |
POUCH CLSD W BARR ATTACHED |
A5052 |
$0.00 |
HCPCS / CPT® |
CLSD OSTOMY POUCH W/O BARR |
A5053 |
$0.00 |
HCPCS / CPT® |
CLSD OSTOMY POUCH FACEPLATE |
A5054 |
$0.00 |
HCPCS / CPT® |
CLSD OSTOMY POUCH W/FLANGE |
A5055 |
$0.00 |
HCPCS / CPT® |
STOMA CAP |
A5056 |
$0.00 |
HCPCS / CPT® |
1 PC OST POUCH W FILTER |
A5057 |
$0.00 |
HCPCS / CPT® |
1 PC OST POU W BUILT-IN CONV |
A5061 |
$0.00 |
HCPCS / CPT® |
POUCH DRAINABLE W BARRIER AT |
A5062 |
$0.00 |
HCPCS / CPT® |
DRNBLE OSTOMY POUCH W/O BARR |
A5063 |
$0.00 |
HCPCS / CPT® |
DRAIN OSTOMY POUCH W/FLANGE |
A5071 |
$0.00 |
HCPCS / CPT® |
URINARY POUCH W/BARRIER |
A5072 |
$0.00 |
HCPCS / CPT® |
URINARY POUCH W/O BARRIER |
A5073 |
$0.00 |
HCPCS / CPT® |
URINARY POUCH ON BARR W/FLNG |
A5081 |
$0.00 |
HCPCS / CPT® |
STOMA PLUG OR SEAL, ANY TYPE |
A5082 |
$0.00 |
HCPCS / CPT® |
CONTINENT STOMA CATHETER |
A5083 |
$0.00 |
HCPCS / CPT® |
STOMA ABSORPTIVE COVER |
A5093 |
$0.00 |
HCPCS / CPT® |
OSTOMY ACCESSORY CONVEX INSE |
A5102 |
$0.00 |
HCPCS / CPT® |
BEDSIDE DRAIN BTL W/WO TUBE |
A5105 |
$0.00 |
HCPCS / CPT® |
URINARY SUSPENSORY |
A5112 |
$0.00 |
HCPCS / CPT® |
URINARY LEG BAG |
A5113 |
$0.00 |
HCPCS / CPT® |
LATEX LEG STRAP |
A5114 |
$0.00 |
HCPCS / CPT® |
FOAM/FABRIC LEG STRAP |
A5120 |
$7.66 |
HCPCS / CPT® |
SWAB OR WIPE SKIN BARRIER |
A5121 |
$0.00 |
HCPCS / CPT® |
SOLID SKIN BARRIER 6X6 |
A5122 |
$0.00 |
HCPCS / CPT® |
SOLID SKIN BARRIER 8X8 |
A5126 |
$0.00 |
HCPCS / CPT® |
DISK/FOAM PAD +OR- ADHESIVE |
A5131 |
$0.00 |
HCPCS / CPT® |
APPLIANCE CLEANER |
A5200 |
$153.06 |
HCPCS / CPT® |
PERCUTANEOUS CATHETER ANCHOR |
A5500 |
$0.00 |
HCPCS / CPT® |
DIAB SHOE FOR DENSITY INSERT |
A5501 |
$0.00 |
HCPCS / CPT® |
DIABETIC CUSTOM MOLDED SHOE |
A5503 |
$0.00 |
HCPCS / CPT® |
DIABETIC SHOE W/ROLLER/ROCKR |
A5504 |
$0.00 |
HCPCS / CPT® |
DIABETIC SHOE WITH WEDGE |
A5505 |
$0.00 |
HCPCS / CPT® |
DIAB SHOE W/METATARSAL BAR |
A5506 |
$0.00 |
HCPCS / CPT® |
DIABETIC SHOE W/OFF SET HEEL |
A5507 |
$0.00 |
HCPCS / CPT® |
MODIFICATION DIABETIC SHOE |
A5508 |
$0.00 |
HCPCS / CPT® |
DIABETIC DELUXE SHOE |
A5510 |
$0.00 |
HCPCS / CPT® |
COMPRESSION FORM SHOE INSERT |
A5512 |
$0.00 |
HCPCS / CPT® |
MULTI DEN INSERT DIRECT FORM |
A5513 |
$0.00 |
HCPCS / CPT® |
MULTI DEN INSERT CUSTOM MOLD |
A6000 |
$23.12 |
HCPCS / CPT® |
NON-CONTACT WOUND WARMING WOUND COVER FOR USE WITH THE NON-CONTACT WOUND WARMING DEVICE AND WARMING CARD |
A6010 |
$0.00 |
HCPCS / CPT® |
COLLAGEN BASED WOUND FILLER |
A6011 |
$0.00 |
HCPCS / CPT® |
COLLAGEN GEL/PASTE WOUND FIL |
A6021 |
$22.90 |
HCPCS / CPT® |
COLLAGEN DRESSING <=16 SQ IN |
A6022 |
$0.00 |
HCPCS / CPT® |
COLLAGEN DRSG>16<=48 SQ IN |
A6023 |
$0.00 |
HCPCS / CPT® |
COLLAGEN DRESSING >48 SQ IN |
A6024 |
$0.00 |
HCPCS / CPT® |
COLLAGEN DSG WOUND FILLER |
A6025 |
$0.00 |
HCPCS / CPT® |
SILICONE GEL SHEET, EACH |
A6154 |
$0.00 |
HCPCS / CPT® |
WOUND POUCH EACH |
A6196 |
$0.00 |
HCPCS / CPT® |
ALGINATE DRESSING <=16 SQ IN |
A6197 |
$0.00 |
HCPCS / CPT® |
ALGINATE DRSG >16 <=48 SQ IN |
A6198 |
$18.52 |
HCPCS / CPT® |
ALGINATE DRESSING >48 SQ IN |
A6199 |
$0.00 |
HCPCS / CPT® |
ALGINATE DRSG WOUND FILLER |
A6203 |
$11.45 |
HCPCS / CPT® |
COMPOSITE DRSG 16 SQ IN |
A6204 |
$0.00 |
HCPCS / CPT® |
COMPOSITE DRSG >16<=48 SQ IN |
A6205 |
$27.55 |
HCPCS / CPT® |
COMPOSITE DRSG 48 SQ IN |
A6206 |
$0.00 |
HCPCS / CPT® |
CONTACT LAYER <= 16 SQ IN |
A6207 |
$0.00 |
HCPCS / CPT® |
CONTACT LAYER >16<= 48 SQ IN |
A6208 |
$0.00 |
HCPCS / CPT® |
CONTACT LAYER > 48 SQ IN |
A6209 |
$0.00 |
HCPCS / CPT® |
FOAM DRSG <=16 SQ IN W/O BDR |
A6210 |
$0.00 |
HCPCS / CPT® |
FOAM DRG >16<=48 SQ IN W/O B |
A6211 |
$40.49 |
HCPCS / CPT® |
FOAM DRG > 48 SQ IN W/O BRDR |
A6212 |
$0.00 |
HCPCS / CPT® |
FOAM DRG <=16 SQ IN W/BORDER |
A6213 |
$15.01 |
HCPCS / CPT® |
FOAM DRG >16<=48 SQ IN W/BDR |
A6214 |
$0.00 |
HCPCS / CPT® |
FOAM DRG > 48 SQ IN W/BORDER |
A6215 |
$0.00 |
HCPCS / CPT® |
FOAM DRESSING WOUND FILLER |
A6216 |
$18.52 |
HCPCS / CPT® |
GAUZE – NON-STERILE GAUZE – LESS THAN 16 SQ IN |
A6217 |
$18.52 |
HCPCS / CPT® |
GAUZE – NON-STERILE GAUZE>16 BUT <=48 SQ |
A6218 |
$18.52 |
HCPCS / CPT® |
GAUZE – NON-STERILE GAUZE > 48 SQ IN |
A6219 |
$18.52 |
HCPCS / CPT® |
GAUZE – STERILE GAUZE <= 16 SQ IN W/BORDER |
A6220 |
$0.00 |
HCPCS / CPT® |
GAUZE >16 <=48 SQ IN W/BORDR |
A6221 |
$0.00 |
HCPCS / CPT® |
GAUZE > 48 SQ IN W/BORDER |
A6222 |
$30.00 |
HCPCS / CPT® |
IODOFORM GAUZE 16 IN NO W/SAL W/O B |
A6223 |
$0.00 |
HCPCS / CPT® |
GAUZE >16<=48 NO W/SAL W/O B |
A6224 |
$24.74 |
HCPCS / CPT® |
GAUZE 48 IN NO WSAL WO B |
A6228 |
$0.00 |
HCPCS / CPT® |
GAUZE <= 16 SQ IN WATER/SAL |
A6229 |
$0.00 |
HCPCS / CPT® |
GAUZE >16<=48 SQ IN WATR/SAL |
A6230 |
$0.00 |
HCPCS / CPT® |
GAUZE > 48 SQ IN WATER/SALNE |
A6231 |
$92.45 |
HCPCS / CPT® |
GAUZE – KERLIX DRESSING LESS THAN 16 SQ IN |
A6232 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DSG>16<=48 SQ IN |
A6233 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRESSING >48 SQ IN |
A6234 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLD DRG <=16 W/O BDR |
A6235 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLD DRG >16<=48 W/O B |
A6236 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLD DRG > 48 IN W/O B |
A6237 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLD DRG <=16 IN W/BDR |
A6238 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLD DRG >16<=48 W/BDR |
A6239 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLD DRG > 48 IN W/BDR |
A6240 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLD DRG FILLER PASTE |
A6241 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLOID DRG FILLER DRY |
A6242 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRG <=16 IN W/O BDR |
A6243 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRG >16<=48 W/O BDR |
A6244 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRG >48 IN W/O BDR |
A6245 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRG <= 16 IN W/BDR |
A6246 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRG >16<=48 IN W/B |
A6247 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRG > 48 SQ IN W/B |
A6248 |
$0.00 |
HCPCS / CPT® |
HYDROGEL DRSG GEL FILLER |
A6250 |
$44.93 |
HCPCS / CPT® |
SKIN SEAL PROTECT MOISTURIZER OINTMENT |
A6251 |
$10.00 |
HCPCS / CPT® |
ABSORPT DRG <=16 SQ IN W/O B |
A6252 |
$0.00 |
HCPCS / CPT® |
ABSORPT DRG >16 <=48 W/O BDR |
A6253 |
$0.00 |
HCPCS / CPT® |
ABSORPT DRG > 48 SQ IN W/O B |
A6254 |
$0.00 |
HCPCS / CPT® |
ABSORPT DRG <=16 SQ IN W/BDR |
A6255 |
$0.00 |
HCPCS / CPT® |
ABSORPT DRG >16<=48 IN W/BDR |
A6256 |
$0.00 |
HCPCS / CPT® |
ABSORPT DRG > 48 SQ IN W/BDR |
A6257 |
$11.49 |
HCPCS / CPT® |
TRANSPARENT FILM |
A6258 |
$31.13 |
HCPCS / CPT® |
TRANSPARENT FILM >16<=48 IN |
A6259 |
$0.00 |
HCPCS / CPT® |
TRANSPARENT FILM > 48 SQ IN |
A6260 |
$130.11 |
HCPCS / CPT® |
WOUND CLEANSER |
A6261 |
$0.00 |
HCPCS / CPT® |
WOUND FILLER GEL/PASTE /OZ |
A6262 |
$0.00 |
HCPCS / CPT® |
WOUND FILLER DRY FORM / GRAM |
A6266 |
$51.75 |
HCPCS / CPT® |
IMPREG GAUZE NO H20/SAL/YARD |
A6402 |
$5.45 |
HCPCS / CPT® |
STERILE GAUZE 16 SQ IN |
A6403 |
$0.00 |
HCPCS / CPT® |
STERILE GAUZE>16 <= 48 SQ IN |
A6404 |
$0.00 |
HCPCS / CPT® |
STERILE GAUZE > 48 SQ IN |
A6407 |
$40.00 |
HCPCS / CPT® |
STERI-STRIPS-IODOFORM-PACKING GAUZE |
A6410 |
$7.66 |
HCPCS / CPT® |
STERILE EYE PAD OR STRIP |
A6411 |
$0.00 |
HCPCS / CPT® |
NON-STERILE EYE PAD |
A6412 |
$0.00 |
HCPCS / CPT® |
OCCLUSIVE EYE PATCH |
A6413 |
$6.90 |
HCPCS / CPT® |
ADHESIVE BANDAGE, FIRST-AID |
A6442 |
$0.00 |
HCPCS / CPT® |
CONFORM BAND N/S W <3/YD |
A6443 |
$0.00 |
HCPCS / CPT® |
CONFORM BAND N/S W>=3 <5/YD |
A6444 |
$10.00 |
HCPCS / CPT® |
CONFORM BAND N/S W>=5/YD |
A6445 |
$5.31 |
HCPCS / CPT® |
CONFORM BAND S W <3″/YD |
A6446 |
$12.00 |
HCPCS / CPT® |
Conforming bandage |
A6447 |
$0.00 |
HCPCS / CPT® |
CONFORM BAND S W >=5/YD |
A6448 |
$15.01 |
HCPCS / CPT® |
LT COMPRES BAND <3Ö/YD |
A6449 |
$15.31 |
HCPCS / CPT® |
ACE WRAP (LT COMPRES BAND |
A6450 |
$22.97 |
HCPCS / CPT® |
ACE WRAP – LT COMPRES BAND >=5″/YD |
A6451 |
$0.00 |
HCPCS / CPT® |
MOD COMPRES BAND W>=3 <5/YD |
A6452 |
$0.00 |
HCPCS / CPT® |
HIGH COMPRES BAND W>=3 <5YD |
A6453 |
$5.45 |
HCPCS / CPT® |
BANDAGE – SELF-ADHER BAND W <3Ö/YD |
A6454 |
$15.00 |
HCPCS / CPT® |
SELF-ADHER BAND 3-5 YD |
A6455 |
$0.00 |
HCPCS / CPT® |
SELF-ADHER BAND >=5/YD |
A6456 |
$0.00 |
HCPCS / CPT® |
ZINC PASTE BAND W >=3 <5/YD |
A6457 |
$53.73 |
HCPCS / CPT® |
TUBULAR DRESSING |
A6501 |
$0.00 |
HCPCS / CPT® |
COMPRES BURNGARMENT BODYSUIT |
A6502 |
$0.00 |
HCPCS / CPT® |
COMPRES BURNGARMENT CHINSTRP |
A6503 |
$0.00 |
HCPCS / CPT® |
COMPRES BURNGARMENT FACEHOOD |
A6504 |
$0.00 |
HCPCS / CPT® |
CMPRSBURNGARMENT GLOVE-WRIST |
A6505 |
$0.00 |
HCPCS / CPT® |
CMPRSBURNGARMENT GLOVE-ELBOW |
A6506 |
$0.00 |
HCPCS / CPT® |
CMPRSBURNGRMNT GLOVE-AXILLA |
A6507 |
$0.00 |
HCPCS / CPT® |
CMPRS BURNGARMENT FOOT-KNEE |
A6508 |
$0.00 |
HCPCS / CPT® |
CMPRS BURNGARMENT FOOT-THIGH |
A6509 |
$0.00 |
HCPCS / CPT® |
COMPRES BURN GARMENT JACKET |
A6510 |
$0.00 |
HCPCS / CPT® |
COMPRES BURN GARMENT LEOTARD |
A6511 |
$0.00 |
HCPCS / CPT® |
COMPRES BURN GARMENT PANTY |
A6512 |
$0.00 |
HCPCS / CPT® |
COMPRES BURN GARMENT, NOC |
A6513 |
$0.00 |
HCPCS / CPT® |
COMPRESS BURN MASK FACE/NECK |
A6530 |
$0.00 |
HCPCS / CPT® |
COMPRESSION STOCKING BK18-30 |
A6531 |
$0.00 |
HCPCS / CPT® |
COMPRESSION STOCKING BK30-40 |
A6532 |
$0.00 |
HCPCS / CPT® |
COMPRESSION STOCKING BK40-50 |
A6533 |
$0.00 |
HCPCS / CPT® |
GC STOCKING THIGHLNGTH 18-30 |
A6534 |
$0.00 |
HCPCS / CPT® |
GC STOCKING THIGHLNGTH 30-40 |
A6535 |
$0.00 |
HCPCS / CPT® |
GC STOCKING THIGHLNGTH 40-50 |
A6536 |
$0.00 |
HCPCS / CPT® |
GC STOCKING FULL LNGTH 18-30 |
A6537 |
$0.00 |
HCPCS / CPT® |
GC STOCKING FULL LNGTH 30-40 |
A6538 |
$0.00 |
HCPCS / CPT® |
GC STOCKING FULL LNGTH 40-50 |
A6539 |
$0.00 |
HCPCS / CPT® |
GC STOCKING WAISTLNGTH 18-30 |
A6540 |
$0.00 |
HCPCS / CPT® |
GC STOCKING WAISTLNGTH 30-40 |
A6541 |
$0.00 |
HCPCS / CPT® |
GC STOCKING WAISTLNGTH 40-50 |
A6544 |
$0.00 |
HCPCS / CPT® |
GC STOCKING GARTER BELT |
A6545 |
$0.00 |
HCPCS / CPT® |
GRAD COMP NON-ELASTIC BK |
A6549 |
$0.00 |
HCPCS / CPT® |
G COMPRESSION STOCKING |
A6550 |
$0.00 |
HCPCS / CPT® |
NEG PRES WOUND THER DRSG SET |
A7000 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE CANISTER FOR PUMP |
A7001 |
$13.02 |
HCPCS / CPT® |
CANISTER, NON-DISPOSABLE, USED WITH SUCTION PUMP, EACH |
A7002 |
$122.75 |
HCPCS / CPT® |
SUCTION TUBING USED W PUMP |
A7003 |
$73.92 |
HCPCS / CPT® |
NEBULIZER ADMINISTRATION SET |
A7004 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE NEBULIZER SML VOL |
A7005 |
$0.00 |
HCPCS / CPT® |
NONDISPOSABLE NEBULIZER SET |
A7006 |
$0.00 |
HCPCS / CPT® |
FILTERED NEBULIZER ADMIN SET |
A7007 |
$0.00 |
HCPCS / CPT® |
LG VOL NEBULIZER DISPOSABLE |
A7008 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE NEBULIZER PREFILL |
A7009 |
$0.00 |
HCPCS / CPT® |
NEBULIZER RESERVOIR BOTTLE |
A7010 |
$40.00 |
HCPCS / CPT® |
DISPOSABLE CORRUGATED TUBING |
A7012 |
$0.00 |
HCPCS / CPT® |
NEBULIZER WATER COLLEC DEVIC |
A7013 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE COMPRESSOR FILTER |
A7014 |
$0.00 |
HCPCS / CPT® |
COMPRESSOR NONDISPOS FILTER |
A7015 |
$73.92 |
HCPCS / CPT® |
NEBULIZER MASK USED W NEBULIZER |
A7016 |
$30.61 |
HCPCS / CPT® |
NEBULIZER DOME & MOUTHPIECE |
A7017 |
$73.92 |
HCPCS / CPT® |
NEBULIZER MASK NOT USED W OXYGEN |
A7018 |
$0.00 |
HCPCS / CPT® |
WATER DISTILLED W/NEBULIZER |
A7020 |
$0.00 |
HCPCS / CPT® |
INTERFACE, COUGH STIM DEVICE |
A7025 |
$0.00 |
HCPCS / CPT® |
REPLACE CHEST COMPRESS VEST |
A7026 |
$0.00 |
HCPCS / CPT® |
REPLACE CHST CMPRSS SYS HOSE |
A7027 |
$0.00 |
HCPCS / CPT® |
COMBINATION ORAL/NASAL MASK |
A7028 |
$0.00 |
HCPCS / CPT® |
REPL ORAL CUSHION COMBO MASK |
A7029 |
$0.00 |
HCPCS / CPT® |
REPL NASAL PILLOW COMB MASK |
A7030 |
$1161.86 |
HCPCS / CPT® |
CPAP FULL FACE MASK |
A7031 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT FACEMASK INTERFA |
A7032 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT NASAL CUSHION |
A7033 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT NASAL PILLOWS |
A7034 |
$0.00 |
HCPCS / CPT® |
NASAL APPLICATION DEVICE |
A7035 |
$10.00 |
HCPCS / CPT® |
POS AIRWAY PRESS HEADGEAR |
A7036 |
$10.00 |
HCPCS / CPT® |
POS AIRWAY PRESS CHINSTRAP |
A7037 |
$10.00 |
HCPCS / CPT® |
POS AIRWAY PRESSURE TUBING |
A7038 |
$0.00 |
HCPCS / CPT® |
POS AIRWAY PRESSURE FILTER |
A7039 |
$0.00 |
HCPCS / CPT® |
FILTER, NON DISPOSABLE W PAP |
A7040 |
$0.00 |
HCPCS / CPT® |
ONE WAY CHEST DRAIN VALVE |
A7041 |
$0.00 |
HCPCS / CPT® |
WATER SEAL DRAIN CONTAINER |
A7044 |
$0.00 |
HCPCS / CPT® |
PAP ORAL INTERFACE |
A7045 |
$0.00 |
HCPCS / CPT® |
REPL EXHALATION PORT FOR PAP |
A7046 |
$0.00 |
HCPCS / CPT® |
REPL WATER CHAMBER, PAP DEV |
A7047 |
$0.00 |
HCPCS / CPT® |
RESP SUCTION ORAL INTERFACE |
A7048 |
$0.00 |
HCPCS / CPT® |
VACUUM DRAIN BOTTLE/TUBE KIT |
A7501 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMA VALVE W DIAPHRA |
A7502 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT DIAPHRAGM/FPLATE |
A7503 |
$0.00 |
HCPCS / CPT® |
HMES FILTER HOLDER OR CAP |
A7504 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMA HMES FILTER |
A7505 |
$0.00 |
HCPCS / CPT® |
HMES OR TRACH VALVE HOUSING |
A7506 |
$0.00 |
HCPCS / CPT® |
HMES/TRACHVALVE ADHESIVEDISK |
A7507 |
$0.00 |
HCPCS / CPT® |
INTEGRATED FILTER & HOLDER |
A7508 |
$0.00 |
HCPCS / CPT® |
HOUSING & INTEGRATED ADHESIV |
A7509 |
$0.00 |
HCPCS / CPT® |
HEAT & MOISTURE EXCHANGE SYS |
A7520 |
$48.60 |
HCPCS / CPT® |
TRACH/LARYN TUBE NON-CUFFED |
A7521 |
$0.00 |
HCPCS / CPT® |
TRACH/LARYN TUBE CUFFED |
A7522 |
$0.00 |
HCPCS / CPT® |
TRACH/LARYN TUBE STAINLESS |
A7523 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMY SHOWER PROTECT |
A7524 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMA STENT/STUD/BTTN |
A7525 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMY MASK |
A7526 |
$0.00 |
HCPCS / CPT® |
TRACHEOSTOMY TUBE COLLAR |
A7527 |
$0.00 |
HCPCS / CPT® |
TRACH/LARYN TUBE PLUG/STOP |
A8000 |
$0.00 |
HCPCS / CPT® |
SOFT PROTECT HELMET PREFAB |
A8001 |
$0.00 |
HCPCS / CPT® |
HARD PROTECT HELMET PREFAB |
A8002 |
$0.00 |
HCPCS / CPT® |
SOFT PROTECT HELMET CUSTOM |
A8003 |
$0.00 |
HCPCS / CPT® |
HARD PROTECT HELMET CUSTOM |
A8004 |
$0.00 |
HCPCS / CPT® |
REPL SOFT INTERFACE, HELMET |
A9150 |
$8.84 |
HCPCS / CPT® |
MISC/EXPER NON-PRESCRIPT DRU |
A9150ACET3 |
$15.00 |
HCPCS / CPT® |
ACETAMINOPHEN – TYLENOL; 325MG TAB PO |
A9150ACET5 |
$15.00 |
HCPCS / CPT® |
ACETAMINOPHEN – TYLENOL; 500MG TAB PO |
A9150ACETP |
$10.00 |
HCPCS / CPT® |
ACETAMINOPHEN-TYLENOL; 120 MG SUPPOSITORY |
A9150ACETS |
$10.00 |
HCPCS / CPT® |
ACETAMINOPHEN – TYLENOL; 160MG/5ML SUSP PO |
A9150ASP3 |
$10.00 |
HCPCS / CPT® |
ASPIRIN; 325MG TAB PO |
A9150ASP81 |
$10.00 |
HCPCS / CPT® |
ASPIRIN – ASA; 81MG PO |
A9150BEN25 |
$25.00 |
HCPCS / CPT® |
BENADRYL – DIPHENHYDRAMINE HCI; 25MG PO |
A9150BENS |
$40.00 |
HCPCS / CPT® |
Benadryl – Diphenhydramine; 12.5mg/5ml Susp PO |
A9150CLARI |
$10.00 |
HCPCS / CPT® |
CLARITIN-LORATADINE; 5MG TAB PO |
A9150EXCED |
$20.00 |
HCPCS / CPT® |
EXCEDRIN MIGRAINE-ACETAMINOPHEN, ASPIRIN, CAFFEINE; 250MG-250MG-65MG TAB PO |
A9150IM |
$25.00 |
HCPCS / CPT® |
IMMODIUM/LOPERAMIDE; PO |
A9150IMOD |
$15.00 |
HCPCS / CPT® |
IMODIUM; 4MG TAB PO |
A9150MAG |
$15.00 |
HCPCS / CPT® |
MAGNESIUM CITRATE; 150ML PO |
A9150MOT2 |
$10.00 |
HCPCS / CPT® |
Motrin/Ibuprofen, Tab 200mg |
A9150MOT4 |
$10.00 |
HCPCS / CPT® |
MOTRIN/IBUPROFEN; 400MG TAB PO |
A9150MOTS |
$15.00 |
HCPCS / CPT® |
IBUPROFEN – MOTRIN; 100MG/5ML SUSP PO |
A9150NEOSY |
$15.00 |
HCPCS / CPT® |
NEO-SYNEPHRINE – PHENYLEPHRINE HCl; NASAL SPRAY |
A9150PEP |
$25.00 |
HCPCS / CPT® |
PEPCID/FAMOTIDINE; 20MG PO |
A9150PRILO |
$25.00 |
HCPCS / CPT® |
PRILOSEC-OMEPRAZOLE; 20MG TAB PO |
A9150SUDA |
$10.00 |
HCPCS / CPT® |
SUDAFED |
A9152 |
$0.00 |
HCPCS / CPT® |
SINGLE VITAMIN NOS |
A9153 |
$0.00 |
HCPCS / CPT® |
MULTI-VITAMIN NOS |
A9155 |
$0.00 |
HCPCS / CPT® |
ARTIFICIAL SALIVA |
A9180 |
$0.00 |
HCPCS / CPT® |
LICE TREATMENT, TOPICAL |
A9270 |
$0.00 |
HCPCS / CPT® |
NON-COVERED ITEM OR SERVICE |
A9272 |
$0.00 |
HCPCS / CPT® |
DISP WOUND SUCT, DRSG/ACCESS |
A9273 |
$16.84 |
HCPCS / CPT® |
HOT/COLD H2OBOT/CAP/COL/WRAP |
A9274 |
$0.00 |
HCPCS / CPT® |
EXT AMB INSULIN DELIVERY SYS |
A9275 |
$0.00 |
HCPCS / CPT® |
DISP HOME GLUCOSE MONITOR |
A9276 |
$0.00 |
HCPCS / CPT® |
DISPOSABLE SENSOR, CGM SYS |
A9277 |
$0.00 |
HCPCS / CPT® |
EXTERNAL TRANSMITTER, CGM |
A9278 |
$0.00 |
HCPCS / CPT® |
EXTERNAL RECEIVER, CGM SYS |
A9279 |
$0.00 |
HCPCS / CPT® |
MONITORING FEATURE/DEVICENOC |
A9280 |
$0.00 |
HCPCS / CPT® |
ALERT DEVICE, NOC |
A9281 |
$0.00 |
HCPCS / CPT® |
REACHING/GRABBING DEVICE |
A9282 |
$0.00 |
HCPCS / CPT® |
WIG ANY TYPE |
A9283 |
$0.00 |
HCPCS / CPT® |
FOOT PRESS OFF LOAD SUPP DEV |
A9284 |
$0.00 |
HCPCS / CPT® |
NON-ELECTRONIC SPIROMETER |
A9285 |
$0.00 |
HCPCS / CPT® |
INVERSION EVERSION COR DEVIC |
A9286 |
$0.00 |
HCPCS / CPT® |
ANY HYGIENIC ITEM, DEVICE |
A9300 |
$0.00 |
HCPCS / CPT® |
EXERCISE EQUIPMENT |
A9500 |
$0.00 |
HCPCS / CPT® |
TC99M SESTAMIBI |
A9501 |
$0.00 |
HCPCS / CPT® |
TECHNETIUM TC-99M TEBOROXIME |
A9502 |
$0.00 |
HCPCS / CPT® |
TC99M TETROFOSMIN |
A9503 |
$0.00 |
HCPCS / CPT® |
TC99M MEDRONATE |
A9504 |
$0.00 |
HCPCS / CPT® |
TC99M APCITIDE |
A9505 |
$0.00 |
HCPCS / CPT® |
TL201 THALLIUM |
A9507 |
$0.00 |
HCPCS / CPT® |
IN111 CAPROMAB |
A9508 |
$0.00 |
HCPCS / CPT® |
I131 IODOBENGUATE, DX |
A9509 |
$0.00 |
HCPCS / CPT® |
IODINE I-123 SOD IODIDE MIL |
A9510 |
$0.00 |
HCPCS / CPT® |
TC99M DISOFENIN |
A9512 |
$0.00 |
HCPCS / CPT® |
TC99M PERTECHNETATE |
A9515 |
$0.00 |
HCPCS / CPT® |
CHOLINE C-11 |
A9516 |
$0.00 |
HCPCS / CPT® |
IODINE I-123 SOD IODIDE MIC |
A9517 |
$0.00 |
HCPCS / CPT® |
I131 IODIDE CAP, RX |
A9520 |
$0.00 |
HCPCS / CPT® |
TC99 TILMANOCEPT DIAG 0.5MCI |
A9521 |
$0.00 |
HCPCS / CPT® |
TC99M EXAMETAZIME |
A9524 |
$0.00 |
HCPCS / CPT® |
I131 SERUM ALBUMIN, DX |
A9526 |
$0.00 |
HCPCS / CPT® |
NITROGEN N-13 AMMONIA |
A9527 |
$0.00 |
HCPCS / CPT® |
IODINE I-125 SODIUM IODIDE |
A9528 |
$0.00 |
HCPCS / CPT® |
IODINE I-131 IODIDE CAP, DX |
A9529 |
$0.00 |
HCPCS / CPT® |
I131 IODIDE SOL, DX |
A9530 |
$0.00 |
HCPCS / CPT® |
I131 IODIDE SOL, RX |
A9531 |
$0.00 |
HCPCS / CPT® |
I131 MAX 100UCI |
A9532 |
$0.00 |
HCPCS / CPT® |
I125 SERUM ALBUMIN, DX |
A9536 |
$0.00 |
HCPCS / CPT® |
TC99M DEPREOTIDE |
A9537 |
$0.00 |
HCPCS / CPT® |
TC99M MEBROFENIN |
A9538 |
$0.00 |
HCPCS / CPT® |
TC99M PYROPHOSPHATE |
A9539 |
$0.00 |
HCPCS / CPT® |
TC99M PENTETATE |
A9540 |
$0.00 |
HCPCS / CPT® |
TC99M MAA |
A9541 |
$0.00 |
HCPCS / CPT® |
TC99M SULFUR COLLOID |
A9542 |
$0.00 |
HCPCS / CPT® |
IN111 IBRITUMOMAB, DX |
A9543 |
$0.00 |
HCPCS / CPT® |
Y90 IBRITUMOMAB, RX |
A9546 |
$0.00 |
HCPCS / CPT® |
CO57/58 |
A9547 |
$0.00 |
HCPCS / CPT® |
IN111 OXYQUINOLINE |
A9548 |
$0.00 |
HCPCS / CPT® |
IN111 PENTETATE |
A9550 |
$0.00 |
HCPCS / CPT® |
TC99M GLUCEPTATE |
A9551 |
$0.00 |
HCPCS / CPT® |
TC99M SUCCIMER |
A9552 |
$0.00 |
HCPCS / CPT® |
F18 FDG |
A9553 |
$0.00 |
HCPCS / CPT® |
CR51 CHROMATE |
A9554 |
$0.00 |
HCPCS / CPT® |
I125 IOTHALAMATE, DX |
A9555 |
$0.00 |
HCPCS / CPT® |
RB82 RUBIDIUM |
A9556 |
$0.00 |
HCPCS / CPT® |
GA67 GALLIUM |
A9557 |
$0.00 |
HCPCS / CPT® |
TC99M BICISATE |
A9558 |
$0.00 |
HCPCS / CPT® |
XE133 XENON 10MCI |
A9559 |
$0.00 |
HCPCS / CPT® |
CO57 CYANO |
A9560 |
$0.00 |
HCPCS / CPT® |
TC99M LABELED RBC |
A9561 |
$0.00 |
HCPCS / CPT® |
TC99M OXIDRONATE |
A9562 |
$0.00 |
HCPCS / CPT® |
TC99M MERTIATIDE |
A9563 |
$0.00 |
HCPCS / CPT® |
P32 NA PHOSPHATE |
A9564 |
$0.00 |
HCPCS / CPT® |
P32 CHROMIC PHOSPHATE |
A9566 |
$0.00 |
HCPCS / CPT® |
TC99M FANOLESOMAB |
A9567 |
$0.00 |
HCPCS / CPT® |
TECHNETIUM TC-99M AEROSOL |
A9568 |
$0.00 |
HCPCS / CPT® |
TECHNETIUM TC99M ARCITUMOMAB |
A9569 |
$0.00 |
HCPCS / CPT® |
TECHNETIUM TC-99M AUTO WBC |
A9570 |
$0.00 |
HCPCS / CPT® |
INDIUM IN-111 AUTO WBC |
A9571 |
$0.00 |
HCPCS / CPT® |
INDIUM IN-111 AUTO PLATELET |
A9572 |
$0.00 |
HCPCS / CPT® |
INDIUM IN-111 PENTETREOTIDE |
A9575 |
$0.00 |
HCPCS / CPT® |
INJ GADOTERATE MEGLUMI 0.1ML |
A9576 |
$0.00 |
HCPCS / CPT® |
INJ PROHANCE MULTIPACK |
A9577 |
$0.00 |
HCPCS / CPT® |
INJ MULTIHANCE |
A9578 |
$0.00 |
HCPCS / CPT® |
INJ MULTIHANCE MULTIPACK |
A9579 |
$20.63 |
HCPCS / CPT® |
GAD-BASE MR CONTRAST NOS,1ML |
A9580 |
$0.00 |
HCPCS / CPT® |
SODIUM FLUORIDE F-18 |
A9581 |
$0.00 |
HCPCS / CPT® |
GADOXETATE DISODIUM INJ |
A9582 |
$0.00 |
HCPCS / CPT® |
IODINE I-123 IOBENGUANE |
A9583 |
$0.00 |
HCPCS / CPT® |
GADOFOSVESET TRISODIUM INJ |
A9584 |
$0.00 |
HCPCS / CPT® |
IODINE I-123 IOFLUPANE |
A9585 |
$0.00 |
HCPCS / CPT® |
GADOBUTROL INJECTION |
A9586 |
$0.00 |
HCPCS / CPT® |
FLORBETAPIR F18 |
A9587 |
$0.00 |
HCPCS / CPT® |
GALLIUM GA-68 |
A9588 |
$0.00 |
HCPCS / CPT® |
FLUCICLOVINE F-18 |
A9597 |
$0.00 |
HCPCS / CPT® |
PET, DX, FOR TUMOR ID, NOC |
A9598 |
$0.00 |
HCPCS / CPT® |
PET DX FOR NON-TUMOR ID, NOC |
A9599 |
$0.00 |
HCPCS / CPT® |
RADIOPH DX B AMYLOID PET NOS |
A9600 |
$0.00 |
HCPCS / CPT® |
SR89 STRONTIUM |
A9604 |
$0.00 |
HCPCS / CPT® |
SM 153 LEXIDRONAM |
A9606 |
$0.00 |
HCPCS / CPT® |
RADIUM RA223 DICHLORIDE THER |
A9698 |
$0.00 |
HCPCS / CPT® |
NON-RAD CONTRAST MATERIALNOC |
A9699 |
$0.00 |
HCPCS / CPT® |
RADIOPHARM RX AGENT NOC |
A9700 |
$0.00 |
HCPCS / CPT® |
ECHOCARDIOGRAPHY CONTRAST |
A9900 |
$0.00 |
HCPCS / CPT® |
SUPPLY/ACCESSORY/SERVICE |
A9901 |
$0.00 |
HCPCS / CPT® |
DELIVERY/SET UP/DISPENSING |
A9999 |
$0.00 |
HCPCS / CPT® |
DME SUPPLY OR ACCESSORY, NOS |
AMA |
$0.00 |
HCPCS / CPT® |
PT LEFT AGAINST MEDICAL ADVICE |
B4034 |
$0.00 |
HCPCS / CPT® |
ENTER FEED SUPKIT SYR BY DAY |
B4035 |
$0.00 |
HCPCS / CPT® |
ENTERAL FEED SUPP PUMP PER D |
B4036 |
$0.00 |
HCPCS / CPT® |
ENTERAL FEED SUP KIT GRAV BY |
B4081 |
$0.00 |
HCPCS / CPT® |
ENTERAL NG TUBING W/ STYLET |
B4082 |
$25.00 |
HCPCS / CPT® |
ENTERAL NG TUBING W/O STYLET |
B4083 |
$0.00 |
HCPCS / CPT® |
ENTERAL STOMACH TUBE LEVINE |
B4087 |
$0.00 |
HCPCS / CPT® |
GASTRO/JEJUNO TUBE, STD |
B4088 |
$0.00 |
HCPCS / CPT® |
GASTRO/JEJUNO TUBE, LOW-PRO |
B4100 |
$0.00 |
HCPCS / CPT® |
FOOD THICKENER ORAL |
B4102 |
$0.00 |
HCPCS / CPT® |
EF ADULT FLUIDS AND ELECTRO |
B4103 |
$0.00 |
HCPCS / CPT® |
EF PED FLUID AND ELECTROLYTE |
B4104 |
$0.00 |
HCPCS / CPT® |
ADDITIVE FOR ENTERAL FORMULA |
B4149 |
$0.00 |
HCPCS / CPT® |
EF BLENDERIZED FOODS |
B4150 |
$0.00 |
HCPCS / CPT® |
EF COMPLET W/INTACT NUTRIENT |
B4152 |
$0.00 |
HCPCS / CPT® |
EF CALORIE DENSE>/=1.5KCAL |
B4153 |
$0.00 |
HCPCS / CPT® |
EF HYDROLYZED/AMINO ACIDS |
B4154 |
$0.00 |
HCPCS / CPT® |
EF SPEC METABOLIC NONINHERIT |
B4155 |
$0.00 |
HCPCS / CPT® |
EF INCOMPLETE/MODULAR |
B4157 |
$0.00 |
HCPCS / CPT® |
EF SPECIAL METABOLIC INHERIT |
B4158 |
$0.00 |
HCPCS / CPT® |
EF PED COMPLETE INTACT NUT |
B4159 |
$0.00 |
HCPCS / CPT® |
EF PED COMPLETE SOY BASED |
B4160 |
$0.00 |
HCPCS / CPT® |
EF PED CALORIC DENSE>/=0.7KC |
B4161 |
$0.00 |
HCPCS / CPT® |
EF PED HYDROLYZED/AMINO ACID |
B4162 |
$0.00 |
HCPCS / CPT® |
EF PED SPECMETABOLIC INHERIT |
B4164 |
$0.00 |
HCPCS / CPT® |
PARENTERAL 50% DEXTROSE SOLU |
B4168 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL AMINO ACID 3. |
B4172 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL AMINO ACID 5. |
B4176 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL AMINO ACID 7- |
B4178 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL AMINO ACID > |
B4180 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL CARB > 50% |
B4185 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL 10 GM LIPIDS |
B4189 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL AMINO ACID & |
B4193 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL 52-73 GM PROT |
B4197 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL 74-100 GM PRO |
B4199 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL > 100GM PROTE |
B4216 |
$0.00 |
HCPCS / CPT® |
PARENTERAL NUTRITION ADDITIV |
B4220 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SUPPLY KIT PREMIX |
B4222 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SUPPLY KIT HOMEMI |
B4224 |
$0.00 |
HCPCS / CPT® |
PARENTERAL ADMINISTRATION KI |
B5000 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL RENAL-AMIROSY |
B5100 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOLUTION HEPATIC |
B5200 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SOL HEPATIC FREAM |
B9002 |
$0.00 |
HCPCS / CPT® |
ENTER NUTR INF PUMP ANY TYPE |
B9004 |
$0.00 |
HCPCS / CPT® |
PARENTERAL INFUS PUMP PORTAB |
B9006 |
$0.00 |
HCPCS / CPT® |
PARENTERAL INFUS PUMP STATIO |
B9998 |
$0.00 |
HCPCS / CPT® |
ENTERAL SUPP NOT OTHERWISE C |
B9999 |
$0.00 |
HCPCS / CPT® |
PARENTERAL SUPP NOT OTHRWS C |
C1713 |
$0.00 |
HCPCS / CPT® |
ANCHOR/SCREW BN/BN,TIS/BN |
C1714 |
$0.00 |
HCPCS / CPT® |
CATH, TRANS ATHERECTOMY, DIR |
C1715 |
$0.00 |
HCPCS / CPT® |
BRACHYTHERAPY NEEDLE |
C1716 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STR, GOLD-198 |
C1717 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STR,HDR IR-192 |
C1719 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NS, NON-HDRIR-192 |
C1721 |
$0.00 |
HCPCS / CPT® |
AICD, DUAL CHAMBER |
C1722 |
$0.00 |
HCPCS / CPT® |
AICD, SINGLE CHAMBER |
C1724 |
$0.00 |
HCPCS / CPT® |
CATH, TRANS ATHEREC,ROTATION |
C1725 |
$0.00 |
HCPCS / CPT® |
CATH, TRANSLUMIN NON-LASER |
C1726 |
$0.00 |
HCPCS / CPT® |
CATH, BAL DIL, NON-VASCULAR |
C1727 |
$0.00 |
HCPCS / CPT® |
CATH, BAL TIS DIS, NON-VAS |
C1728 |
$0.00 |
HCPCS / CPT® |
CATH, BRACHYTX SEED ADM |
C1729 |
$0.00 |
HCPCS / CPT® |
CATH, DRAINAGE |
C1730 |
$0.00 |
HCPCS / CPT® |
CATH, EP, 19 OR FEW ELECT |
C1731 |
$0.00 |
HCPCS / CPT® |
CATH, EP, 20 OR MORE ELEC |
C1732 |
$0.00 |
HCPCS / CPT® |
CATH, EP, DIAG/ABL, 3D/VECT |
C1733 |
$0.00 |
HCPCS / CPT® |
CATH, EP, OTHR THAN COOL-TIP |
C1749 |
$0.00 |
HCPCS / CPT® |
ENDO, COLON, RETRO IMAGING |
C1750 |
$0.00 |
HCPCS / CPT® |
CATH, HEMODIALYSIS,LONG-TERM |
C1751 |
$0.00 |
HCPCS / CPT® |
CATH, INF, PER/CENT/MIDLINE |
C1752 |
$0.00 |
HCPCS / CPT® |
CATH,HEMODIALYSIS,SHORT-TERM |
C1753 |
$0.00 |
HCPCS / CPT® |
CATH, INTRAVAS ULTRASOUND |
C1754 |
$0.00 |
HCPCS / CPT® |
CATHETER, INTRADISCAL |
C1755 |
$0.00 |
HCPCS / CPT® |
CATHETER, INTRASPINAL |
C1756 |
$0.00 |
HCPCS / CPT® |
CATH, PACING, TRANSESOPH |
C1757 |
$0.00 |
HCPCS / CPT® |
CATH, THROMBECTOMY/EMBOLECT |
C1758 |
$0.00 |
HCPCS / CPT® |
CATHETER, URETERAL |
C1759 |
$0.00 |
HCPCS / CPT® |
CATH, INTRA ECHOCARDIOGRAPHY |
C1760 |
$0.00 |
HCPCS / CPT® |
CLOSURE DEV, VASC |
C1762 |
$0.00 |
HCPCS / CPT® |
CONN TISS, HUMAN(INC FASCIA) |
C1763 |
$0.00 |
HCPCS / CPT® |
CONN TISS, NON-HUMAN |
C1764 |
$0.00 |
HCPCS / CPT® |
EVENT RECORDER, CARDIAC |
C1765 |
$0.00 |
HCPCS / CPT® |
ADHESION BARRIER |
C1766 |
$0.00 |
HCPCS / CPT® |
INTRO/SHEATH,STRBLE,NON-PEEL |
C1767 |
$0.00 |
HCPCS / CPT® |
GENERATOR, NEURO NON-RECHARG |
C1768 |
$0.00 |
HCPCS / CPT® |
GRAFT, VASCULAR |
C1769 |
$0.00 |
HCPCS / CPT® |
GUIDE WIRE |
C1770 |
$0.00 |
HCPCS / CPT® |
IMAGING COIL, MR, INSERTABLE |
C1771 |
$0.00 |
HCPCS / CPT® |
REP DEV, URINARY, W/SLING |
C1772 |
$0.00 |
HCPCS / CPT® |
INFUSION PUMP, PROGRAMMABLE |
C1773 |
$0.00 |
HCPCS / CPT® |
RET DEV, INSERTABLE |
C1776 |
$0.00 |
HCPCS / CPT® |
JOINT DEVICE (IMPLANTABLE) |
C1777 |
$0.00 |
HCPCS / CPT® |
LEAD, AICD, ENDO SINGLE COIL |
C1778 |
$0.00 |
HCPCS / CPT® |
LEAD, NEUROSTIMULATOR |
C1779 |
$0.00 |
HCPCS / CPT® |
LEAD, PMKR, TRANSVENOUS VDD |
C1780 |
$0.00 |
HCPCS / CPT® |
LENS, INTRAOCULAR (NEW TECH) |
C1781 |
$0.00 |
HCPCS / CPT® |
MESH (IMPLANTABLE) |
C1782 |
$0.00 |
HCPCS / CPT® |
MORCELLATOR |
C1783 |
$0.00 |
HCPCS / CPT® |
OCULAR IMP, AQUEOUS DRAIN DE |
C1784 |
$0.00 |
HCPCS / CPT® |
OCULAR DEV, INTRAOP, DET RET |
C1785 |
$0.00 |
HCPCS / CPT® |
PMKR, DUAL, RATE-RESP |
C1786 |
$0.00 |
HCPCS / CPT® |
PMKR, SINGLE, RATE-RESP |
C1787 |
$0.00 |
HCPCS / CPT® |
PATIENT PROGR, NEUROSTIM |
C1788 |
$0.00 |
HCPCS / CPT® |
PORT, INDWELLING, IMP |
C1789 |
$0.00 |
HCPCS / CPT® |
PROSTHESIS, BREAST, IMP |
C1813 |
$0.00 |
HCPCS / CPT® |
PROSTHESIS, PENILE, INFLATAB |
C1814 |
$0.00 |
HCPCS / CPT® |
RETINAL TAMP, SILICONE OIL |
C1815 |
$0.00 |
HCPCS / CPT® |
PROS, URINARY SPH, IMP |
C1816 |
$0.00 |
HCPCS / CPT® |
RECEIVER/TRANSMITTER, NEURO |
C1817 |
$0.00 |
HCPCS / CPT® |
SEPTAL DEFECT IMP SYS |
C1818 |
$0.00 |
HCPCS / CPT® |
INTEGRATED KERATOPROSTHESIS |
C1819 |
$0.00 |
HCPCS / CPT® |
TISSUE LOCALIZATION-EXCISION |
C1820 |
$0.00 |
HCPCS / CPT® |
GENERATOR NEURO RECHG BAT SY |
C1821 |
$0.00 |
HCPCS / CPT® |
INTERSPINOUS IMPLANT |
C1822 |
$0.00 |
HCPCS / CPT® |
GEN, NEURO, HF, RECHG BAT |
C1830 |
$0.00 |
HCPCS / CPT® |
POWER BONE MARROW BX NEEDLE |
C1840 |
$0.00 |
HCPCS / CPT® |
TELESCOPIC INTRAOCULAR LENS |
C1841 |
$0.00 |
HCPCS / CPT® |
RETINAL PROSTH INT/EXT COMP |
C1874 |
$0.00 |
HCPCS / CPT® |
STENT, COATED/COV W/DEL SYS |
C1875 |
$0.00 |
HCPCS / CPT® |
STENT, COATED/COV W/O DEL SY |
C1876 |
$0.00 |
HCPCS / CPT® |
STENT, NON-COA/NON-COV W/DEL |
C1877 |
$0.00 |
HCPCS / CPT® |
STENT, NON-COAT/COV W/O DEL |
C1878 |
$0.00 |
HCPCS / CPT® |
MATRL FOR VOCAL CORD |
C1880 |
$0.00 |
HCPCS / CPT® |
VENA CAVA FILTER |
C1881 |
$0.00 |
HCPCS / CPT® |
DIALYSIS ACCESS SYSTEM |
C1882 |
$0.00 |
HCPCS / CPT® |
AICD, OTHER THAN SING/DUAL |
C1883 |
$0.00 |
HCPCS / CPT® |
ADAPT/EXT, PACING/NEURO LEAD |
C1884 |
$0.00 |
HCPCS / CPT® |
EMBOLIZATION PROTECT SYST |
C1885 |
$0.00 |
HCPCS / CPT® |
CATH, TRANSLUMIN ANGIO LASER |
C1886 |
$0.00 |
HCPCS / CPT® |
CATHETER, ABLATION |
C1887 |
$0.00 |
HCPCS / CPT® |
CATHETER, GUIDING |
C1888 |
$0.00 |
HCPCS / CPT® |
ENDOVAS NON-CARDIAC ABL CATH |
C1889 |
$0.00 |
HCPCS / CPT® |
IMPLANT/INSERT DEVICE, NOC |
C1891 |
$0.00 |
HCPCS / CPT® |
INFUSION PUMP,NON-PROG, PERM |
C1892 |
$0.00 |
HCPCS / CPT® |
INTRO/SHEATH,FIXED,PEEL-AWAY |
C1893 |
$0.00 |
HCPCS / CPT® |
INTRO/SHEATH, FIXED,NON-PEEL |
C1894 |
$0.00 |
HCPCS / CPT® |
INTRO/SHEATH, NON-LASER |
C1895 |
$0.00 |
HCPCS / CPT® |
LEAD, AICD, ENDO DUAL COIL |
C1896 |
$0.00 |
HCPCS / CPT® |
LEAD, AICD, NON SING/DUAL |
C1897 |
$0.00 |
HCPCS / CPT® |
LEAD, NEUROSTIM TEST KIT |
C1898 |
$0.00 |
HCPCS / CPT® |
LEAD, PMKR, OTHER THAN TRANS |
C1899 |
$0.00 |
HCPCS / CPT® |
LEAD, PMKR/AICD COMBINATION |
C1900 |
$0.00 |
HCPCS / CPT® |
LEAD, CORONARY VENOUS |
C2613 |
$0.00 |
HCPCS / CPT® |
LUNG BX PLUG W/DEL SYS |
C2614 |
$0.00 |
HCPCS / CPT® |
PROBE, PERC LUMB DISC |
C2615 |
$0.00 |
HCPCS / CPT® |
SEALANT, PULMONARY, LIQUID |
C2616 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STR,YTTRIUM-90 |
C2617 |
$0.00 |
HCPCS / CPT® |
STENT, NON-COR, TEM W/O DEL |
C2618 |
$0.00 |
HCPCS / CPT® |
PROBE/NEEDLE, CRYO |
C2619 |
$0.00 |
HCPCS / CPT® |
PMKR, DUAL, NON RATE-RESP |
C2620 |
$0.00 |
HCPCS / CPT® |
PMKR, SINGLE, NON RATE-RESP |
C2621 |
$0.00 |
HCPCS / CPT® |
PMKR, OTHER THAN SING/DUAL |
C2622 |
$0.00 |
HCPCS / CPT® |
PROSTHESIS, PENILE, NON-INF |
C2623 |
$0.00 |
HCPCS / CPT® |
CATH, TRANSLUMIN, DRUG-COAT |
C2624 |
$0.00 |
HCPCS / CPT® |
WIRELESS PRESSURE SENSOR |
C2625 |
$0.00 |
HCPCS / CPT® |
STENT, NON-COR, TEM W/DEL SY |
C2626 |
$0.00 |
HCPCS / CPT® |
INFUSION PUMP, NON-PROG,TEMP |
C2627 |
$0.00 |
HCPCS / CPT® |
CATH, SUPRAPUBIC/CYSTOSCOPIC |
C2628 |
$0.00 |
HCPCS / CPT® |
CATHETER, OCCLUSION |
C2629 |
$0.00 |
HCPCS / CPT® |
INTRO/SHEATH, LASER |
C2630 |
$0.00 |
HCPCS / CPT® |
CATH, EP, COOL-TIP |
C2631 |
$0.00 |
HCPCS / CPT® |
REP DEV, URINARY, W/O SLING |
C2634 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STR, HA, I-125 |
C2635 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STR, HA, P-103 |
C2636 |
$0.00 |
HCPCS / CPT® |
BRACHY LINEAR, NON-STR,P-103 |
C2637 |
$0.00 |
HCPCS / CPT® |
BRACHY,NON-STR,YTTERBIUM-169 |
C2638 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, STRANDED, I-125 |
C2639 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STRANDED,I-125 |
C2640 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, STRANDED, P-103 |
C2641 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STRANDED,P-103 |
C2642 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, STRANDED, C-131 |
C2643 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STRANDED,C-131 |
C2644 |
$0.00 |
HCPCS / CPT® |
BRACHYTX CESIUM-131 CHLORIDE |
C2645 |
$0.00 |
HCPCS / CPT® |
BRACHYTX PLANAR, P-103 |
C2698 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, STRANDED, NOS |
C2699 |
$0.00 |
HCPCS / CPT® |
BRACHYTX, NON-STRANDED, NOS |
C5271 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C5272 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C5273 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C5274 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C5275 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C5276 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C5277 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C5278 |
$0.00 |
HCPCS / CPT® |
LOW COST SKIN SUBSTITUTE APP |
C8900 |
$0.00 |
HCPCS / CPT® |
MRA W/CONT, ABD |
C8901 |
$0.00 |
HCPCS / CPT® |
MRA W/O CONT, ABD |
C8902 |
$0.00 |
HCPCS / CPT® |
MRA W/O FOL W/CONT, ABD |
C8903 |
$0.00 |
HCPCS / CPT® |
MRI W/CONT, BREAST, UNI |
C8904 |
$0.00 |
HCPCS / CPT® |
MRI W/O CONT, BREAST, UNI |
C8905 |
$0.00 |
HCPCS / CPT® |
MRI W/O FOL W/CONT, BRST, UN |
C8906 |
$0.00 |
HCPCS / CPT® |
MRI W/CONT, BREAST, BI |
C8907 |
$0.00 |
HCPCS / CPT® |
MRI W/O CONT, BREAST, BI |
C8908 |
$0.00 |
HCPCS / CPT® |
MRI W/O FOL W/CONT, BREAST, |
C8909 |
$0.00 |
HCPCS / CPT® |
MRA W/CONT, CHEST |
C8910 |
$0.00 |
HCPCS / CPT® |
MRA W/O CONT, CHEST |
C8911 |
$0.00 |
HCPCS / CPT® |
MRA W/O FOL W/CONT, CHEST |
C8912 |
$0.00 |
HCPCS / CPT® |
MRA W/CONT, LWR EXT |
C8913 |
$0.00 |
HCPCS / CPT® |
MRA W/O CONT, LWR EXT |
C8914 |
$0.00 |
HCPCS / CPT® |
MRA W/O FOL W/CONT, LWR EXT |
C8918 |
$0.00 |
HCPCS / CPT® |
MRA W/CONT, PELVIS |
C8919 |
$0.00 |
HCPCS / CPT® |
MRA W/O CONT, PELVIS |
C8920 |
$0.00 |
HCPCS / CPT® |
MRA W/O FOL W/CONT, PELVIS |
C8921 |
$0.00 |
HCPCS / CPT® |
TTE W OR W/O FOL W/CONT, COM |
C8922 |
$0.00 |
HCPCS / CPT® |
TTE W OR W/O FOL W/CONT, F/U |
C8923 |
$0.00 |
HCPCS / CPT® |
2D TTE W OR W/O FOL W/CON,CO |
C8924 |
$0.00 |
HCPCS / CPT® |
2D TTE W OR W/O FOL W/CON,FU |
C8925 |
$0.00 |
HCPCS / CPT® |
2D TEE W OR W/O FOL W/CON,IN |
C8926 |
$0.00 |
HCPCS / CPT® |
TEE W OR W/O FOL W/CONT,CONG |
C8927 |
$0.00 |
HCPCS / CPT® |
TEE W OR W/O FOL W/CONT, MON |
C8928 |
$0.00 |
HCPCS / CPT® |
TTE W OR W/O FOL W/CON,STRES |
C8929 |
$0.00 |
HCPCS / CPT® |
TTE W OR WO FOL WCON,DOPPLER |
C8930 |
$0.00 |
HCPCS / CPT® |
TTE W OR W/O CONTR, CONT ECG |
C8931 |
$0.00 |
HCPCS / CPT® |
MRA, W/DYE, SPINAL CANAL |
C8932 |
$0.00 |
HCPCS / CPT® |
MRA, W/O DYE, SPINAL CANAL |
C8933 |
$0.00 |
HCPCS / CPT® |
MRA, W/O&W/DYE, SPINAL CANAL |
C8934 |
$0.00 |
HCPCS / CPT® |
MRA, W/DYE, UPPER EXTREMITY |
C8935 |
$0.00 |
HCPCS / CPT® |
MRA, W/O DYE, UPPER EXTR |
C8936 |
$0.00 |
HCPCS / CPT® |
MRA, W/O&W/DYE, UPPER EXTR |
C8957 |
$0.00 |
HCPCS / CPT® |
PROLONGED IV INF, REQ PUMP |
C9113 |
$0.00 |
HCPCS / CPT® |
INJ PANTOPRAZOLE SODIUM, VIA |
C9132 |
$0.00 |
HCPCS / CPT® |
KCENTRA, PER I.U. |
C9140 |
$0.00 |
HCPCS / CPT® |
AFSTYLA FACTOR VIII RECOMB |
C9248 |
$0.00 |
HCPCS / CPT® |
INJ, CLEVIDIPINE BUTYRATE |
C9250 |
$0.00 |
HCPCS / CPT® |
ARTISS FIBRIN SEALANT |
C9254 |
$0.00 |
HCPCS / CPT® |
INJECTION, LACOSAMIDE |
C9257 |
$0.00 |
HCPCS / CPT® |
BEVACIZUMAB INJECTION |
C9275 |
$0.00 |
HCPCS / CPT® |
HEXAMINOLEVULINATE HCL |
C9285 |
$101.03 |
HCPCS / CPT® |
PATCH, LIDOCAINE/TETRACAINE |
C9290 |
$0.00 |
HCPCS / CPT® |
INJ, BUPIVACAINE LIPOSOME |
C9293 |
$0.00 |
HCPCS / CPT® |
INJECTION, GLUCARPIDASE |
C9352 |
$0.00 |
HCPCS / CPT® |
NEURAGEN NERVE GUIDE, PER CM |
C9353 |
$0.00 |
HCPCS / CPT® |
NEURAWRAP NERVE PROTECTOR,CM |
C9354 |
$0.00 |
HCPCS / CPT® |
VERITAS COLLAGEN MATRIX, CM2 |
C9355 |
$0.00 |
HCPCS / CPT® |
NEUROMATRIX NERVE CUFF, CM |
C9356 |
$0.00 |
HCPCS / CPT® |
TENOGLIDE TENDON PROT, CM2 |
C9358 |
$0.00 |
HCPCS / CPT® |
SURGIMEND, FETAL |
C9359 |
$0.00 |
HCPCS / CPT® |
IMPLNT,BON VOID FILLER-PUTTY |
C9360 |
$0.00 |
HCPCS / CPT® |
SURGIMEND, NEONATAL |
C9361 |
$0.00 |
HCPCS / CPT® |
NEUROMEND NERVE WRAP |
C9362 |
$0.00 |
HCPCS / CPT® |
IMPLNT,BON VOID FILLER-STRIP |
C9363 |
$0.00 |
HCPCS / CPT® |
INTEGRA MESHED BIL WOUND MAT |
C9364 |
$0.00 |
HCPCS / CPT® |
PORCINE IMPLANT, PERMACOL |
C9399 |
$0.00 |
HCPCS / CPT® |
C9399 |
C9447 |
$0.00 |
HCPCS / CPT® |
INJ, PHENYLEPHRINE KETOROLAC |
C9460 |
$0.00 |
HCPCS / CPT® |
INJECTION, CANGRELOR |
C9482 |
$0.00 |
HCPCS / CPT® |
SOTALOL HYDROCHLORIDE IV |
C9483 |
$0.00 |
HCPCS / CPT® |
INJECTION, ATEZOLIZUMAB |
C9497 |
$0.00 |
HCPCS / CPT® |
LOXAPINE, INHALATION POWDER |
C9600 |
$0.00 |
HCPCS / CPT® |
PERC DRUG-EL COR STENT SING |
C9601 |
$0.00 |
HCPCS / CPT® |
PERC DRUG-EL COR STENT BRAN |
C9602 |
$0.00 |
HCPCS / CPT® |
PERC D-E COR STENT ATHER S |
C9603 |
$0.00 |
HCPCS / CPT® |
PERC D-E COR STENT ATHER BR |
C9604 |
$0.00 |
HCPCS / CPT® |
PERC D-E COR REVASC T CABG S |
C9605 |
$0.00 |
HCPCS / CPT® |
PERC D-E COR REVASC T CABG B |
C9606 |
$0.00 |
HCPCS / CPT® |
PERC D-E COR REVASC W AMI S |
C9607 |
$0.00 |
HCPCS / CPT® |
PERC D-E COR REVASC CHRO SIN |
C9608 |
$0.00 |
HCPCS / CPT® |
PERC D-E COR REVASC CHRO ADD |
C9725 |
$0.00 |
HCPCS / CPT® |
PLACE ENDORECTAL APP |
C9726 |
$0.00 |
HCPCS / CPT® |
RXT BREAST APPL PLACE/REMOV |
C9727 |
$0.00 |
HCPCS / CPT® |
INSERT PALATE IMPLANTS |
C9728 |
$0.00 |
HCPCS / CPT® |
PLACE DEVICE/MARKER, NON PRO |
C9733 |
$0.00 |
HCPCS / CPT® |
NON-OPHTHALMIC FVA |
C9734 |
$0.00 |
HCPCS / CPT® |
U/S TRTMT, NOT LEIOMYOMATA |
C9739 |
$0.00 |
HCPCS / CPT® |
CYSTOSCOPY PROSTATIC IMP 1-3 |
C9740 |
$0.00 |
HCPCS / CPT® |
CYSTO IMPL 4 OR MORE |
C9741 |
$0.00 |
HCPCS / CPT® |
IMPL PRESSURE SENSOR W/ANGIO |
C9744 |
$0.00 |
HCPCS / CPT® |
ABD US W/CONTRAST |
C9898 |
$0.00 |
HCPCS / CPT® |
INPNT STAY RADIOLABELED ITEM |
C9899 |
$0.00 |
HCPCS / CPT® |
INPT IMPLANT PROS DEV,NO COV |
E0100 |
$0.00 |
HCPCS / CPT® |
CANE ADJUST/FIXED WITH TIP |
E0105 |
$0.00 |
HCPCS / CPT® |
CANE ADJUST/FIXED QUAD/3 PRO |
E0110 |
$0.00 |
HCPCS / CPT® |
CRUTCH FOREARM PAIR |
E0111 |
$0.00 |
HCPCS / CPT® |
CRUTCH FOREARM EACH |
E0112 |
$0.00 |
HCPCS / CPT® |
CRUTCH UNDERARM PAIR WOOD |
E0113 |
$0.00 |
HCPCS / CPT® |
CRUTCH UNDERARM EACH WOOD |
E0114 |
$76.53 |
HCPCS / CPT® |
CRUTCH UNDERARM PAIR NO WOOD |
E0116 |
$76.53 |
HCPCS / CPT® |
CRUTCH UNDERARM EACH NO WOOD |
E0117 |
$0.00 |
HCPCS / CPT® |
UNDERARM SPRINGASSIST CRUTCH |
E0118 |
$0.00 |
HCPCS / CPT® |
CRUTCH SUBSTITUTE |
E0130 |
$0.00 |
HCPCS / CPT® |
WALKER RIGID ADJUST/FIXED HT |
E0135 |
$0.00 |
HCPCS / CPT® |
WALKER FOLDING ADJUST/FIXED |
E0140 |
$0.00 |
HCPCS / CPT® |
WALKER W TRUNK SUPPORT |
E0141 |
$0.00 |
HCPCS / CPT® |
RIGID WHEELED WALKER ADJ/FIX |
E0143 |
$0.00 |
HCPCS / CPT® |
WALKER FOLDING WHEELED W/O S |
E0144 |
$1879.66 |
HCPCS / CPT® |
ENCLOSED WALKER W REAR SEAT |
E0147 |
$0.00 |
HCPCS / CPT® |
WALKER VARIABLE WHEEL RESIST |
E0148 |
$0.00 |
HCPCS / CPT® |
HEAVYDUTY WALKER NO WHEELS |
E0149 |
$0.00 |
HCPCS / CPT® |
HEAVY DUTY WHEELED WALKER |
E0153 |
$0.00 |
HCPCS / CPT® |
FOREARM CRUTCH PLATFORM ATTA |
E0154 |
$0.00 |
HCPCS / CPT® |
WALKER PLATFORM ATTACHMENT |
E0155 |
$0.00 |
HCPCS / CPT® |
WALKER WHEEL ATTACHMENT,PAIR |
E0156 |
$0.00 |
HCPCS / CPT® |
WALKER SEAT ATTACHMENT |
E0157 |
$0.00 |
HCPCS / CPT® |
WALKER CRUTCH ATTACHMENT |
E0158 |
$0.00 |
HCPCS / CPT® |
WALKER LEG EXTENDERS SET OF4 |
E0159 |
$0.00 |
HCPCS / CPT® |
BRAKE FOR WHEELED WALKER |
E0160 |
$0.00 |
HCPCS / CPT® |
SITZ TYPE BATH OR EQUIPMENT |
E0161 |
$0.00 |
HCPCS / CPT® |
SITZ BATH/EQUIPMENT W/FAUCET |
E0162 |
$0.00 |
HCPCS / CPT® |
SITZ BATH CHAIR |
E0163 |
$0.00 |
HCPCS / CPT® |
COMMODE CHAIR WITH FIXED ARM |
E0165 |
$0.00 |
HCPCS / CPT® |
COMMODE CHAIR WITH DETACHARM |
E0167 |
$0.00 |
HCPCS / CPT® |
COMMODE CHAIR PAIL OR PAN |
E0168 |
$0.00 |
HCPCS / CPT® |
HEAVYDUTY/WIDE COMMODE CHAIR |
E0170 |
$0.00 |
HCPCS / CPT® |
COMMODE CHAIR ELECTRIC |
E0171 |
$0.00 |
HCPCS / CPT® |
COMMODE CHAIR NON-ELECTRIC |
E0172 |
$0.00 |
HCPCS / CPT® |
SEAT LIFT MECHANISM TOILET |
E0175 |
$0.00 |
HCPCS / CPT® |
COMMODE CHAIR FOOT REST |
E0181 |
$0.00 |
HCPCS / CPT® |
PRESS PAD ALTERNATING W/ PUM |
E0182 |
$0.00 |
HCPCS / CPT® |
REPLACE PUMP, ALT PRESS PAD |
E0184 |
$0.00 |
HCPCS / CPT® |
DRY PRESSURE MATTRESS |
E0185 |
$0.00 |
HCPCS / CPT® |
GEL PRESSURE MATTRESS PAD |
E0186 |
$0.00 |
HCPCS / CPT® |
AIR PRESSURE MATTRESS |
E0187 |
$0.00 |
HCPCS / CPT® |
WATER PRESSURE MATTRESS |
E0188 |
$0.00 |
HCPCS / CPT® |
SYNTHETIC SHEEPSKIN PAD |
E0189 |
$0.00 |
HCPCS / CPT® |
LAMBSWOOL SHEEPSKIN PAD |
E0190 |
$0.00 |
HCPCS / CPT® |
POSITIONING CUSHION |
E0191 |
$0.00 |
HCPCS / CPT® |
PROTECTOR HEEL OR ELBOW |
E0193 |
$0.00 |
HCPCS / CPT® |
POWERED AIR FLOTATION BED |
E0194 |
$0.00 |
HCPCS / CPT® |
AIR FLUIDIZED BED |
E0196 |
$0.00 |
HCPCS / CPT® |
GEL PRESSURE MATTRESS |
E0197 |
$0.00 |
HCPCS / CPT® |
AIR PRESSURE PAD FOR MATTRES |
E0198 |
$0.00 |
HCPCS / CPT® |
WATER PRESSURE PAD FOR MATTR |
E0199 |
$0.00 |
HCPCS / CPT® |
DRY PRESSURE PAD FOR MATTRES |
E0200 |
$0.00 |
HCPCS / CPT® |
HEAT LAMP WITHOUT STAND |
E0202 |
$0.00 |
HCPCS / CPT® |
PHOTOTHERAPY LIGHT W/ PHOTOM |
E0203 |
$0.00 |
HCPCS / CPT® |
THERAPEUTIC LIGHTBOX TABLETP |
E0205 |
$0.00 |
HCPCS / CPT® |
HEAT LAMP WITH STAND |
E0210 |
$0.00 |
HCPCS / CPT® |
ELECTRIC HEAT PAD STANDARD |
E0215 |
$0.00 |
HCPCS / CPT® |
ELECTRIC HEAT PAD MOIST |
E0217 |
$0.00 |
HCPCS / CPT® |
WATER CIRC HEAT PAD W PUMP |
E0218 |
$0.00 |
HCPCS / CPT® |
WATER CIRC COLD PAD W PUMP |
E0220 |
$45.92 |
HCPCS / CPT® |
HOT WATER BOTTLE |
E0221 |
$0.00 |
HCPCS / CPT® |
INFRARED HEATING PAD SYSTEM |
E0225 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLATOR UNIT |
E0230 |
$14.52 |
HCPCS / CPT® |
ICE CAP OR COLLAR |
E0231 |
$0.00 |
HCPCS / CPT® |
WOUND WARMING DEVICE |
E0232 |
$0.00 |
HCPCS / CPT® |
WARMING CARD FOR NWT |
E0235 |
$0.00 |
HCPCS / CPT® |
PARAFFIN BATH UNIT PORTABLE |
E0236 |
$0.00 |
HCPCS / CPT® |
PUMP FOR WATER CIRCULATING P |
E0239 |
$0.00 |
HCPCS / CPT® |
HYDROCOLLATOR UNIT PORTABLE |
E0240 |
$0.00 |
HCPCS / CPT® |
BATH/SHOWER CHAIR |
E0241 |
$0.00 |
HCPCS / CPT® |
BATH TUB WALL RAIL |
E0242 |
$0.00 |
HCPCS / CPT® |
BATH TUB RAIL FLOOR |
E0243 |
$0.00 |
HCPCS / CPT® |
TOILET RAIL |
E0244 |
$0.00 |
HCPCS / CPT® |
TOILET SEAT RAISED |
E0245 |
$0.00 |
HCPCS / CPT® |
TUB STOOL OR BENCH |
E0246 |
$0.00 |
HCPCS / CPT® |
TRANSFER TUB RAIL ATTACHMENT |
E0247 |
$0.00 |
HCPCS / CPT® |
TRANS BENCH W/WO COMM OPEN |
E0248 |
$0.00 |
HCPCS / CPT® |
HDTRANS BENCH W/WO COMM OPEN |
E0249 |
$0.00 |
HCPCS / CPT® |
PAD WATER CIRCULATING HEAT U |
E0250 |
$0.00 |
HCPCS / CPT® |
HOSP BED FIXED HT W/ MATTRES |
E0251 |
$0.00 |
HCPCS / CPT® |
HOSP BED FIXD HT W/O MATTRES |
E0255 |
$0.00 |
HCPCS / CPT® |
HOSPITAL BED VAR HT W/ MATTR |
E0256 |
$0.00 |
HCPCS / CPT® |
HOSPITAL BED VAR HT W/O MATT |
E0260 |
$0.00 |
HCPCS / CPT® |
HOSP BED SEMI-ELECTR W/ MATT |
E0261 |
$0.00 |
HCPCS / CPT® |
HOSP BED SEMI-ELECTR W/O MAT |
E0265 |
$0.00 |
HCPCS / CPT® |
HOSP BED TOTAL ELECTR W/ MAT |
E0266 |
$0.00 |
HCPCS / CPT® |
HOSP BED TOTAL ELEC W/O MATT |
E0270 |
$0.00 |
HCPCS / CPT® |
HOSPITAL BED INSTITUTIONAL T |
E0271 |
$0.00 |
HCPCS / CPT® |
MATTRESS INNERSPRING |
E0272 |
$0.00 |
HCPCS / CPT® |
MATTRESS FOAM RUBBER |
E0273 |
$0.00 |
HCPCS / CPT® |
BED BOARD |
E0274 |
$0.00 |
HCPCS / CPT® |
OVER-BED TABLE |
E0275 |
$15.31 |
HCPCS / CPT® |
BED PAN STANDARD |
E0276 |
$0.00 |
HCPCS / CPT® |
BED PAN FRACTURE |
E0277 |
$0.00 |
HCPCS / CPT® |
POWERED PRES-REDU AIR MATTRS |
E0280 |
$0.00 |
HCPCS / CPT® |
BED CRADLE |
E0290 |
$0.00 |
HCPCS / CPT® |
HOSP BED FX HT W/O RAILS W/M |
E0291 |
$0.00 |
HCPCS / CPT® |
HOSP BED FX HT W/O RAIL W/O |
E0292 |
$0.00 |
HCPCS / CPT® |
HOSP BED VAR HT NO SR W/MATT |
E0293 |
$0.00 |
HCPCS / CPT® |
HOSP BED VAR HT NO SR NO MAT |
E0294 |
$0.00 |
HCPCS / CPT® |
HOSP BED SEMI-ELECT W/ MATTR |
E0295 |
$0.00 |
HCPCS / CPT® |
HOSP BED SEMI-ELECT W/O MATT |
E0296 |
$0.00 |
HCPCS / CPT® |
HOSP BED TOTAL ELECT W/ MATT |
E0297 |
$0.00 |
HCPCS / CPT® |
HOSP BED TOTAL ELECT W/O MAT |
E0300 |
$0.00 |
HCPCS / CPT® |
ENCLOSED PED CRIB HOSP GRADE |
E0301 |
$0.00 |
HCPCS / CPT® |
HD HOSP BED, 350-600 LBS |
E0302 |
$0.00 |
HCPCS / CPT® |
EX HD HOSP BED > 600 LBS |
E0303 |
$0.00 |
HCPCS / CPT® |
HOSP BED HVY DTY XTRA WIDE |
E0304 |
$0.00 |
HCPCS / CPT® |
HOSP BED XTRA HVY DTY X WIDE |
E0305 |
$0.00 |
HCPCS / CPT® |
RAILS BED SIDE HALF LENGTH |
E0310 |
$0.00 |
HCPCS / CPT® |
RAILS BED SIDE FULL LENGTH |
E0315 |
$0.00 |
HCPCS / CPT® |
BED ACCESSORY BRD/TBL/SUPPRT |
E0316 |
$0.00 |
HCPCS / CPT® |
BED SAFETY ENCLOSURE |
E0325 |
$8.43 |
HCPCS / CPT® |
URINAL MALE JUG-TYPE |
E0326 |
$0.00 |
HCPCS / CPT® |
URINAL FEMALE JUG-TYPE |
E0328 |
$0.00 |
HCPCS / CPT® |
PED HOSPITAL BED, MANUAL |
E0329 |
$0.00 |
HCPCS / CPT® |
PED HOSPITAL BED SEMI/ELECT |
E0350 |
$0.00 |
HCPCS / CPT® |
CONTROL UNIT BOWEL SYSTEM |
E0352 |
$231.60 |
HCPCS / CPT® |
DISPOSABLE PACK W/BOWEL SYST (VAG SPECULUM) |
E0370 |
$0.00 |
HCPCS / CPT® |
AIR ELEVATOR FOR HEEL |
E0371 |
$0.00 |
HCPCS / CPT® |
NONPOWER MATTRESS OVERLAY |
E0372 |
$0.00 |
HCPCS / CPT® |
POWERED AIR MATTRESS OVERLAY |
E0373 |
$0.00 |
HCPCS / CPT® |
NONPOWERED PRESSURE MATTRESS |
E0424 |
$0.00 |
HCPCS / CPT® |
STATIONARY COMPRESSED GAS 02 |
E0425 |
$0.00 |
HCPCS / CPT® |
GAS SYSTEM STATIONARY COMPRE |
E0430 |
$0.00 |
HCPCS / CPT® |
OXYGEN SYSTEM GAS PORTABLE |
E0431 |
$0.00 |
HCPCS / CPT® |
PORTABLE GASEOUS 02 |
E0433 |
$0.00 |
HCPCS / CPT® |
PORTABLE LIQUID OXYGEN SYS |
E0434 |
$0.00 |
HCPCS / CPT® |
PORTABLE LIQUID 02 |
E0435 |
$0.00 |
HCPCS / CPT® |
OXYGEN SYSTEM LIQUID PORTABL |
E0439 |
$0.00 |
HCPCS / CPT® |
STATIONARY LIQUID 02 |
E0440 |
$0.00 |
HCPCS / CPT® |
OXYGEN SYSTEM LIQUID STATION |
E0441 |
$0.00 |
HCPCS / CPT® |
STATIONARY O2 CONTENTS, GAS |
E0442 |
$0.00 |
HCPCS / CPT® |
STATIONARY O2 CONTENTS, LIQ |
E0443 |
$0.00 |
HCPCS / CPT® |
PORTABLE 02 CONTENTS, GAS |
E0444 |
$0.00 |
HCPCS / CPT® |
PORTABLE 02 CONTENTS, LIQUID |
E0445 |
$757.68 |
HCPCS / CPT® |
OXIMETER NON-INVASIVE |
E0446 |
$0.00 |
HCPCS / CPT® |
TOPICAL OX DELIVER SYS, NOS |
E0455 |
$0.00 |
HCPCS / CPT® |
OXYGEN TENT EXCL CROUP/PED T |
E0457 |
$0.00 |
HCPCS / CPT® |
CHEST SHELL |
E0459 |
$0.00 |
HCPCS / CPT® |
CHEST WRAP |
E0462 |
$0.00 |
HCPCS / CPT® |
ROCKING BED W/ OR W/O SIDE R |
E0465 |
$0.00 |
HCPCS / CPT® |
HOME VENT INVASIVE INTERFACE |
E0466 |
$0.00 |
HCPCS / CPT® |
HOME VENT NON-INVASIVE INTER |
E0470 |
$0.00 |
HCPCS / CPT® |
RAD W/O BACKUP NON-INV INTFC |
E0471 |
$0.00 |
HCPCS / CPT® |
RAD W/BACKUP NON INV INTRFC |
E0472 |
$0.00 |
HCPCS / CPT® |
RAD W BACKUP INVASIVE INTRFC |
E0480 |
$0.00 |
HCPCS / CPT® |
PERCUSSOR ELECT/PNEUM HOME M |
E0481 |
$0.00 |
HCPCS / CPT® |
INTRPULMNRY PERCUSS VENT SYS |
E0482 |
$0.00 |
HCPCS / CPT® |
COUGH STIMULATING DEVICE |
E0483 |
$0.00 |
HCPCS / CPT® |
CHEST COMPRESSION GEN SYSTEM |
E0484 |
$0.00 |
HCPCS / CPT® |
NON-ELEC OSCILLATORY PEP DVC |
E0485 |
$0.00 |
HCPCS / CPT® |
ORAL DEVICE/APPLIANCE PREFAB |
E0486 |
$0.00 |
HCPCS / CPT® |
ORAL DEVICE/APPLIANCE CUSFAB |
E0487 |
$0.00 |
HCPCS / CPT® |
ELECTRONIC SPIROMETER |
E0500 |
$0.00 |
HCPCS / CPT® |
IPPB ALL TYPES |
E0550 |
$0.00 |
HCPCS / CPT® |
HUMIDIF EXTENS SUPPLE W IPPB |
E0555 |
$0.00 |
HCPCS / CPT® |
HUMIDIFIER FOR USE W/ REGULA |
E0560 |
$0.00 |
HCPCS / CPT® |
HUMIDIFIER SUPPLEMENTAL W/ I |
E0561 |
$0.00 |
HCPCS / CPT® |
HUMIDIFIER NONHEATED W PAP |
E0562 |
$0.00 |
HCPCS / CPT® |
HUMIDIFIER HEATED USED W PAP |
E0565 |
$0.00 |
HCPCS / CPT® |
COMPRESSOR AIR POWER SOURCE |
E0570 |
$887.78 |
HCPCS / CPT® |
NEBULIZER WITH COMPRESSION |
E0572 |
$0.00 |
HCPCS / CPT® |
AEROSOL COMPRESSOR ADJUST PR |
E0574 |
$0.00 |
HCPCS / CPT® |
ULTRASONIC GENERATOR W SVNEB |
E0575 |
$0.00 |
HCPCS / CPT® |
NEBULIZER ULTRASONIC |
E0580 |
$382.66 |
HCPCS / CPT® |
NEBULIZER FOR USE W/ REGULAT |
E0585 |
$0.00 |
HCPCS / CPT® |
NEBULIZER W/ COMPRESSOR & HE |
E0600 |
$0.00 |
HCPCS / CPT® |
SUCTION PUMP PORTAB HOM MODL |
E0601 |
$0.00 |
HCPCS / CPT® |
CONT AIRWAY PRESSURE DEVICE |
E0602 |
$0.00 |
HCPCS / CPT® |
MANUAL BREAST PUMP |
E0603 |
$0.00 |
HCPCS / CPT® |
ELECTRIC BREAST PUMP |
E0604 |
$0.00 |
HCPCS / CPT® |
HOSP GRADE ELEC BREAST PUMP |
E0605 |
$0.00 |
HCPCS / CPT® |
VAPORIZER ROOM TYPE |
E0606 |
$0.00 |
HCPCS / CPT® |
DRAINAGE BOARD POSTURAL |
E0607 |
$0.00 |
HCPCS / CPT® |
BLOOD GLUCOSE MONITOR HOME |
E0610 |
$0.00 |
HCPCS / CPT® |
PACEMAKER MONITR AUDIBLE/VIS |
E0615 |
$0.00 |
HCPCS / CPT® |
PACEMAKER MONITR DIGITAL/VIS |
E0616 |
$0.00 |
HCPCS / CPT® |
CARDIAC EVENT RECORDER |
E0617 |
$0.00 |
HCPCS / CPT® |
AUTOMATIC EXT DEFIBRILLATOR |
E0618 |
$0.00 |
HCPCS / CPT® |
APNEA MONITOR |
E0619 |
$0.00 |
HCPCS / CPT® |
APNEA MONITOR W RECORDER |
E0620 |
$0.00 |
HCPCS / CPT® |
CAP BLD SKIN PIERCING LASER |
E0621 |
$0.00 |
HCPCS / CPT® |
PATIENT LIFT SLING OR SEAT |
E0625 |
$0.00 |
HCPCS / CPT® |
PATIENT LIFT BATHROOM OR TOI |
E0627 |
$0.00 |
HCPCS / CPT® |
SEAT LIFT MECH, ELECTRIC ANY |
E0629 |
$0.00 |
HCPCS / CPT® |
SEAT LIFT MECH, NON-ELECTRIC |
E0630 |
$0.00 |
HCPCS / CPT® |
PATIENT LIFT HYDRAULIC |
E0635 |
$0.00 |
HCPCS / CPT® |
PATIENT LIFT ELECTRIC |
E0636 |
$0.00 |
HCPCS / CPT® |
PT SUPPORT & POSITIONING SYS |
E0637 |
$0.00 |
HCPCS / CPT® |
COMBINATION SIT TO STAND SYS |
E0638 |
$0.00 |
HCPCS / CPT® |
STANDING FRAME SYS |
E0639 |
$0.00 |
HCPCS / CPT® |
MOVEABLE PATIENT LIFT SYSTEM |
E0640 |
$0.00 |
HCPCS / CPT® |
FIXED PATIENT LIFT SYSTEM |
E0641 |
$0.00 |
HCPCS / CPT® |
MULTI-POSITION STND FRAM SYS |
E0642 |
$0.00 |
HCPCS / CPT® |
DYNAMIC STANDING FRAME |
E0650 |
$0.00 |
HCPCS / CPT® |
PNEUMA COMPRESOR NON-SEGMENT |
E0651 |
$0.00 |
HCPCS / CPT® |
PNEUM COMPRESSOR SEGMENTAL |
E0652 |
$0.00 |
HCPCS / CPT® |
PNEUM COMPRES W/CAL PRESSURE |
E0655 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC APPLIANCE HALF ARM |
E0656 |
$0.00 |
HCPCS / CPT® |
SEGMENTAL PNEUMATIC TRUNK |
E0657 |
$0.00 |
HCPCS / CPT® |
SEGMENTAL PNEUMATIC CHEST |
E0660 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC APPLIANCE FULL LEG |
E0665 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC APPLIANCE FULL ARM |
E0666 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC APPLIANCE HALF LEG |
E0667 |
$0.00 |
HCPCS / CPT® |
SEG PNEUMATIC APPL FULL LEG |
E0668 |
$0.00 |
HCPCS / CPT® |
SEG PNEUMATIC APPL FULL ARM |
E0669 |
$0.00 |
HCPCS / CPT® |
SEG PNEUMATIC APPLI HALF LEG |
E0670 |
$0.00 |
HCPCS / CPT® |
SEG PNEUM INT LEGS/TRUNK |
E0671 |
$0.00 |
HCPCS / CPT® |
PRESSURE PNEUM APPL FULL LEG |
E0672 |
$0.00 |
HCPCS / CPT® |
PRESSURE PNEUM APPL FULL ARM |
E0673 |
$0.00 |
HCPCS / CPT® |
PRESSURE PNEUM APPL HALF LEG |
E0675 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC COMPRESSION DEVICE |
E0676 |
$0.00 |
HCPCS / CPT® |
INTER LIMB COMPRESS DEV NOS |
E0691 |
$0.00 |
HCPCS / CPT® |
UVL PNL 2 SQ FT OR LESS |
E0692 |
$0.00 |
HCPCS / CPT® |
UVL SYS PANEL 4 FT |
E0693 |
$0.00 |
HCPCS / CPT® |
UVL SYS PANEL 6 FT |
E0694 |
$0.00 |
HCPCS / CPT® |
UVL MD CABINET SYS 6 FT |
E0700 |
$0.00 |
HCPCS / CPT® |
SAFETY EQUIPMENT |
E0705 |
$0.00 |
HCPCS / CPT® |
TRANSFER DEVICE |
E0710 |
$0.00 |
HCPCS / CPT® |
RESTRAINTS ANY TYPE |
E0720 |
$0.00 |
HCPCS / CPT® |
TENS TWO LEAD |
E0730 |
$0.00 |
HCPCS / CPT® |
TENS FOUR LEAD |
E0731 |
$0.00 |
HCPCS / CPT® |
CONDUCTIVE GARMENT FOR TENS/ |
E0740 |
$0.00 |
HCPCS / CPT® |
NON-IMPLANT PELV FLR E-STIM |
E0744 |
$0.00 |
HCPCS / CPT® |
NEUROMUSCULAR STIM FOR SCOLI |
E0745 |
$0.00 |
HCPCS / CPT® |
NEUROMUSCULAR STIM FOR SHOCK |
E0746 |
$0.00 |
HCPCS / CPT® |
ELECTROMYOGRAPH BIOFEEDBACK |
E0747 |
$0.00 |
HCPCS / CPT® |
ELEC OSTEOGEN STIM NOT SPINE |
E0748 |
$0.00 |
HCPCS / CPT® |
ELEC OSTEOGEN STIM SPINAL |
E0749 |
$0.00 |
HCPCS / CPT® |
ELEC OSTEOGEN STIM IMPLANTED |
E0755 |
$0.00 |
HCPCS / CPT® |
ELECTRONIC SALIVARY REFLEX S |
E0760 |
$0.00 |
HCPCS / CPT® |
OSTEOGEN ULTRASOUND STIMLTOR |
E0761 |
$0.00 |
HCPCS / CPT® |
NONTHERM ELECTROMGNTC DEVICE |
E0762 |
$0.00 |
HCPCS / CPT® |
TRANS ELEC JT STIM DEV SYS |
E0764 |
$0.00 |
HCPCS / CPT® |
FUNCTIONAL NEUROMUSCULARSTIM |
E0765 |
$0.00 |
HCPCS / CPT® |
NERVE STIMULATOR FOR TX N&V |
E0766 |
$0.00 |
HCPCS / CPT® |
ELEC STIM CANCER TREATMENT |
E0769 |
$0.00 |
HCPCS / CPT® |
ELECTRIC WOUND TREATMENT DEV |
E0770 |
$0.00 |
HCPCS / CPT® |
FUNCTIONAL ELECTRIC STIM NOS |
E0776 |
$0.00 |
HCPCS / CPT® |
IV POLE |
E0779 |
$0.00 |
HCPCS / CPT® |
AMB INFUSION PUMP MECHANICAL |
E0780 |
$0.00 |
HCPCS / CPT® |
MECH AMB INFUSION PUMP <8HRS |
E0781 |
$0.00 |
HCPCS / CPT® |
EXTERNAL AMBULATORY INFUS PU |
E0782 |
$0.00 |
HCPCS / CPT® |
NON-PROGRAMBLE INFUSION PUMP |
E0783 |
$0.00 |
HCPCS / CPT® |
PROGRAMMABLE INFUSION PUMP |
E0784 |
$0.00 |
HCPCS / CPT® |
EXT AMB INFUSN PUMP INSULIN |
E0785 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT IMPL PUMP CATHET |
E0786 |
$0.00 |
HCPCS / CPT® |
IMPLANTABLE PUMP REPLACEMENT |
E0791 |
$0.00 |
HCPCS / CPT® |
PARENTERAL INFUSION PUMP STA |
E0830 |
$0.00 |
HCPCS / CPT® |
AMBULATORY TRACTION DEVICE |
E0840 |
$0.00 |
HCPCS / CPT® |
TRACT FRAME ATTACH HEADBOARD |
E0849 |
$0.00 |
HCPCS / CPT® |
CERVICAL PNEUM TRAC EQUIP |
E0850 |
$0.00 |
HCPCS / CPT® |
TRACTION STAND FREE STANDING |
E0855 |
$0.00 |
HCPCS / CPT® |
CERVICAL TRACTION EQUIPMENT |
E0856 |
$0.00 |
HCPCS / CPT® |
CERVIC COLLAR W AIR BLADDERS |
E0860 |
$0.00 |
HCPCS / CPT® |
TRACT EQUIP CERVICAL TRACT |
E0870 |
$0.00 |
HCPCS / CPT® |
TRACT FRAME ATTACH FOOTBOARD |
E0880 |
$0.00 |
HCPCS / CPT® |
TRAC STAND FREE STAND EXTREM |
E0890 |
$0.00 |
HCPCS / CPT® |
TRACTION FRAME ATTACH PELVIC |
E0900 |
$0.00 |
HCPCS / CPT® |
TRAC STAND FREE STAND PELVIC |
E0910 |
$0.00 |
HCPCS / CPT® |
TRAPEZE BAR ATTACHED TO BED |
E0911 |
$0.00 |
HCPCS / CPT® |
HD TRAPEZE BAR ATTACH TO BED |
E0912 |
$0.00 |
HCPCS / CPT® |
HD TRAPEZE BAR FREE STANDING |
E0920 |
$0.00 |
HCPCS / CPT® |
FRACTURE FRAME ATTACHED TO B |
E0930 |
$0.00 |
HCPCS / CPT® |
FRACTURE FRAME FREE STANDING |
E0935 |
$0.00 |
HCPCS / CPT® |
CONT PAS MOTION EXERCISE DEV |
E0936 |
$0.00 |
HCPCS / CPT® |
CPM DEVICE, OTHER THAN KNEE |
E0940 |
$0.00 |
HCPCS / CPT® |
TRAPEZE BAR FREE STANDING |
E0941 |
$0.00 |
HCPCS / CPT® |
GRAVITY ASSISTED TRACTION DE |
E0942 |
$0.00 |
HCPCS / CPT® |
CERVICAL HEAD HARNESS/HALTER |
E0944 |
$0.00 |
HCPCS / CPT® |
PELVIC BELT/HARNESS/BOOT |
E0945 |
$0.00 |
HCPCS / CPT® |
BELT/HARNESS EXTREMITY |
E0946 |
$0.00 |
HCPCS / CPT® |
FRACTURE FRAME DUAL W CROSS |
E0947 |
$0.00 |
HCPCS / CPT® |
FRACTURE FRAME ATTACHMNTS PE |
E0948 |
$0.00 |
HCPCS / CPT® |
FRACTURE FRAME ATTACHMNTS CE |
E0950 |
$0.00 |
HCPCS / CPT® |
TRAY |
E0951 |
$0.00 |
HCPCS / CPT® |
LOOP HEEL |
E0952 |
$0.00 |
HCPCS / CPT® |
TOE LOOP/HOLDER, EACH |
E0955 |
$0.00 |
HCPCS / CPT® |
CUSHIONED HEADREST |
E0956 |
$0.00 |
HCPCS / CPT® |
W/C LATERAL TRUNK/HIP SUPPOR |
E0957 |
$0.00 |
HCPCS / CPT® |
W/C MEDIAL THIGH SUPPORT |
E0958 |
$0.00 |
HCPCS / CPT® |
WHLCHR ATT- CONV 1 ARM DRIVE |
E0959 |
$0.00 |
HCPCS / CPT® |
AMPUTEE ADAPTER |
E0960 |
$0.00 |
HCPCS / CPT® |
W/C SHOULDER HARNESS/STRAPS |
E0961 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR BRAKE EXTENSION |
E0966 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR HEAD REST EXTENSI |
E0967 |
$0.00 |
HCPCS / CPT® |
MAN WC RIM/PROJECTION REP EA |
E0968 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR COMMODE SEAT |
E0969 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR NARROWING DEVICE |
E0970 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR NO. 2 FOOTPLATES |
E0971 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR ANTI-TIPPING DEVI |
E0973 |
$0.00 |
HCPCS / CPT® |
W/CH ACCESS DET ADJ ARMREST |
E0974 |
$0.00 |
HCPCS / CPT® |
W/CH ACCESS ANTI-ROLLBACK |
E0978 |
$0.00 |
HCPCS / CPT® |
W/C ACC,SAF BELT PELV STRAP |
E0980 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SAFETY VEST |
E0981 |
$0.00 |
HCPCS / CPT® |
SEAT UPHOLSTERY, REPLACEMENT |
E0982 |
$0.00 |
HCPCS / CPT® |
BACK UPHOLSTERY, REPLACEMENT |
E0983 |
$0.00 |
HCPCS / CPT® |
ADD PWR JOYSTICK |
E0984 |
$0.00 |
HCPCS / CPT® |
ADD PWR TILLER |
E0985 |
$0.00 |
HCPCS / CPT® |
W/C SEAT LIFT MECHANISM |
E0986 |
$0.00 |
HCPCS / CPT® |
MAN W/C PUSH-RIM POWR SYSTEM |
E0988 |
$0.00 |
HCPCS / CPT® |
LEVER-ACTIVATED WHEEL DRIVE |
E0990 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR ELEVATING LEG RES |
E0992 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SOLID SEAT INSERT |
E0994 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR ARM REST |
E0995 |
$0.00 |
HCPCS / CPT® |
WC CALF REST, PAD REPLACEMNT |
E1002 |
$0.00 |
HCPCS / CPT® |
PWR SEAT TILT |
E1003 |
$0.00 |
HCPCS / CPT® |
PWR SEAT RECLINE |
E1004 |
$0.00 |
HCPCS / CPT® |
PWR SEAT RECLINE MECH |
E1005 |
$0.00 |
HCPCS / CPT® |
PWR SEAT RECLINE PWR |
E1006 |
$0.00 |
HCPCS / CPT® |
PWR SEAT COMBO W/O SHEAR |
E1007 |
$0.00 |
HCPCS / CPT® |
PWR SEAT COMBO W/SHEAR |
E1008 |
$0.00 |
HCPCS / CPT® |
PWR SEAT COMBO PWR SHEAR |
E1009 |
$0.00 |
HCPCS / CPT® |
ADD MECH LEG ELEVATION |
E1010 |
$0.00 |
HCPCS / CPT® |
ADD PWR LEG ELEVATION |
E1011 |
$0.00 |
HCPCS / CPT® |
PED WC MODIFY WIDTH ADJUSTM |
E1012 |
$0.00 |
HCPCS / CPT® |
CTR MOUNT PWR ELEV LEG REST |
E1014 |
$0.00 |
HCPCS / CPT® |
RECLINING BACK ADD PED W/C |
E1015 |
$0.00 |
HCPCS / CPT® |
SHOCK ABSORBER FOR MAN W/C |
E1016 |
$0.00 |
HCPCS / CPT® |
SHOCK ABSORBER FOR POWER W/C |
E1017 |
$0.00 |
HCPCS / CPT® |
HD SHCK ABSRBR FOR HD MAN WC |
E1018 |
$0.00 |
HCPCS / CPT® |
HD SHCK ABSRBER FOR HD POWWC |
E1020 |
$0.00 |
HCPCS / CPT® |
RESIDUAL LIMB SUPPORT SYSTEM |
E1028 |
$0.00 |
HCPCS / CPT® |
W/C MANUAL SWINGAWAY |
E1029 |
$0.00 |
HCPCS / CPT® |
W/C VENT TRAY FIXED |
E1030 |
$0.00 |
HCPCS / CPT® |
W/C VENT TRAY GIMBALED |
E1031 |
$0.00 |
HCPCS / CPT® |
ROLLABOUT CHAIR WITH CASTERS |
E1035 |
$0.00 |
HCPCS / CPT® |
PATIENT TRANSFER SYSTEM <300 |
E1036 |
$0.00 |
HCPCS / CPT® |
PATIENT TRANSFER SYSTEM >300 |
E1037 |
$0.00 |
HCPCS / CPT® |
TRANSPORT CHAIR, PED SIZE |
E1038 |
$0.00 |
HCPCS / CPT® |
TRANSPORT CHAIR PT WT<=300LB |
E1039 |
$0.00 |
HCPCS / CPT® |
TRANSPORT CHAIR PT WT >300LB |
E1050 |
$0.00 |
HCPCS / CPT® |
WHELCHR FXD FULL LENGTH ARMS |
E1060 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR DETACHABLE ARMS |
E1070 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR DETACHABLE FOOT R |
E1083 |
$0.00 |
HCPCS / CPT® |
HEMI-WHEELCHAIR FIXED ARMS |
E1084 |
$0.00 |
HCPCS / CPT® |
HEMI-WHEELCHAIR DETACHABLE A |
E1085 |
$0.00 |
HCPCS / CPT® |
HEMI-WHEELCHAIR FIXED ARMS |
E1086 |
$0.00 |
HCPCS / CPT® |
HEMI-WHEELCHAIR DETACHABLE A |
E1087 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR LIGHTWT FIXED ARM |
E1088 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR LIGHTWEIGHT DET A |
E1089 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR LIGHTWT FIXED ARM |
E1090 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR LIGHTWEIGHT DET A |
E1092 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR WIDE W/ LEG RESTS |
E1093 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR WIDE W/ FOOT REST |
E1100 |
$0.00 |
HCPCS / CPT® |
WHCHR S-RECL FXD ARM LEG RES |
E1110 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SEMI-RECL DETACH |
E1130 |
$0.00 |
HCPCS / CPT® |
WHLCHR STAND FXD ARM FT REST |
E1140 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR STANDARD DETACH A |
E1150 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR STANDARD W/ LEG R |
E1160 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR FIXED ARMS |
E1161 |
$0.00 |
HCPCS / CPT® |
MANUAL ADULT WC W TILTINSPAC |
E1170 |
$0.00 |
HCPCS / CPT® |
WHLCHR AMPU FXD ARM LEG REST |
E1171 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR AMPUTEE W/O LEG R |
E1172 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR AMPUTEE DETACH AR |
E1180 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR AMPUTEE W/ FOOT R |
E1190 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR AMPUTEE W/ LEG RE |
E1195 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR AMPUTEE HEAVY DUT |
E1200 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR AMPUTEE FIXED ARM |
E1220 |
$0.00 |
HCPCS / CPT® |
WHLCHR SPECIAL SIZE/CONSTRC |
E1221 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPEC SIZE W FOOT |
E1222 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPEC SIZE W/ LEG |
E1223 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPEC SIZE W FOOT |
E1224 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPEC SIZE W/ LEG |
E1225 |
$0.00 |
HCPCS / CPT® |
MANUAL SEMI-RECLINING BACK |
E1226 |
$0.00 |
HCPCS / CPT® |
MANUAL FULLY RECLINING BACK |
E1227 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPEC SZ SPEC HT A |
E1228 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPEC SZ SPEC HT B |
E1229 |
$0.00 |
HCPCS / CPT® |
PEDIATRIC WHEELCHAIR NOS |
E1230 |
$0.00 |
HCPCS / CPT® |
POWER OPERATED VEHICLE |
E1231 |
$0.00 |
HCPCS / CPT® |
RIGID PED W/C TILT-IN-SPACE |
E1232 |
$0.00 |
HCPCS / CPT® |
FOLDING PED WC TILT-IN-SPACE |
E1233 |
$0.00 |
HCPCS / CPT® |
RIG PED WC TLTNSPC W/O SEAT |
E1234 |
$0.00 |
HCPCS / CPT® |
FLD PED WC TLTNSPC W/O SEAT |
E1235 |
$0.00 |
HCPCS / CPT® |
RIGID PED WC ADJUSTABLE |
E1236 |
$0.00 |
HCPCS / CPT® |
FOLDING PED WC ADJUSTABLE |
E1237 |
$0.00 |
HCPCS / CPT® |
RGD PED WC ADJSTABL W/O SEAT |
E1238 |
$0.00 |
HCPCS / CPT® |
FLD PED WC ADJSTABL W/O SEAT |
E1239 |
$0.00 |
HCPCS / CPT® |
PED POWER WHEELCHAIR NOS |
E1240 |
$0.00 |
HCPCS / CPT® |
WHCHR LITWT DET ARM LEG REST |
E1250 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR LIGHTWT FIXED ARM |
E1260 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR LIGHTWT FOOT REST |
E1270 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR LIGHTWEIGHT LEG R |
E1280 |
$0.00 |
HCPCS / CPT® |
WHCHR H-DUTY DET ARM LEG RES |
E1285 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR HEAVY DUTY FIXED |
E1290 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR HVY DUTY DETACH A |
E1295 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR HEAVY DUTY FIXED |
E1296 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPECIAL SEAT HEIG |
E1297 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPECIAL SEAT DEPT |
E1298 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR SPEC SEAT DEPTH/W |
E1300 |
$0.00 |
HCPCS / CPT® |
WHIRLPOOL PORTABLE |
E1310 |
$0.00 |
HCPCS / CPT® |
WHIRLPOOL NON-PORTABLE |
E1352 |
$0.00 |
HCPCS / CPT® |
O2 FLOW REG POS INSPIR PRESS |
E1353 |
$0.00 |
HCPCS / CPT® |
OXYGEN SUPPLIES REGULATOR |
E1354 |
$0.00 |
HCPCS / CPT® |
WHEELED CART, PORT CYL/CONC |
E1355 |
$0.00 |
HCPCS / CPT® |
OXYGEN SUPPLIES STAND/RACK |
E1356 |
$0.00 |
HCPCS / CPT® |
BATT PACK/CART, PORT CONC |
E1357 |
$0.00 |
HCPCS / CPT® |
BATTERY CHARGER, PORT CONC |
E1358 |
$0.00 |
HCPCS / CPT® |
DC POWER ADAPTER, PORT CONC |
E1372 |
$0.00 |
HCPCS / CPT® |
OXY SUPPL HEATER FOR NEBULIZ |
E1390 |
$0.00 |
HCPCS / CPT® |
OXYGEN CONCENTRATOR |
E1391 |
$0.00 |
HCPCS / CPT® |
OXYGEN CONCENTRATOR, DUAL |
E1392 |
$0.00 |
HCPCS / CPT® |
PORTABLE OXYGEN CONCENTRATOR |
E1399 |
$0.00 |
HCPCS / CPT® |
DURABLE MEDICAL EQUIPMENT MI |
E1405 |
$0.00 |
HCPCS / CPT® |
O2/WATER VAPOR ENRICH W/HEAT |
E1406 |
$0.00 |
HCPCS / CPT® |
O2/WATER VAPOR ENRICH W/O HE |
E1500 |
$0.00 |
HCPCS / CPT® |
CENTRIFUGE |
E1510 |
$0.00 |
HCPCS / CPT® |
KIDNEY DIALYSATE DELIVRY SYS |
E1520 |
$0.00 |
HCPCS / CPT® |
HEPARIN INFUSION PUMP |
E1530 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT AIR BUBBLE DETEC |
E1540 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT PRESSURE ALARM |
E1550 |
$0.00 |
HCPCS / CPT® |
BATH CONDUCTIVITY METER |
E1560 |
$0.00 |
HCPCS / CPT® |
REPLACE BLOOD LEAK DETECTOR |
E1570 |
$0.00 |
HCPCS / CPT® |
ADJUSTABLE CHAIR FOR ESRD PT |
E1575 |
$0.00 |
HCPCS / CPT® |
TRANSDUCER PROTECT/FLD BAR |
E1580 |
$0.00 |
HCPCS / CPT® |
UNIPUNCTURE CONTROL SYSTEM |
E1590 |
$0.00 |
HCPCS / CPT® |
HEMODIALYSIS MACHINE |
E1592 |
$0.00 |
HCPCS / CPT® |
AUTO INTERM PERITONEAL DIALY |
E1594 |
$0.00 |
HCPCS / CPT® |
CYCLER DIALYSIS MACHINE |
E1600 |
$0.00 |
HCPCS / CPT® |
DELI/INSTALL CHRG HEMO EQUIP |
E1610 |
$0.00 |
HCPCS / CPT® |
REVERSE OSMOSIS H2O PURI SYS |
E1615 |
$0.00 |
HCPCS / CPT® |
DEIONIZER H2O PURI SYSTEM |
E1620 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT BLOOD PUMP |
E1625 |
$0.00 |
HCPCS / CPT® |
WATER SOFTENING SYSTEM |
E1630 |
$0.00 |
HCPCS / CPT® |
RECIPROCATING PERITONEAL DIA |
E1632 |
$0.00 |
HCPCS / CPT® |
WEARABLE ARTIFICIAL KIDNEY |
E1634 |
$0.00 |
HCPCS / CPT® |
PERITONEAL DIALYSIS CLAMP |
E1635 |
$0.00 |
HCPCS / CPT® |
COMPACT TRAVEL HEMODIALYZER |
E1636 |
$0.00 |
HCPCS / CPT® |
SORBENT CARTRIDGES PER 10 |
E1637 |
$0.00 |
HCPCS / CPT® |
HEMOSTATS FOR DIALYSIS, EACH |
E1639 |
$0.00 |
HCPCS / CPT® |
DIALYSIS SCALE |
E1699 |
$0.00 |
HCPCS / CPT® |
DIALYSIS EQUIPMENT NOC |
E1700 |
$0.00 |
HCPCS / CPT® |
JAW MOTION REHAB SYSTEM |
E1701 |
$0.00 |
HCPCS / CPT® |
REPL CUSHIONS FOR JAW MOTION |
E1702 |
$0.00 |
HCPCS / CPT® |
REPL MEASR SCALES JAW MOTION |
E1800 |
$0.00 |
HCPCS / CPT® |
ADJUST ELBOW EXT/FLEX DEVICE |
E1801 |
$0.00 |
HCPCS / CPT® |
SPS ELBOW DEVICE |
E1802 |
$0.00 |
HCPCS / CPT® |
ADJST FOREARM PRO/SUP DEVICE |
E1805 |
$0.00 |
HCPCS / CPT® |
ADJUST WRIST EXT/FLEX DEVICE |
E1806 |
$0.00 |
HCPCS / CPT® |
SPS WRIST DEVICE |
E1810 |
$0.00 |
HCPCS / CPT® |
ADJUST KNEE EXT/FLEX DEVICE |
E1811 |
$0.00 |
HCPCS / CPT® |
SPS KNEE DEVICE |
E1812 |
$0.00 |
HCPCS / CPT® |
KNEE EXT/FLEX W ACT RES CTRL |
E1815 |
$0.00 |
HCPCS / CPT® |
ADJUST ANKLE EXT/FLEX DEVICE |
E1816 |
$0.00 |
HCPCS / CPT® |
SPS ANKLE DEVICE |
E1818 |
$0.00 |
HCPCS / CPT® |
SPS FOREARM DEVICE |
E1820 |
$0.00 |
HCPCS / CPT® |
SOFT INTERFACE MATERIAL |
E1821 |
$0.00 |
HCPCS / CPT® |
REPLACEMENT INTERFACE SPSD |
E1825 |
$0.00 |
HCPCS / CPT® |
ADJUST FINGER EXT/FLEX DEVC |
E1830 |
$0.00 |
HCPCS / CPT® |
ADJUST TOE EXT/FLEX DEVICE |
E1831 |
$0.00 |
HCPCS / CPT® |
STATIC STR TOE DEV EXT/FLEX |
E1840 |
$0.00 |
HCPCS / CPT® |
ADJ SHOULDER EXT/FLEX DEVICE |
E1841 |
$0.00 |
HCPCS / CPT® |
STATIC STR SHLDR DEV ROM ADJ |
E1902 |
$0.00 |
HCPCS / CPT® |
AAC NON-ELECTRONIC BOARD |
E2000 |
$0.00 |
HCPCS / CPT® |
GASTRIC SUCTION PUMP HME MDL |
E2100 |
$0.00 |
HCPCS / CPT® |
BLD GLUCOSE MONITOR W VOICE |
E2101 |
$0.00 |
HCPCS / CPT® |
BLD GLUCOSE MONITOR W LANCE |
E2120 |
$0.00 |
HCPCS / CPT® |
PULSE GEN SYS TX ENDOLYMP FL |
E2201 |
$0.00 |
HCPCS / CPT® |
MAN W/CH ACC SEAT W>=20 <24 |
E2202 |
$0.00 |
HCPCS / CPT® |
SEAT WIDTH 24-27 IN |
E2203 |
$0.00 |
HCPCS / CPT® |
FRAME DEPTH LESS THAN 22 IN |
E2204 |
$0.00 |
HCPCS / CPT® |
FRAME DEPTH 22 TO 25 IN |
E2205 |
$0.00 |
HCPCS / CPT® |
MANUAL WC ACCESSORY, HANDRIM |
E2206 |
$0.00 |
HCPCS / CPT® |
MAN WC WHL LOCK COMP REPL EA |
E2207 |
$0.00 |
HCPCS / CPT® |
CRUTCH AND CANE HOLDER |
E2208 |
$0.00 |
HCPCS / CPT® |
CYLINDER TANK CARRIER |
E2209 |
$0.00 |
HCPCS / CPT® |
ARM TROUGH EACH |
E2210 |
$0.00 |
HCPCS / CPT® |
WHEELCHAIR BEARINGS |
E2211 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC PROPULSION TIRE |
E2212 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC PROP TIRE TUBE |
E2213 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC PROP TIRE INSERT |
E2214 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC CASTER TIRE EACH |
E2215 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC CASTER TIRE TUBE |
E2216 |
$0.00 |
HCPCS / CPT® |
FOAM FILLED PROPULSION TIRE |
E2217 |
$0.00 |
HCPCS / CPT® |
FOAM FILLED CASTER TIRE EACH |
E2218 |
$0.00 |
HCPCS / CPT® |
FOAM PROPULSION TIRE EACH |
E2219 |
$0.00 |
HCPCS / CPT® |
FOAM CASTER TIRE ANY SIZE EA |
E2220 |
$0.00 |
HCPCS / CPT® |
SOLID PROPULS TIRE, REPL, EA |
E2221 |
$0.00 |
HCPCS / CPT® |
SOLID CASTER TIRE REPL, EACH |
E2222 |
$0.00 |
HCPCS / CPT® |
SOLID CASTER INTEG WHL, REPL |
E2224 |
$0.00 |
HCPCS / CPT® |
PROPULSION WHL EXCL TIRE REP |
E2225 |
$0.00 |
HCPCS / CPT® |
CASTER WHEEL EXCLUDES TIRE |
E2226 |
$0.00 |
HCPCS / CPT® |
CASTER FORK REPLACEMENT ONLY |
E2227 |
$0.00 |
HCPCS / CPT® |
GEAR REDUCTION DRIVE WHEEL |
E2228 |
$0.00 |
HCPCS / CPT® |
MWC ACC, WHEELCHAIR BRAKE |
E2230 |
$0.00 |
HCPCS / CPT® |
MANUAL STANDING SYSTEM |
E2231 |
$0.00 |
HCPCS / CPT® |
SOLID SEAT SUPPORT BASE |
E2291 |
$0.00 |
HCPCS / CPT® |
PLANAR BACK FOR PED SIZE WC |
E2292 |
$0.00 |
HCPCS / CPT® |
PLANAR SEAT FOR PED SIZE WC |
E2293 |
$0.00 |
HCPCS / CPT® |
CONTOUR BACK FOR PED SIZE WC |
E2294 |
$0.00 |
HCPCS / CPT® |
CONTOUR SEAT FOR PED SIZE WC |
E2295 |
$0.00 |
HCPCS / CPT® |
PED DYNAMIC SEATING FRAME |
E2300 |
$0.00 |
HCPCS / CPT® |
PWR SEAT ELEVATION SYS |
E2301 |
$0.00 |
HCPCS / CPT® |
PWR STANDING |
E2310 |
$0.00 |
HCPCS / CPT® |
ELECTRO CONNECT BTW CONTROL |
E2311 |
$0.00 |
HCPCS / CPT® |
ELECTRO CONNECT BTW 2 SYS |
E2312 |
$0.00 |
HCPCS / CPT® |
MINI-PROP REMOTE JOYSTICK |
E2313 |
$0.00 |
HCPCS / CPT® |
PWC HARNESS, EXPAND CONTROL |
E2321 |
$0.00 |
HCPCS / CPT® |
HAND INTERFACE JOYSTICK |
E2322 |
$0.00 |
HCPCS / CPT® |
MULT MECH SWITCHES |
E2323 |
$0.00 |
HCPCS / CPT® |
SPECIAL JOYSTICK HANDLE |
E2324 |
$0.00 |
HCPCS / CPT® |
CHIN CUP INTERFACE |
E2325 |
$0.00 |
HCPCS / CPT® |
SIP AND PUFF INTERFACE |
E2326 |
$0.00 |
HCPCS / CPT® |
BREATH TUBE KIT |
E2327 |
$0.00 |
HCPCS / CPT® |
HEAD CONTROL INTERFACE MECH |
E2328 |
$0.00 |
HCPCS / CPT® |
HEAD/EXTREMITY CONTROL INTER |
E2329 |
$0.00 |
HCPCS / CPT® |
HEAD CONTROL NONPROPORTIONAL |
E2330 |
$0.00 |
HCPCS / CPT® |
HEAD CONTROL PROXIMITY SWITC |
E2331 |
$0.00 |
HCPCS / CPT® |
ATTENDANT CONTROL |
E2340 |
$0.00 |
HCPCS / CPT® |
W/C WDTH 20-23 IN SEAT FRAME |
E2341 |
$0.00 |
HCPCS / CPT® |
W/C WDTH 24-27 IN SEAT FRAME |
E2342 |
$0.00 |
HCPCS / CPT® |
W/C DPTH 20-21 IN SEAT FRAME |
E2343 |
$0.00 |
HCPCS / CPT® |
W/C DPTH 22-25 IN SEAT FRAME |
E2351 |
$0.00 |
HCPCS / CPT® |
ELECTRONIC SGD INTERFACE |
E2358 |
$0.00 |
HCPCS / CPT® |
GR 34 NONSEALED LEADACID |
E2359 |
$0.00 |
HCPCS / CPT® |
GR34 SEALED LEADACID BATTERY |
E2360 |
$0.00 |
HCPCS / CPT® |
22NF NONSEALED LEADACID |
E2361 |
$0.00 |
HCPCS / CPT® |
22NF SEALED LEADACID BATTERY |
E2362 |
$0.00 |
HCPCS / CPT® |
GR24 NONSEALED LEADACID |
E2363 |
$0.00 |
HCPCS / CPT® |
GR24 SEALED LEADACID BATTERY |
E2364 |
$0.00 |
HCPCS / CPT® |
U1NONSEALED LEADACID BATTERY |
E2365 |
$0.00 |
HCPCS / CPT® |
U1 SEALED LEADACID BATTERY |
E2366 |
$0.00 |
HCPCS / CPT® |
BATTERY CHARGER, SINGLE MODE |
E2367 |
$0.00 |
HCPCS / CPT® |
BATTERY CHARGER, DUAL MODE |
E2368 |
$0.00 |
HCPCS / CPT® |
PWR WC DRIVEWHEEL MOTOR REPL |
E2369 |
$0.00 |
HCPCS / CPT® |
PWR WC DRIVEWHEEL GEAR REPL |
E2370 |
$0.00 |
HCPCS / CPT® |
PWR WC DR WH MOTOR/GEAR COMB |
E2371 |
$0.00 |
HCPCS / CPT® |
GR27 SEALED LEADACID BATTERY |
E2372 |
$0.00 |
HCPCS / CPT® |
GR27 NON-SEALED LEADACID |
E2373 |
$0.00 |
HCPCS / CPT® |
HAND/CHIN CTRL SPEC JOYSTICK |
E2374 |
$0.00 |
HCPCS / CPT® |
HAND/CHIN CTRL STD JOYSTICK |
E2375 |
$0.00 |
HCPCS / CPT® |
NON-EXPANDABLE CONTROLLER |
E2376 |
$0.00 |
HCPCS / CPT® |
EXPANDABLE CONTROLLER, REPL |
E2377 |
$0.00 |
HCPCS / CPT® |
EXPANDABLE CONTROLLER, INITL |
E2378 |
$0.00 |
HCPCS / CPT® |
PW ACTUATOR REPLACEMENT |
E2381 |
$0.00 |
HCPCS / CPT® |
PNEUM DRIVE WHEEL TIRE |
E2382 |
$0.00 |
HCPCS / CPT® |
TUBE, PNEUM WHEEL DRIVE TIRE |
E2383 |
$0.00 |
HCPCS / CPT® |
INSERT, PNEUM WHEEL DRIVE |
E2384 |
$0.00 |
HCPCS / CPT® |
PNEUMATIC CASTER TIRE |
E2385 |
$0.00 |
HCPCS / CPT® |
TUBE, PNEUMATIC CASTER TIRE |
E2386 |
$0.00 |
HCPCS / CPT® |
FOAM FILLED DRIVE WHEEL TIRE |
E2387 |
$0.00 |
HCPCS / CPT® |
FOAM FILLED CASTER TIRE |
E2388 |
$0.00 |
HCPCS / CPT® |
FOAM DRIVE WHEEL TIRE |
E2389 |
$0.00 |
HCPCS / CPT® |
FOAM CASTER TIRE |
E2390 |
$0.00 |
HCPCS / CPT® |
SOLID DRIVE WHEEL TIRE |
E2391 |
$0.00 |
HCPCS / CPT® |
SOLID CASTER TIRE |
E2392 |
$0.00 |
HCPCS / CPT® |
SOLID CASTER TIRE, INTEGRATE |
E2394 |
$0.00 |
HCPCS / CPT® |
DRIVE WHEEL EXCLUDES TIRE |
E2395 |
$0.00 |
HCPCS / CPT® |
CASTER WHEEL EXCLUDES TIRE |
E2396 |
$0.00 |
HCPCS / CPT® |
CASTER FORK |
E2397 |
$0.00 |
HCPCS / CPT® |
PWC ACC, LITH-BASED BATTERY |
E2402 |
$0.00 |
HCPCS / CPT® |
NEG PRESS WOUND THERAPY PUMP |
E2500 |
$0.00 |
HCPCS / CPT® |
SGD DIGITIZED PRE-REC <=8MIN |
E2502 |
$0.00 |
HCPCS / CPT® |
SGD PREREC MSG >8MIN <=20MIN |
E2504 |
$0.00 |
HCPCS / CPT® |
SGD PREREC MSG>20MIN <=40MIN |
E2506 |
$0.00 |
HCPCS / CPT® |
SGD PREREC MSG > 40 MIN |
E2508 |
$0.00 |
HCPCS / CPT® |
SGD SPELLING PHYS CONTACT |
E2510 |
$0.00 |
HCPCS / CPT® |
SGD W MULTI METHODS MSG/ACCS |
E2511 |
$0.00 |
HCPCS / CPT® |
SGD SFTWRE PRGRM FOR PC/PDA |
E2512 |
$0.00 |
HCPCS / CPT® |
SGD ACCESSORY, MOUNTING SYS |
E2599 |
$0.00 |
HCPCS / CPT® |
SGD ACCESSORY NOC |
E2601 |
$0.00 |
HCPCS / CPT® |
GEN W/C CUSHION WDTH < 22 IN |
E2602 |
$0.00 |
HCPCS / CPT® |
GEN W/C CUSHION WDTH >=22 IN |
E2603 |
$0.00 |
HCPCS / CPT® |
SKIN PROTECT WC CUS WD <22IN |
E2604 |
$0.00 |
HCPCS / CPT® |
SKIN PROTECT WC CUS WD>=22IN |
E2605 |
$0.00 |
HCPCS / CPT® |
POSITION WC CUSH WDTH <22 IN |
E2606 |
$0.00 |
HCPCS / CPT® |
POSITION WC CUSH WDTH>=22 IN |
E2607 |
$0.00 |
HCPCS / CPT® |
SKIN PRO/POS WC CUS WD <22IN |
E2608 |
$0.00 |
HCPCS / CPT® |
SKIN PRO/POS WC CUS WD>=22IN |
E2609 |
$0.00 |
HCPCS / CPT® |
CUSTOM FABRICATE W/C CUSHION |
E2610 |
$0.00 |
HCPCS / CPT® |
POWERED W/C CUSHION |
E2611 |
$0.00 |
HCPCS / CPT® |
GEN USE BACK CUSH WDTH <22IN |
E2612 |
$0.00 |
HCPCS / CPT® |
GEN USE BACK CUSH WDTH>=22IN |
E2613 |
$0.00 |
HCPCS / CPT® |
POSITION BACK CUSH WD <22IN |
E2614 |
$0.00 |
HCPCS / CPT® |
POSITION BACK CUSH WD>=22IN |
E2615 |
$0.00 |
HCPCS / CPT® |
POS BACK POST/LAT WDTH <22IN |
E2616 |
$0.00 |
HCPCS / CPT® |
POS BACK POST/LAT WDTH>=22IN |
E2617 |
$0.00 |
HCPCS / CPT® |
CUSTOM FAB W/C BACK CUSHION |
E2619 |
$0.00 |
HCPCS / CPT® |
REPLACE COVER W/C SEAT CUSH |
E2620 |
$0.00 |
HCPCS / CPT® |
WC PLANAR BACK CUSH WD <22IN |
E2621 |
$0.00 |
HCPCS / CPT® |
WC PLANAR BACK CUSH WD>=22IN |
E2622 |
$0.00 |
HCPCS / CPT® |
ADJ SKIN PRO W/C CUS WD <22IN |
E2623 |
$0.00 |
HCPCS / CPT® |
ADJ SKIN PRO WC CUS WD>=22IN |
E2624 |
$0.00 |
HCPCS / CPT® |
ADJ SKIN PRO/POS CUS <22IN |
E2625 |
$0.00 |
HCPCS / CPT® |
ADJ SKIN PRO/POS WC CUS>=22 |
E2626 |
$0.00 |
HCPCS / CPT® |
SEO MOBILE ARM SUP ATT TO WC |
E2627 |
$0.00 |
HCPCS / CPT® |
ARM SUPP ATT TO WC RANCHO TY |
E2628 |
$0.00 |
HCPCS / CPT® |
MOBILE ARM SUPPORTS RECLININ |
E2629 |
$0.00 |
HCPCS / CPT® |
FRICTION DAMPENING ARM SUPP |
E2630 |
$0.00 |
HCPCS / CPT® |
MONOSUSPENSION ARM/HAND SUPP |
E2631 |
$0.00 |
HCPCS / CPT® |
ELEVAT PROXIMAL ARM SUPPORT |
E2632 |
$0.00 |
HCPCS / CPT® |
OFFSET/LAT ROCKER ARM W/ELA |
E2633 |
$0.00 |
HCPCS / CPT® |
MOBILE ARM SUPPORT SUPINATOR |
E8000 |
$0.00 |
HCPCS / CPT® |
POSTERIOR GAIT TRAINER |
E8001 |
$0.00 |
HCPCS / CPT® |
UPRIGHT GAIT TRAINER |
E8002 |
$0.00 |
HCPCS / CPT® |
ANTERIOR GAIT TRAINER |
FEE |
$46.20 |
HCPCS / CPT® |
RETURNED CHECK FEE |
G0008 |
$0.00 |
HCPCS / CPT® |
ADMIN INFLUENZA VIRUS VAC |
G0009 |
$0.00 |
HCPCS / CPT® |
ADMIN PNEUMOCOCCAL VACCINE |
G0010 |
$0.00 |
HCPCS / CPT® |
ADMIN HEPATITIS B VACCINE |
G0027 |
$0.00 |
HCPCS / CPT® |
SEMEN ANALYSIS |
G0101 |
$0.00 |
HCPCS / CPT® |
CA SCREEN;PELVIC/BREAST EXAM |
G0102 |
$0.00 |
HCPCS / CPT® |
PROSTATE CA SCREENING; DRE |
G0103 |
$0.00 |
HCPCS / CPT® |
PSA SCREENING |
G0104 |
$0.00 |
HCPCS / CPT® |
CA SCREEN;FLEXI SIGMOIDSCOPE |
G0105 |
$0.00 |
HCPCS / CPT® |
COLORECTAL SCRN; HI RISK IND |
G0106 |
$0.00 |
HCPCS / CPT® |
COLON CA SCREEN;BARIUM ENEMA |
G0108 |
$0.00 |
HCPCS / CPT® |
DIAB MANAGE TRN PER INDIV |
G0109 |
$0.00 |
HCPCS / CPT® |
DIAB MANAGE TRN IND/GROUP |
G0117 |
$0.00 |
HCPCS / CPT® |
GLAUCOMA SCRN HGH RISK DIREC |
G0118 |
$0.00 |
HCPCS / CPT® |
GLAUCOMA SCRN HGH RISK DIREC |
G0120 |
$0.00 |
HCPCS / CPT® |
COLON CA SCRN; BARIUM ENEMA |
G0121 |
$0.00 |
HCPCS / CPT® |
COLON CA SCRN NOT HI RSK IND |
G0122 |
$0.00 |
HCPCS / CPT® |
COLON CA SCRN; BARIUM ENEMA |
G0123 |
$0.00 |
HCPCS / CPT® |
SCREEN CERV/VAG THIN LAYER |
G0124 |
$0.00 |
HCPCS / CPT® |
SCREEN C/V THIN LAYER BY MD |
G0127 |
$0.00 |
HCPCS / CPT® |
TRIM NAIL(S) |
G0128 |
$0.00 |
HCPCS / CPT® |
CORF SKILLED NURSING SERVICE |
G0129 |
$0.00 |
HCPCS / CPT® |
PARTIAL HOSP PROG SERVICE |
G0130 |
$0.00 |
HCPCS / CPT® |
SINGLE ENERGY X-RAY STUDY |
G0141 |
$0.00 |
HCPCS / CPT® |
SCR C/V CYTO,AUTOSYS AND MD |
G0143 |
$0.00 |
HCPCS / CPT® |
SCR C/V CYTO,THINLAYER,RESCR |
G0144 |
$0.00 |
HCPCS / CPT® |
SCR C/V CYTO,THINLAYER,RESCR |
G0145 |
$0.00 |
HCPCS / CPT® |
SCR C/V CYTO,THINLAYER,RESCR |
G0147 |
$0.00 |
HCPCS / CPT® |
SCR C/V CYTO, AUTOMATED SYS |
G0148 |
$0.00 |
HCPCS / CPT® |
SCR C/V CYTO, AUTOSYS, RESCR |
G0151 |
$0.00 |
HCPCS / CPT® |
HHCP-SERV OF PT,EA 15 MIN |
G0152 |
$0.00 |
HCPCS / CPT® |
HHCP-SERV OF OT,EA 15 MIN |
G0153 |
$0.00 |
HCPCS / CPT® |
HHCP-SVS OF S/L PATH,EA 15MN |
G0155 |
$0.00 |
HCPCS / CPT® |
HHCP-SVS OF CSW,EA 15 MIN |
G0156 |
$0.00 |
HCPCS / CPT® |
HHCP-SVS OF AIDE,EA 15 MIN |
G0157 |
$0.00 |
HCPCS / CPT® |
HHC PT ASSISTANT EA 15 |
G0158 |
$0.00 |
HCPCS / CPT® |
HHC OT ASSISTANT EA 15 |
G0159 |
$0.00 |
HCPCS / CPT® |
HHC PT MAINT EA 15 MIN |
G0160 |
$0.00 |
HCPCS / CPT® |
HHC OCCUP THERAPY EA 15 |
G0161 |
$0.00 |
HCPCS / CPT® |
HHC SLP EA 15 MIN |
G0162 |
$0.00 |
HCPCS / CPT® |
HHC RN E&M PLAN SVS, 15 MIN |
G0166 |
$0.00 |
HCPCS / CPT® |
EXTRNL COUNTERPULSE, PER TX |
G0168 |
$43.73 |
HCPCS / CPT® |
DERMABOND – WOUND CLOSURE BY ADHESIVE |
G0175 |
$0.00 |
HCPCS / CPT® |
OPPS SERVICE,SCHED TEAM CONF |
G0176 |
$0.00 |
HCPCS / CPT® |
OPPS/PHP;ACTIVITY THERAPY |
G0177 |
$0.00 |
HCPCS / CPT® |
OPPS/PHP; TRAIN & EDUC SERV |
G0179 |
$0.00 |
HCPCS / CPT® |
MD RECERTIFICATION HHA PT |
G0180 |
$0.00 |
HCPCS / CPT® |
MD CERTIFICATION HHA PATIENT |
G0181 |
$0.00 |
HCPCS / CPT® |
HOME HEALTH CARE SUPERVISION |
G0182 |
$0.00 |
HCPCS / CPT® |
HOSPICE CARE SUPERVISION |
G0186 |
$0.00 |
HCPCS / CPT® |
DSTRY EYE LESN,FDR VSSL TECH |
G0202 |
$0.00 |
HCPCS / CPT® |
SCR MAMMO BI INCL CAD |
G0204 |
$0.00 |
HCPCS / CPT® |
DX MAMMO INCL CAD BI |
G0206 |
$0.00 |
HCPCS / CPT® |
DX MAMMO INCL CAD UNI |
G0219 |
$0.00 |
HCPCS / CPT® |
PET IMG WHOLBOD MELANO NONCO |
G0235 |
$0.00 |
HCPCS / CPT® |
PET NOT OTHERWISE SPECIFIED |
G0237 |
$0.00 |
HCPCS / CPT® |
THERAPEUTIC PROCD STRG ENDUR |
G0238 |
$0.00 |
HCPCS / CPT® |
OTH RESP PROC, INDIV |
G0239 |
$0.00 |
HCPCS / CPT® |
OTH RESP PROC, GROUP |
G0245 |
$0.00 |
HCPCS / CPT® |
INITIAL FOOT EXAM PT LOPS |
G0246 |
$0.00 |
HCPCS / CPT® |
FOLLOWUP EVAL OF FOOT PT LOP |
G0247 |
$0.00 |
HCPCS / CPT® |
ROUTINE FOOTCARE PT W LOPS |
G0248 |
$0.00 |
HCPCS / CPT® |
DEMONSTRATE USE HOME INR MON |
G0249 |
$0.00 |
HCPCS / CPT® |
PROVIDE INR TEST MATER/EQUIP |
G0250 |
$0.00 |
HCPCS / CPT® |
MD INR TEST REVIE INTER MGMT |
G0252 |
$0.00 |
HCPCS / CPT® |
PET IMAGING INITIAL DX |
G0255 |
$0.00 |
HCPCS / CPT® |
CURRENT PERCEP THRESHOLD TST |
G0257 |
$0.00 |
HCPCS / CPT® |
UNSCHED DIALYSIS ESRD PT HOS |
G0259 |
$0.00 |
HCPCS / CPT® |
INJECT FOR SACROILIAC JOINT |
G0260 |
$0.00 |
HCPCS / CPT® |
INJ FOR SACROILIAC JT ANESTH |
G0268 |
$248.89 |
HCPCS / CPT® |
REMOVAL OF IMPACTED WAX MD |
G0269 |
$0.00 |
HCPCS / CPT® |
OCCLUSIVE DEVICE IN VEIN ART |
G0270 |
$0.00 |
HCPCS / CPT® |
MNT SUBS TX FOR CHANGE DX |
G0271 |
$0.00 |
HCPCS / CPT® |
GROUP MNT 2 OR MORE 30 MINS |
G0276 |
$0.00 |
HCPCS / CPT® |
PILD/PLACEBO CONTROL CLIN TR |
G0277 |
$0.00 |
HCPCS / CPT® |
HBOT, FULL BODY CHAMBER, 30M |
G0278 |
$0.00 |
HCPCS / CPT® |
ILIAC ART ANGIO,CARDIAC CATH |
G0279 |
$0.00 |
HCPCS / CPT® |
TOMOSYNTHESIS, MAMMO |
G0281 |
$0.00 |
HCPCS / CPT® |
ELEC STIM UNATTEND FOR PRESS |
G0282 |
$0.00 |
HCPCS / CPT® |
ELECT STIM WOUND CARE NOT PD |
G0283 |
$0.00 |
HCPCS / CPT® |
ELEC STIM OTHER THAN WOUND |
G0288 |
$0.00 |
HCPCS / CPT® |
RECON, CTA FOR SURG PLAN |
G0289 |
$0.00 |
HCPCS / CPT® |
ARTHRO, LOOSE BODY + CHONDRO |
G0293 |
$0.00 |
HCPCS / CPT® |
NON-COV SURG PROC,CLIN TRIAL |
G0294 |
$0.00 |
HCPCS / CPT® |
NON-COV PROC, CLINICAL TRIAL |
G0295 |
$0.00 |
HCPCS / CPT® |
ELECTROMAGNETIC THERAPY ONC |
G0296 |
$0.00 |
HCPCS / CPT® |
VISIT TO DETERM LDCT ELIG |
G0297 |
$0.00 |
HCPCS / CPT® |
LDCT FOR LUNG CA SCREEN |
G0299 |
$0.00 |
HCPCS / CPT® |
HHS/HOSPICE OF RN EA 15 MIN |
G0300 |
$0.00 |
HCPCS / CPT® |
HHS/HOSPICE OF LPN EA 15 MIN |
G0302 |
$0.00 |
HCPCS / CPT® |
PRE-OP SERVICE LVRS COMPLETE |
G0303 |
$0.00 |
HCPCS / CPT® |
PRE-OP SERVICE LVRS 10-15DOS |
G0304 |
$0.00 |
HCPCS / CPT® |
PRE-OP SERVICE LVRS 1-9 DOS |
G0305 |
$0.00 |
HCPCS / CPT® |
POST OP SERVICE LVRS MIN 6 |
G0306 |
$0.00 |
HCPCS / CPT® |
CBC/DIFFWBC W/O PLATELET |
G0307 |
$0.00 |
HCPCS / CPT® |
CBC WITHOUT PLATELET |
G0328 |
$0.00 |
HCPCS / CPT® |
FECAL BLOOD SCRN IMMUNOASSAY |
G0329 |
$0.00 |
HCPCS / CPT® |
ELECTROMAGNTIC TX FOR ULCERS |
G0333 |
$0.00 |
HCPCS / CPT® |
DISPENSE FEE INITIAL 30 DAY |
G0337 |
$0.00 |
HCPCS / CPT® |
HOSPICE EVALUATION PREELECTI |
G0339 |
$0.00 |
HCPCS / CPT® |
ROBOT LIN-RADSURG COM, FIRST |
G0340 |
$0.00 |
HCPCS / CPT® |
ROBT LIN-RADSURG FRACTX 2-5 |
G0341 |
$0.00 |
HCPCS / CPT® |
PERCUTANEOUS ISLET CELLTRANS |
G0342 |
$0.00 |
HCPCS / CPT® |
LAPAROSCOPY ISLET CELL TRANS |
G0343 |
$0.00 |
HCPCS / CPT® |
LAPAROTOMY ISLET CELL TRANSP |
G0364 |
$0.00 |
HCPCS / CPT® |
BONE MARROW ASPIRATE &BIOPSY |
G0365 |
$0.00 |
HCPCS / CPT® |
VESSEL MAPPING HEMO ACCESS |
G0372 |
$0.00 |
HCPCS / CPT® |
MD SERVICE REQUIRED FOR PMD |
G0378 |
$1800.00 |
HCPCS / CPT® |
HOSPITAL OBSERVATION PER HR |
G0379 |
$1600.00 |
HCPCS / CPT® |
DIRECT REFERRAL TO OBSERVATION |
G0380 |
$0.00 |
HCPCS / CPT® |
LEV 1 HOSP TYPE B ED VISIT |
G0381 |
$0.00 |
HCPCS / CPT® |
LEV 2 HOSP TYPE B ED VISIT |
G0382 |
$0.00 |
HCPCS / CPT® |
LEV 3 HOSP TYPE B ED VISIT |
G0383 |
$0.00 |
HCPCS / CPT® |
LEV 4 HOSP TYPE B ED VISIT |
G0384 |
$0.00 |
HCPCS / CPT® |
LEV 5 HOSP TYPE B ED VISIT |
G0390 |
$0.00 |
HCPCS / CPT® |
TRAUMA RESPONS W/HOSP CRITI |
G0396 |
$0.00 |
HCPCS / CPT® |
ALCOHOL/SUBS INTERV 15-30MN |
G0397 |
$0.00 |
HCPCS / CPT® |
ALCOHOL/SUBS INTERV >30 MIN |
G0398 |
$0.00 |
HCPCS / CPT® |
HOME SLEEP TEST/TYPE 2 PORTA |
G0399 |
$0.00 |
HCPCS / CPT® |
HOME SLEEP TEST/TYPE 3 PORTA |
G0400 |
$0.00 |
HCPCS / CPT® |
HOME SLEEP TEST/TYPE 4 PORTA |
G0402 |
$0.00 |
HCPCS / CPT® |
INITIAL PREVENTIVE EXAM |
G0403 |
$0.00 |
HCPCS / CPT® |
EKG FOR INITIAL PREVENT EXAM |
G0404 |
$107.95 |
HCPCS / CPT® |
EKG TRACING FOR INITIAL PREV |
G0405 |
$0.00 |
HCPCS / CPT® |
EKG INTERPRET & REPORT PREVE |
G0406 |
$0.00 |
HCPCS / CPT® |
INPT/TELE FOLLOW UP 15 |
G0407 |
$0.00 |
HCPCS / CPT® |
INPT/TELE FOLLOW UP 25 |
G0408 |
$0.00 |
HCPCS / CPT® |
INPT/TELE FOLLOW UP 35 |
G0409 |
$0.00 |
HCPCS / CPT® |
CORF RELATED SERV 15 MINS EA |
G0410 |
$0.00 |
HCPCS / CPT® |
GRP PSYCH PARTIAL HOSP 45-50 |
G0411 |
$0.00 |
HCPCS / CPT® |
INTER ACTIVE GRP PSYCH PARTI |
G0412 |
$0.00 |
HCPCS / CPT® |
OPEN TX ILIAC SPINE UNI/BIL |
G0413 |
$0.00 |
HCPCS / CPT® |
PELVIC RING FRACTURE UNI/BIL |
G0414 |
$0.00 |
HCPCS / CPT® |
PELVIC RING FX TREAT INT FIX |
G0415 |
$0.00 |
HCPCS / CPT® |
OPEN TX POST PELVIC FXCTURE |
G0416 |
$0.00 |
HCPCS / CPT® |
PROSTATE BIOPSY, ANY MTHD |
G0420 |
$0.00 |
HCPCS / CPT® |
ED SVC CKD IND PER SESSION |
G0421 |
$0.00 |
HCPCS / CPT® |
ED SVC CKD GRP PER SESSION |
G0422 |
$0.00 |
HCPCS / CPT® |
INTENS CARDIAC REHAB W/EXERC |
G0423 |
$0.00 |
HCPCS / CPT® |
INTENS CARDIAC REHAB NO EXER |
G0424 |
$0.00 |
HCPCS / CPT® |
PULMONARY REHAB W EXER |
G0425 |
$0.00 |
HCPCS / CPT® |
INPT/ED TELECONSULT30 |
G0426 |
$0.00 |
HCPCS / CPT® |
INPT/ED TELECONSULT50 |
G0427 |
$0.00 |
HCPCS / CPT® |
INPT/ED TELECONSULT70 |
G0428 |
$0.00 |
HCPCS / CPT® |
COLLAGEN MENISCUS IMPLANT |
G0429 |
$0.00 |
HCPCS / CPT® |
DERMAL FILLER INJECTION(S) |
G0431 |
$366.13 |
HCPCS / CPT® |
UDS – URINE DRUG SCREEN QUAL 1 DRUG CLASS METH EA DRUG CLASS |
G0432 |
$0.00 |
HCPCS / CPT® |
EIA HIV-1/HIV-2 SCREEN |
G0433 |
$0.00 |
HCPCS / CPT® |
ELISA HIV-1/HIV-2 SCREEN |
G0435 |
$0.00 |
HCPCS / CPT® |
ORAL HIV-1/HIV-2 SCREEN |
G0438 |
$0.00 |
HCPCS / CPT® |
PPPS, INITIAL VISIT |
G0439 |
$0.00 |
HCPCS / CPT® |
PPPS, SUBSEQ VISIT |
G0442 |
$0.00 |
HCPCS / CPT® |
ANNUAL ALCOHOL SCREEN 15 MIN |
G0443 |
$0.00 |
HCPCS / CPT® |
BRIEF ALCOHOL MISUSE COUNSEL |
G0444 |
$0.00 |
HCPCS / CPT® |
DEPRESSION SCREEN ANNUAL |
G0445 |
$0.00 |
HCPCS / CPT® |
HIGH INTEN BEH COUNS STD 30M |
G0446 |
$0.00 |
HCPCS / CPT® |
INTENS BEHAVE THER CARDIO DX |
G0447 |
$0.00 |
HCPCS / CPT® |
BEHAVIOR COUNSEL OBESITY 15M |
G0448 |
$0.00 |
HCPCS / CPT® |
PLACE PERM PACING CARDIOVERT |
G0451 |
$0.00 |
HCPCS / CPT® |
DEVLOPMENT TEST INTERPT&REP |
G0452 |
$0.00 |
HCPCS / CPT® |
MOLECULAR PATHOLOGY INTERPR |
G0453 |
$0.00 |
HCPCS / CPT® |
CONT INTRAOP NEURO MONITOR |
G0454 |
$0.00 |
HCPCS / CPT® |
MD DOCUMENT VISIT BY NPP |
G0455 |
$0.00 |
HCPCS / CPT® |
FECAL MICROBIOTA PREP INSTIL |
G0458 |
$0.00 |
HCPCS / CPT® |
LDR PROSTATE BRACHY COMP RAT |
G0459 |
$0.00 |
HCPCS / CPT® |
TELEHEALTH INPT PHARM MGMT |
G0460 |
$0.00 |
HCPCS / CPT® |
AUTOLOGOUS PRP FOR ULCERS |
G0463 |
$0.00 |
HCPCS / CPT® |
HOSPITAL OUTPT CLINIC VISIT |
G0466 |
$0.00 |
HCPCS / CPT® |
FQHC VISIT NEW PATIENT |
G0467 |
$0.00 |
HCPCS / CPT® |
FQHC VISIT, ESTAB PT |
G0468 |
$0.00 |
HCPCS / CPT® |
FQHC VISIT, IPPE OR AWV |
G0469 |
$0.00 |
HCPCS / CPT® |
FQHC VISIT, MH NEW PT |
G0470 |
$0.00 |
HCPCS / CPT® |
FQHC VISIT, MH ESTAB PT |
G0471 |
$0.00 |
HCPCS / CPT® |
VEN BLOOD COLL SNF/HHA |
G0472 |
$0.00 |
HCPCS / CPT® |
HEP C SCREEN HIGH RISK/OTHER |
G0473 |
$0.00 |
HCPCS / CPT® |
GROUP BEHAVE COUNS 2-10 |
G0475 |
$0.00 |
HCPCS / CPT® |
HIV COMBINATION ASSAY |
G0476 |
$0.00 |
HCPCS / CPT® |
HPV COMBO ASSAY CA SCREEN |
G0477 |
$0.00 |
HCPCS / CPT® |
DRUG TEST PRESUMP OPTICAL |
G0478 |
$0.00 |
HCPCS / CPT® |
DRUG TEST PRESUMP OPT INST |
G0479 |
$366.13 |
HCPCS / CPT® |
UDS – URINE DRUG SCREEN QUAL 1 DRUG CLASS METH EA DRUG CLASS |
G0480 |
$264.80 |
HCPCS / CPT® |
Alcohol, Ethyl, Blood |
G0481 |
$0.00 |
HCPCS / CPT® |
DRUG TEST DEF 8-14 CLASSES |
G0482 |
$0.00 |
HCPCS / CPT® |
DRUG TEST DEF 15-21 CLASSES |
G0483 |
$0.00 |
HCPCS / CPT® |
DRUG TEST DEF 22+ CLASSES |
G0490 |
$0.00 |
HCPCS / CPT® |
HOME VISIT RN, LPN BY RHC/FQ |
G0491 |
$0.00 |
HCPCS / CPT® |
DIALYSIS ACU KIDNEY NO ESRD |
G0492 |
$0.00 |
HCPCS / CPT® |
MD/OTH EVAL ACUT KID NO ESRD |
G0493 |
$0.00 |
HCPCS / CPT® |
RN CARE EA 15 MIN HH/HOSPICE |
G0494 |
$0.00 |
HCPCS / CPT® |
LPN CARE EA 15MIN HH/HOSPICE |
G0495 |
$0.00 |
HCPCS / CPT® |
RN CARE TRAIN/EDU IN HH |
G0496 |
$0.00 |
HCPCS / CPT® |
LPN CARE TRAIN/EDU IN HH |
G0498 |
$0.00 |
HCPCS / CPT® |
CHEMO EXTEND IV INFUS W/PUMP |
G0499 |
$0.00 |
HCPCS / CPT® |
HEPB SCREEN HIGH RISK INDIV |
G0500 |
$0.00 |
HCPCS / CPT® |
MOD SEDAT ENDO SERVICE >5YRS |
G0501 |
$0.00 |
HCPCS / CPT® |
RESOURCE-INTEN SVC DURING OV |
G0502 |
$0.00 |
HCPCS / CPT® |
INIT PSYCH CARE MANAG, 70MIN |
G0503 |
$0.00 |
HCPCS / CPT® |
SUBSEQ PSYCH CARE MAN,60MI |
G0504 |
$0.00 |
HCPCS / CPT® |
INIT/SUB PSYCH CARE ADD 30 M |
G0505 |
$0.00 |
HCPCS / CPT® |
COG/FUNC ASSESSMENT OUTPT |
G0506 |
$0.00 |
HCPCS / CPT® |
COMP ASSES CARE PLAN CCM SVC |
G0507 |
$0.00 |
HCPCS / CPT® |
CARE MANAGE SERV MINIMUM 20 |
G0508 |
$0.00 |
HCPCS / CPT® |
CRIT CARE TELEHEA CONSULT 60 |
G0509 |
$0.00 |
HCPCS / CPT® |
CRIT CARE TELEHEA CONSULT 50 |
G0913 |
$0.00 |
HCPCS / CPT® |
IMPROVE VISUAL FUNCT |
G0914 |
$0.00 |
HCPCS / CPT® |
SURVEY NOT COMPLETE |
G0915 |
$0.00 |
HCPCS / CPT® |
NO IMPROVE VISUAL FUNCT |
G0916 |
$0.00 |
HCPCS / CPT® |
SATISFY WITH CARE |
G0917 |
$0.00 |
HCPCS / CPT® |
SATISFY SURVEY NOT COMPLETE |
G0918 |
$0.00 |
HCPCS / CPT® |
NO SATISFY WITH CARE |
G6001 |
$0.00 |
HCPCS / CPT® |
ECHO GUIDANCE RADIOTHERAPY |
G6002 |
$0.00 |
HCPCS / CPT® |
STEREOSCOPIC X-RAY GUIDANCE |
G6003 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6004 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6005 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6006 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6007 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6008 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6009 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6010 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6011 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6012 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6013 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6014 |
$0.00 |
HCPCS / CPT® |
RADIATION TREATMENT DELIVERY |
G6015 |
$0.00 |
HCPCS / CPT® |
RADIATION TX DELIVERY IMRT |
G6016 |
$0.00 |
HCPCS / CPT® |
DELIVERY COMP IMRT |
G6017 |
$0.00 |
HCPCS / CPT® |
INTRAFRACTION TRACK MOTION |
G6038 |
$126.72 |
HCPCS / CPT® |
SALICYLATE |
G6039 |
$258.83 |
HCPCS / CPT® |
ACETAMINOPHEN |
G8395 |
$0.00 |
HCPCS / CPT® |
LVEF>=40% DOC NORMAL OR MILD |
G8396 |
$0.00 |
HCPCS / CPT® |
LVEF NOT PERFORMED |
G8397 |
$0.00 |
HCPCS / CPT® |
DIL MACULA/FUNDUS EXAM/W DOC |
G8398 |
$0.00 |
HCPCS / CPT® |
DIL MACULAR/FUNDUS NOT PERFO |
G8399 |
$0.00 |
HCPCS / CPT® |
PT W/DXA RESULTS DOCUMENT |
G8400 |
$0.00 |
HCPCS / CPT® |
PT W/DXA NO RESULTS DOC |
G8404 |
$0.00 |
HCPCS / CPT® |
LOW EXTEMITY NEUR EXAM DOCUM |
G8405 |
$0.00 |
HCPCS / CPT® |
LOW EXTEMITY NEUR NOT PERFOR |
G8410 |
$0.00 |
HCPCS / CPT® |
EVAL ON FOOT DOCUMENTED |
G8415 |
$0.00 |
HCPCS / CPT® |
EVAL ON FOOT NOT PERFORMED |
G8416 |
$0.00 |
HCPCS / CPT® |
PT INELIG FOOTWEAR EVALUATIO |
G8417 |
$0.00 |
HCPCS / CPT® |
CALC BMI ABV UP PARAM F/U |
G8418 |
$0.00 |
HCPCS / CPT® |
CALC BMI BLW LOW PARAM F/U |
G8419 |
$0.00 |
HCPCS / CPT® |
CALC BMI OUT NRM PARAM NOF/U |
G8420 |
$0.00 |
HCPCS / CPT® |
CALC BMI NORM PARAMETERS |
G8421 |
$0.00 |
HCPCS / CPT® |
BMI NOT CALCULATED |
G8422 |
$0.00 |
HCPCS / CPT® |
PT INELIG BMI CALCULATION |
G8427 |
$0.00 |
HCPCS / CPT® |
DOCREV CUR MEDS BY ELIG CLIN |
G8428 |
$0.00 |
HCPCS / CPT® |
CUR MEDS NOT DOCUMENT |
G8430 |
$0.00 |
HCPCS / CPT® |
PT INELIG MED CHECK |
G8431 |
$0.00 |
HCPCS / CPT® |
POS CLIN DEPRES SCRN F/U DOC |
G8432 |
$0.00 |
HCPCS / CPT® |
DEP SCR NOT DOC, RNG |
G8433 |
$0.00 |
HCPCS / CPT® |
SCR DEP NOT DONE, DOC RSN |
G8442 |
$0.00 |
HCPCS / CPT® |
PT INELIG PAIN ASSESSMENT |
G8450 |
$0.00 |
HCPCS / CPT® |
BETA-BLOC RX PT W/ABN LVEF |
G8451 |
$0.00 |
HCPCS / CPT® |
PT W/ABN LVEF INELIG B-BLOC |
G8452 |
$0.00 |
HCPCS / CPT® |
PT W/ABN LVEF B-BLOC NO RX |
G8465 |
$0.00 |
HCPCS / CPT® |
HIGH RISK RECURRENCE PRO CA |
G8473 |
$0.00 |
HCPCS / CPT® |
ACE/ARB THXPY RX’D |
G8474 |
$0.00 |
HCPCS / CPT® |
ACE/ARB NOT RX’D; DOC REAS |
G8475 |
$0.00 |
HCPCS / CPT® |
ACE/ARB THXPY NOT RX’D |
G8476 |
$0.00 |
HCPCS / CPT® |
BP SYS <140 AND DIAS <90 |
G8477 |
$0.00 |
HCPCS / CPT® |
BP SYS>=140 AND/OR DIAS >=90 |
G8478 |
$0.00 |
HCPCS / CPT® |
BP NOT PERFORMED/DOC |
G8482 |
$0.00 |
HCPCS / CPT® |
FLU IMMUNIZE ORDER/ADMIN |
G8483 |
$0.00 |
HCPCS / CPT® |
FLU IMM NO ADMIN DOC REA |
G8484 |
$0.00 |
HCPCS / CPT® |
FLU IMMUNIZE NO ADMIN |
G8506 |
$0.00 |
HCPCS / CPT® |
PT REC ACE/ARB |
G8509 |
$0.00 |
HCPCS / CPT® |
POS PAIN ASSESS NO F/U DOC |
G8510 |
$0.00 |
HCPCS / CPT® |
SCR DEP NEG, NO PLAN REQD |
G8511 |
$0.00 |
HCPCS / CPT® |
SCR DEP POS, NO PLAN DOC RNG |
G8535 |
$0.00 |
HCPCS / CPT® |
PT INELIG NO ELD MAL SCRN |
G8536 |
$0.00 |
HCPCS / CPT® |
NO DOC ELDER MAL SCRN |
G8539 |
$0.00 |
HCPCS / CPT® |
DOC FUNCT AND CARE PLAN |
G8540 |
$0.00 |
HCPCS / CPT® |
PT INELIG FUNCT ASSESS |
G8541 |
$0.00 |
HCPCS / CPT® |
NO DOC CUR FUNCT ASSESS |
G8542 |
$0.00 |
HCPCS / CPT® |
DOC FUNCT NO DEFICIENCIES |
G8543 |
$0.00 |
HCPCS / CPT® |
CUR FUNCT ASSES; NO CARE PLN |
G8559 |
$0.00 |
HCPCS / CPT® |
PT REF DOC OTO EVAL |
G8560 |
$0.00 |
HCPCS / CPT® |
PT HX ACT DRAIN PREV 90 DAYS |
G8561 |
$0.00 |
HCPCS / CPT® |
PT INELIG FOR REF OTO EVAL |
G8562 |
$0.00 |
HCPCS / CPT® |
PT NO HX ACT DRAIN 90 D |
G8563 |
$0.00 |
HCPCS / CPT® |
PT NO REF OTO REAS NO SPEC |
G8564 |
$0.00 |
HCPCS / CPT® |
PT REF OTO EVAL |
G8565 |
$0.00 |
HCPCS / CPT® |
VER DOC HEAR LOSS |
G8566 |
$0.00 |
HCPCS / CPT® |
PT INELIG REF OTO EVAL |
G8567 |
$0.00 |
HCPCS / CPT® |
PT NO DOC HEAR LOSS |
G8568 |
$0.00 |
HCPCS / CPT® |
PT NO REF OTOLO NO SPEC |
G8569 |
$0.00 |
HCPCS / CPT® |
PROL INTUBATION REQ |
G8570 |
$0.00 |
HCPCS / CPT® |
NO PROL INTUB REQ |
G8571 |
$0.00 |
HCPCS / CPT® |
STER WD IFX 30 D POSTOP |
G8572 |
$0.00 |
HCPCS / CPT® |
NO STER WD IFX |
G8573 |
$0.00 |
HCPCS / CPT® |
STK CABG |
G8574 |
$0.00 |
HCPCS / CPT® |
NO STRK CABG |
G8575 |
$0.00 |
HCPCS / CPT® |
POSTOP REN FAIL |
G8576 |
$0.00 |
HCPCS / CPT® |
NO POSTOP REN FAIL |
G8577 |
$0.00 |
HCPCS / CPT® |
REOP REQ BLD GRFT OTH |
G8578 |
$0.00 |
HCPCS / CPT® |
NO REOP REQ BLD GRFT OTH |
G8598 |
$7.50 |
HCPCS / CPT® |
ASPIRIN OR ANOTHER ANTITHROMBOTIC THERAPY USED |
G8599 |
$0.00 |
HCPCS / CPT® |
NO ASA/ANTIPLAT THER USE RNG |
G8600 |
$0.00 |
HCPCS / CPT® |
TPA INITI W/IN 3 HRS |
G8601 |
$0.00 |
HCPCS / CPT® |
NO ELIG TPA INIT W/IN 3 HRS |
G8602 |
$0.00 |
HCPCS / CPT® |
NO TPA INIT W/IN 3 HRS |
G8627 |
$0.00 |
HCPCS / CPT® |
SURG PROC W/IN 30 DAYS |
G8628 |
$0.00 |
HCPCS / CPT® |
NO SURG PROC W/IN 30 DAYS |
G8633 |
$0.00 |
HCPCS / CPT® |
PHARM THER OSTEO RX |
G8635 |
$0.00 |
HCPCS / CPT® |
NO PHARM THER OSTEO RX |
G8647 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE KNEE >= 0 |
G8648 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE KNEE < 0 |
G8649 |
$0.00 |
HCPCS / CPT® |
RAFSCRS KNEE NO MSR, NO FOTO |
G8650 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE KNEE NOT DONE |
G8651 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE HIP >= 0 |
G8652 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE HIP < 0 |
G8653 |
$0.00 |
HCPCS / CPT® |
RAFSCRS HIP, NO MSR, NO SURV |
G8654 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE HIP NOT DONE |
G8655 |
$0.00 |
HCPCS / CPT® |
RAFSCRS FT ANK SCORE >=0 |
G8656 |
$0.00 |
HCPCS / CPT® |
RAFSCRS FT ANK SCORE < 0 |
G8657 |
$0.00 |
HCPCS / CPT® |
RAFSCRS FOOT, NO MSR/NO FOTO |
G8658 |
$0.00 |
HCPCS / CPT® |
RAFSCRS FOOT, NO MSR/NO SURV |
G8659 |
$0.00 |
HCPCS / CPT® |
RAFSCRS LUMB SCORE >= 0 |
G8660 |
$0.00 |
HCPCS / CPT® |
RAFSCRS LUMB SCORE < 0 |
G8661 |
$0.00 |
HCPCS / CPT® |
RAFSCRS LUM, NO MSR/NO FOTO |
G8662 |
$0.00 |
HCPCS / CPT® |
RAFSCRS LUM, NO MSR/NO SURV |
G8663 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE SHDL >=0 |
G8664 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE SHDL < 0 |
G8665 |
$0.00 |
HCPCS / CPT® |
RAFSCRS SHLDR, NO MSR/FOTO |
G8666 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE SHDL NOT DONE |
G8667 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE UE >=0 |
G8668 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE UE < 0 |
G8669 |
$0.00 |
HCPCS / CPT® |
RAFSCRS HAND, NO MSR/SURV |
G8670 |
$0.00 |
HCPCS / CPT® |
FUN STAT SCORE UE NOT DONE |
G8671 |
$0.00 |
HCPCS / CPT® |
RAFSCRS NECK, SCORE >/=0 |
G8672 |
$0.00 |
HCPCS / CPT® |
RAFSCRS NECK, SCORE <0 |
G8673 |
$0.00 |
HCPCS / CPT® |
RAFSCRS NECK, NO MSR/NO FOTO |
G8674 |
$0.00 |
HCPCS / CPT® |
RAFSCRS NECK, NO MSR/NO FOTO |
G8694 |
$0.00 |
HCPCS / CPT® |
LVEF <40% |
G8696 |
$0.00 |
HCPCS / CPT® |
ANTITHROMB THX PRESC |
G8697 |
$0.00 |
HCPCS / CPT® |
ANTITHROMB NO PRESC DOC REAS |
G8698 |
$0.00 |
HCPCS / CPT® |
ANTITHROMB NO PRESC NO REAS |
G8708 |
$0.00 |
HCPCS / CPT® |
ANTIBIOTIC NOT PRES |
G8709 |
$0.00 |
HCPCS / CPT® |
MED REAS ANTIBIOTIC PRES |
G8710 |
$0.00 |
HCPCS / CPT® |
PT PRES ANTIBIOTIC |
G8711 |
$0.00 |
HCPCS / CPT® |
PRES ANTIBIOTIC |
G8712 |
$0.00 |
HCPCS / CPT® |
NOT PRES ANTIBIOTIC |
G8721 |
$0.00 |
HCPCS / CPT® |
PT, PN, HIST GRADE DOC |
G8722 |
$0.00 |
HCPCS / CPT® |
MED REAS PT, PN, NOT DOC |
G8723 |
$0.00 |
HCPCS / CPT® |
SPEC SIT NOT PRIM TUMOR |
G8724 |
$0.00 |
HCPCS / CPT® |
PT, PN, HIST GRADE NOT DOC |
G8730 |
$0.00 |
HCPCS / CPT® |
PAIN DOC POS AND PLAN |
G8731 |
$0.00 |
HCPCS / CPT® |
PAIN NEG NO PLAN |
G8732 |
$0.00 |
HCPCS / CPT® |
NO DOC OF PAIN |
G8733 |
$0.00 |
HCPCS / CPT® |
DOC POS ELDER MAL SCRN PLAN |
G8734 |
$0.00 |
HCPCS / CPT® |
DOC NEG ELDER MAL NO PLAN |
G8735 |
$0.00 |
HCPCS / CPT® |
ELD MAL SCRN POS NO PLAN |
G8749 |
$0.00 |
HCPCS / CPT® |
SIGNS OF MELANOMA ABSENT |
G8752 |
$0.00 |
HCPCS / CPT® |
SYS BP LESS 140 |
G8753 |
$0.00 |
HCPCS / CPT® |
SYS BP > OR = 140 |
G8754 |
$0.00 |
HCPCS / CPT® |
DIAS BP LESS 90 |
G8755 |
$0.00 |
HCPCS / CPT® |
DIAS BP > OR = 90 |
G8756 |
$0.00 |
HCPCS / CPT® |
NO BP MEASURE DOC |
G8783 |
$0.00 |
HCPCS / CPT® |
BP SCRN PERF REC INTERVAL |
G8785 |
$0.00 |
HCPCS / CPT® |
BP SCRN NO PERF AT INTERVAL |
G8797 |
$0.00 |
HCPCS / CPT® |
SPECIMEN SITE NOT ESOPHAGUS |
G8798 |
$0.00 |
HCPCS / CPT® |
SPECIMEN SITE NOT PROSTATE |
G8806 |
$0.00 |
HCPCS / CPT® |
TRANSAB OR TRANSVAG US |
G8807 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO US |
G8808 |
$0.00 |
HCPCS / CPT® |
NO TRANSAB OR TRANSVAG US |
G8809 |
$0.00 |
HCPCS / CPT® |
RH-IMMUNOGLOBULIN ORDER |
G8810 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO RH-IMMUNO |
G8811 |
$0.00 |
HCPCS / CPT® |
NO RH-IMMUNOGLOBULIN ORDER |
G8815 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO STATIN THERAPY |
G8816 |
$0.00 |
HCPCS / CPT® |
STATIN MED PRES AT DISCH |
G8817 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO STATIN MED DISCH |
G8818 |
$0.00 |
HCPCS / CPT® |
PT DISCH TO HOME BY DAY#7 |
G8825 |
$0.00 |
HCPCS / CPT® |
PT NOT DISCH TO HOME DAY#7 |
G8826 |
$0.00 |
HCPCS / CPT® |
PT DISCH HOME DAY #2 EVAR |
G8833 |
$0.00 |
HCPCS / CPT® |
PT NOT DISCH HOME DAY#2 EVAR |
G8834 |
$0.00 |
HCPCS / CPT® |
PT DISCH HOME DAY #2 CEA |
G8838 |
$0.00 |
HCPCS / CPT® |
NOT DISCH HOME BY DAY #2 |
G8839 |
$0.00 |
HCPCS / CPT® |
SLEEP APNEA ASSESS |
G8840 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO SLEEP APNEA |
G8841 |
$0.00 |
HCPCS / CPT® |
NO SLEEP APNEA ASSESS |
G8842 |
$0.00 |
HCPCS / CPT® |
AHI OR RDI INITIAL DX |
G8843 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO AHI OR RDI |
G8844 |
$0.00 |
HCPCS / CPT® |
NO AHI OR RDI INITIAL DX |
G8845 |
$0.00 |
HCPCS / CPT® |
POS AIRWAY PRESS PRESCRIBED |
G8846 |
$0.00 |
HCPCS / CPT® |
MOD OR SEVERE OSA |
G8849 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO POS AIR PRESS |
G8850 |
$0.00 |
HCPCS / CPT® |
NO PAP PRESCRIBED |
G8851 |
$0.00 |
HCPCS / CPT® |
ADHERE POS AIR PRESS THERAPY |
G8852 |
$0.00 |
HCPCS / CPT® |
POS AIR PRESS PRESCRIBE |
G8854 |
$0.00 |
HCPCS / CPT® |
REAS NO ADHERE POS AIR PRES |
G8855 |
$0.00 |
HCPCS / CPT® |
POS AIR PRESS ADHERE NO PERF |
G8856 |
$0.00 |
HCPCS / CPT® |
REF FOR OTO EVAL |
G8857 |
$0.00 |
HCPCS / CPT® |
NO ELIG REF FOR OTO EVAL |
G8858 |
$0.00 |
HCPCS / CPT® |
NOT REF FOR OTO EVAL |
G8861 |
$0.00 |
HCPCS / CPT® |
DXA ORDERED FOR OSTEO |
G8863 |
$0.00 |
HCPCS / CPT® |
NO ASSESS BONE LOSS |
G8864 |
$0.00 |
HCPCS / CPT® |
PNEUMOCOCCAL VACCINE ADMIN |
G8865 |
$0.00 |
HCPCS / CPT® |
DOC MED REAS NO PNEUMOCOCCAL |
G8866 |
$0.00 |
HCPCS / CPT® |
DOC PT REAS NO PNEUMOCOCCAL |
G8867 |
$0.00 |
HCPCS / CPT® |
NO PNEUMOCOCCAL ADMIN |
G8869 |
$0.00 |
HCPCS / CPT® |
DOC IMMUN HEP B 1ST ANTITNF |
G8872 |
$0.00 |
HCPCS / CPT® |
INTRAOP IMAGE CONFIRM EXCISE |
G8873 |
$0.00 |
HCPCS / CPT® |
SPECIMEN NOT INTRAOP IMAGE |
G8874 |
$0.00 |
HCPCS / CPT® |
TISSUE NOT IMAGE INTRAOP |
G8875 |
$0.00 |
HCPCS / CPT® |
BREAST CANCER DX MIN INVSIVE |
G8876 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO MIN INV DX |
G8877 |
$0.00 |
HCPCS / CPT® |
NO BRST CNCR DX MIN INVASIVE |
G8878 |
$0.00 |
HCPCS / CPT® |
SENT LYMPH NODE BIOPSY |
G8879 |
$0.00 |
HCPCS / CPT® |
NODE NEG INV BRST CNCR |
G8880 |
$0.00 |
HCPCS / CPT® |
DOC REAS NO LYMPH NODE BIOP |
G8881 |
$0.00 |
HCPCS / CPT® |
BRST CNCR STAGE > T1N0M0 |
G8882 |
$0.00 |
HCPCS / CPT® |
NO SENT LYMPH NODE BIOPSY |
G8883 |
$0.00 |
HCPCS / CPT® |
REV, COMM, TRACK, DOC BIOPSY |
G8884 |
$0.00 |
HCPCS / CPT® |
DOC REAS BIOPSY NOT REVIEW |
G8885 |
$0.00 |
HCPCS / CPT® |
NO REV, COMM, TRACK BIOPSY |
G8895 |
$9.90 |
HCPCS / CPT® |
ANTROM PRESCRIBE |
G8907 |
$0.00 |
HCPCS / CPT® |
PT DOC NO EVENTS ON DISCHARG |
G8908 |
$0.00 |
HCPCS / CPT® |
PT DOC W BURN PRIOR TO D/C |
G8909 |
$0.00 |
HCPCS / CPT® |
PT DOC NO BURN PRIOR TO D/C |
G8910 |
$0.00 |
HCPCS / CPT® |
PT DOC TO HAVE FALL IN ASC |
G8911 |
$0.00 |
HCPCS / CPT® |
PT DOC NO FALL IN ASC |
G8912 |
$0.00 |
HCPCS / CPT® |
PT DOC WITH WRONG EVENT |
G8913 |
$0.00 |
HCPCS / CPT® |
PT DOC NO WRONG EVENT |
G8914 |
$0.00 |
HCPCS / CPT® |
PT TRANS TO HOSP POST D/C |
G8915 |
$0.00 |
HCPCS / CPT® |
PT NOT TRANS TO HOSP AT D/C |
G8916 |
$0.00 |
HCPCS / CPT® |
PT W IV AB GIVEN ON TIME |
G8917 |
$0.00 |
HCPCS / CPT® |
PT W IV AB NOT GIVEN ON TIME |
G8918 |
$0.00 |
HCPCS / CPT® |
PT W/O PREOP ORDER IV AB PRO |
G8923 |
$0.00 |
HCPCS / CPT® |
LVEF < 40% OR LVSD |
G8924 |
$0.00 |
HCPCS / CPT® |
SPIR FEV1/FVC <70%,FEV <60% |
G8925 |
$0.00 |
HCPCS / CPT® |
SPIR FEV1/FVC>=60% & NO COPD |
G8926 |
$0.00 |
HCPCS / CPT® |
SPIRO NO PERF OR DOC |
G8934 |
$0.00 |
HCPCS / CPT® |
LVEF <40% OR DEP LV SYS FCN |
G8935 |
$0.00 |
HCPCS / CPT® |
RX ACE OR ARB THERAPY |
G8936 |
$0.00 |
HCPCS / CPT® |
PT NOT ELIGIBLE ACE/ARB |
G8937 |
$0.00 |
HCPCS / CPT® |
NO RX ACE/ARB THERAPY |
G8938 |
$0.00 |
HCPCS / CPT® |
BMI CALC, PT NO F/U PLAN ELG |
G8939 |
$0.00 |
HCPCS / CPT® |
PAIN ASSESS DOC, F/U NO DOC |
G8941 |
$0.00 |
HCPCS / CPT® |
NO DOC ELDER SCRN, PT NO EL |
G8942 |
$0.00 |
HCPCS / CPT® |
DOC FCN/CARE PLAN W/30 DAYS |
G8944 |
$0.00 |
HCPCS / CPT® |
AJCC MEL CNR STG 0 – IIC |
G8946 |
$0.00 |
HCPCS / CPT® |
MIBM BUT NO DX OF BREAST CA |
G8947 |
$0.00 |
HCPCS / CPT® |
1 OR MORE NEUROPSYCH |
G8950 |
$0.00 |
HCPCS / CPT® |
PRE-HTN OR HTN DOC, F/U INDC |
G8952 |
$0.00 |
HCPCS / CPT® |
PRE-HTN/HTN, NO F/U, NOT GVN |
G8955 |
$0.00 |
HCPCS / CPT® |
MOST RECENT ASSESS VOL MGMT |
G8956 |
$0.00 |
HCPCS / CPT® |
PT RCV HEDIA OUTPT DYLS FAC |
G8958 |
$0.00 |
HCPCS / CPT® |
ASSESS VOL MGMT NOT DOC |
G8959 |
$0.00 |
HCPCS / CPT® |
CLIN TX MDD COMM TO TX CLIN |
G8960 |
$0.00 |
HCPCS / CPT® |
CLIN TX MDD NOT COMM |
G8961 |
$0.00 |
HCPCS / CPT® |
CSIT LOWRISK SURG PTS PREOP |
G8962 |
$0.00 |
HCPCS / CPT® |
CSIT ON PT ANY REAS 30 DAYS |
G8963 |
$0.00 |
HCPCS / CPT® |
CSI PER ASX PT W/PCI 2 YRS |
G8964 |
$0.00 |
HCPCS / CPT® |
CSI ANY OTHER THAN PCI 2 YR |
G8965 |
$0.00 |
HCPCS / CPT® |
CSIT PERF ON LOW CHD RSK |
G8966 |
$0.00 |
HCPCS / CPT® |
CSIT PERF SX OR HIGH CHD RSK |
G8967 |
$0.00 |
HCPCS / CPT® |
WRFRN OR ORAL ANTIGOAG PRES |
G8968 |
$0.00 |
HCPCS / CPT® |
DOC RSN NO WARF/ANTICOG PRES |
G8969 |
$0.00 |
HCPCS / CPT® |
PT RSN NO PRES WRFRN OR OTHR |
G8970 |
$0.00 |
HCPCS / CPT® |
NO RSK FAC OR 1 MOD RISK TE |
G8971 |
$0.00 |
HCPCS / CPT® |
WARFRN OR OTHR ANTCOG NO RX |
G8972 |
$0.00 |
HCPCS / CPT® |
1>=RISK OR>= MOD RISK FOR TE |
G8973 |
$0.00 |
HCPCS / CPT® |
MST RCNT HBB < 10G/DL |
G8974 |
$0.00 |
HCPCS / CPT® |
HGB NOT DOC RNS NOT GVN |
G8975 |
$0.00 |
HCPCS / CPT® |
HGB <10G/DL, MED RSN |
G8976 |
$0.00 |
HCPCS / CPT® |
HGB >= 10 G/DL |
G8978 |
$0.00 |
HCPCS / CPT® |
MOBILITY CURRENT STATUS |
G8979 |
$0.00 |
HCPCS / CPT® |
MOBILITY GOAL STATUS |
G8980 |
$0.00 |
HCPCS / CPT® |
MOBILITY D/C STATUS |
G8981 |
$0.00 |
HCPCS / CPT® |
BODY POS CURRENT STATUS |
G8982 |
$0.00 |
HCPCS / CPT® |
BODY POS GOAL STATUS |
G8983 |
$0.00 |
HCPCS / CPT® |
BODY POS D/C STATUS |
G8984 |
$0.00 |
HCPCS / CPT® |
CARRY CURRENT STATUS |
G8985 |
$0.00 |
HCPCS / CPT® |
CARRY GOAL STATUS |
G8986 |
$0.00 |
HCPCS / CPT® |
CARRY D/C STATUS |
G8987 |
$0.00 |
HCPCS / CPT® |
SELF CARE CURRENT STATUS |
G8988 |
$0.00 |
HCPCS / CPT® |
SELF CARE GOAL STATUS |
G8989 |
$0.00 |
HCPCS / CPT® |
SELF CARE D/C STATUS |
G8990 |
$0.00 |
HCPCS / CPT® |
OTHER PT/OT CURRENT STATUS |
G8991 |
$0.00 |
HCPCS / CPT® |
OTHER PT/OT GOAL STATUS |
G8992 |
$0.00 |
HCPCS / CPT® |
OTHER PT/OT D/C STATUS |
G8993 |
$0.00 |
HCPCS / CPT® |
SUB PT/OT CURRENT STATUS |
G8994 |
$0.00 |
HCPCS / CPT® |
SUB PT/OT GOAL STATUS |
G8995 |
$0.00 |
HCPCS / CPT® |
SUB PT/OT D/C STATUS |
G8996 |
$0.00 |
HCPCS / CPT® |
SWALLOW CURRENT STATUS |
G8997 |
$0.00 |
HCPCS / CPT® |
SWALLOW GOAL STATUS |
G8998 |
$0.00 |
HCPCS / CPT® |
SWALLOW D/C STATUS |
G8999 |
$0.00 |
HCPCS / CPT® |
MOTOR SPEECH CURRENT STATUS |
G9001 |
$0.00 |
HCPCS / CPT® |
MCCD, INITIAL RATE |
G9002 |
$0.00 |
HCPCS / CPT® |
MCCD,MAINTENANCE RATE |
G9003 |
$0.00 |
HCPCS / CPT® |
MCCD, RISK ADJ HI, INITIAL |
G9004 |
$0.00 |
HCPCS / CPT® |
MCCD, RISK ADJ LO, INITIAL |
G9005 |
$0.00 |
HCPCS / CPT® |
MCCD, RISK ADJ, MAINTENANCE |
G9006 |
$0.00 |
HCPCS / CPT® |
MCCD, HOME MONITORING |
G9007 |
$0.00 |
HCPCS / CPT® |
MCCD, SCH TEAM CONF |
G9008 |
$0.00 |
HCPCS / CPT® |
MCCD,PHYS COOR-CARE OVRSGHT |
G9009 |
$0.00 |
HCPCS / CPT® |
MCCD, RISK ADJ, LEVEL 3 |
G9010 |
$0.00 |
HCPCS / CPT® |
MCCD, RISK ADJ, LEVEL 4 |
G9011 |
$0.00 |
HCPCS / CPT® |
MCCD, RISK ADJ, LEVEL 5 |
G9012 |
$0.00 |
HCPCS / CPT® |
OTHER SPECIFIED CASE MGMT |
G9013 |
$0.00 |
HCPCS / CPT® |
ESRD DEMO BUNDLE LEVEL I |
G9014 |
$0.00 |
HCPCS / CPT® |
ESRD DEMO BUNDLE-LEVEL II |
G9016 |
$0.00 |
HCPCS / CPT® |
DEMO-SMOKING CESSATION COUN |
G9017 |
$0.00 |
HCPCS / CPT® |
AMANTADINE HCL 100MG ORAL |
G9018 |
$0.00 |
HCPCS / CPT® |
ZANAMIVIR,INHALATION PWD 10M |
G9019 |
$0.00 |
HCPCS / CPT® |
OSELTAMIVIR PHOSPHATE 75MG |
G9020 |
$0.00 |
HCPCS / CPT® |
RIMANTADINE HCL 100MG ORAL |
G9033 |
$0.00 |
HCPCS / CPT® |
AMANTADINE HCL ORAL BRAND |
G9034 |
$0.00 |
HCPCS / CPT® |
ZANAMIVIR, INH PWDR, BRAND |
G9035 |
$0.00 |
HCPCS / CPT® |
OSELTAMIVIR PHOSP, BRAND |
G9036 |
$0.00 |
HCPCS / CPT® |
RIMANTADINE HCL, BRAND |
G9050 |
$0.00 |
HCPCS / CPT® |
ONCOLOGY WORK-UP EVALUATION |
G9051 |
$0.00 |
HCPCS / CPT® |
ONCOLOGY TX DECISION-MGMT |
G9052 |
$0.00 |
HCPCS / CPT® |
ONC SURVEILLANCE FOR DISEASE |
G9053 |
$0.00 |
HCPCS / CPT® |
ONC EXPECTANT MANAGEMENT PT |
G9054 |
$0.00 |
HCPCS / CPT® |
ONC SUPERVISION PALLIATIVE |
G9055 |
$0.00 |
HCPCS / CPT® |
ONC VISIT UNSPECIFIED NOS |
G9056 |
$0.00 |
HCPCS / CPT® |
ONC PRAC MGMT ADHERES GUIDE |
G9057 |
$0.00 |
HCPCS / CPT® |
ONC PRACT MGMT DIFFERS TRIAL |
G9058 |
$0.00 |
HCPCS / CPT® |
ONC PRAC MGMT DISAGREE W/GUI |
G9059 |
$0.00 |
HCPCS / CPT® |
ONC PRAC MGMT PT OPT ALTERNA |
G9060 |
$0.00 |
HCPCS / CPT® |
ONC PRAC MGMT DIF PT COMORB |
G9061 |
$0.00 |
HCPCS / CPT® |
ONC PRAC COND NOADD BY GUIDE |
G9062 |
$0.00 |
HCPCS / CPT® |
ONC PRAC GUIDE DIFFERS NOS |
G9063 |
$0.00 |
HCPCS / CPT® |
ONC DX NSCLC STGI NO PROGRES |
G9064 |
$0.00 |
HCPCS / CPT® |
ONC DX NSCLC STG2 NO PROGRES |
G9065 |
$0.00 |
HCPCS / CPT® |
ONC DX NSCLC STG3A NO PROGRE |
G9066 |
$0.00 |
HCPCS / CPT® |
ONC DX NSCLC STG3B-4 METASTA |
G9067 |
$0.00 |
HCPCS / CPT® |
ONC DX NSCLC DX UNKNOWN NOS |
G9068 |
$0.00 |
HCPCS / CPT® |
ONC DX SCLC/NSCLC LIMITED |
G9069 |
$0.00 |
HCPCS / CPT® |
ONC DX SCLC/NSCLC EXT AT DX |
G9070 |
$0.00 |
HCPCS / CPT® |
ONC DX SCLC/NSCLC EXT UNKNWN |
G9071 |
$0.00 |
HCPCS / CPT® |
ONC DX BRST STG1-2B HR,NOPRO |
G9072 |
$0.00 |
HCPCS / CPT® |
ONC DX BRST STG1-2 NOPROGRES |
G9073 |
$0.00 |
HCPCS / CPT® |
ONC DX BRST STG3-HR, NO PRO |
G9074 |
$0.00 |
HCPCS / CPT® |
ONC DX BRST STG3-NOPROGRESS |
G9075 |
$0.00 |
HCPCS / CPT® |
ONC DX BRST METASTIC/ RECUR |
G9077 |
$0.00 |
HCPCS / CPT® |
ONC DX PROSTATE T1NO PROGRES |
G9078 |
$0.00 |
HCPCS / CPT® |
ONC DX PROSTATE T2NO PROGRES |
G9079 |
$0.00 |
HCPCS / CPT® |
ONC DX PROSTATE T3B-T4NOPROG |
G9080 |
$0.00 |
HCPCS / CPT® |
ONC DX PROSTATE W/RISE PSA |
G9083 |
$0.00 |
HCPCS / CPT® |
ONC DX PROSTATE UNKNWN NOS |
G9084 |
$0.00 |
HCPCS / CPT® |
ONC DX COLON T1-3,N1-2,NO PR |
G9085 |
$0.00 |
HCPCS / CPT® |
ONC DX COLON T4, N0 W/O PROG |
G9086 |
$0.00 |
HCPCS / CPT® |
ONC DX COLON T1-4 NO DX PROG |
G9087 |
$0.00 |
HCPCS / CPT® |
ONC DX COLON METAS EVID DX |
G9088 |
$0.00 |
HCPCS / CPT® |
ONC DX COLON METAS NOEVID DX |
G9089 |
$0.00 |
HCPCS / CPT® |
ONC DX COLON EXTENT UNKNOWN |
G9090 |
$0.00 |
HCPCS / CPT® |
ONC DX RECTAL T1-2 NO PROGR |
G9091 |
$0.00 |
HCPCS / CPT® |
ONC DX RECTAL T3 N0 NO PROG |
G9092 |
$0.00 |
HCPCS / CPT® |
ONC DX RECTAL T1-3,N1-2NOPRG |
G9093 |
$0.00 |
HCPCS / CPT® |
ONC DX RECTAL T4,N,M0 NO PRG |
G9094 |
$0.00 |
HCPCS / CPT® |
ONC DX RECTAL M1 W/METS PROG |
G9095 |
$0.00 |
HCPCS / CPT® |
ONC DX RECTAL EXTENT UNKNWN |
G9096 |
$0.00 |
HCPCS / CPT® |
ONC DX ESOPHAG T1-T3 NOPROG |
G9097 |
$0.00 |
HCPCS / CPT® |
ONC DX ESOPHAGEAL T4 NO PROG |
G9098 |
$0.00 |
HCPCS / CPT® |
ONC DX ESOPHAGEAL METS RECUR |
G9099 |
$0.00 |
HCPCS / CPT® |
ONC DX ESOPHAGEAL UNKNOWN |
G9100 |
$0.00 |
HCPCS / CPT® |
ONC DX GASTRIC NO RECURRENCE |
G9101 |
$0.00 |
HCPCS / CPT® |
ONC DX GASTRIC P R1-R2NOPROG |
G9102 |
$0.00 |
HCPCS / CPT® |
ONC DX GASTRIC UNRESECTABLE |
G9103 |
$0.00 |
HCPCS / CPT® |
ONC DX GASTRIC RECURRENT |
G9104 |
$0.00 |
HCPCS / CPT® |
ONC DX GASTRIC UNKNOWN NOS |
G9105 |
$0.00 |
HCPCS / CPT® |
ONC DX PANCREATC P R0 RES NO |
G9106 |
$0.00 |
HCPCS / CPT® |
ONC DX PANCREATC P R1/R2 NO |
G9107 |
$0.00 |
HCPCS / CPT® |
ONC DX PANCREATIC UNRESECTAB |
G9108 |
$0.00 |
HCPCS / CPT® |
ONC DX PANCREATIC UNKNWN NOS |
G9109 |
$0.00 |
HCPCS / CPT® |
ONC DX HEAD/NECK T1-T2NO PRG |
G9110 |
$0.00 |
HCPCS / CPT® |
ONC DX HEAD/NECK T3-4 NOPROG |
G9111 |
$0.00 |
HCPCS / CPT® |
ONC DX HEAD/NECK M1 METS REC |
G9112 |
$0.00 |
HCPCS / CPT® |
ONC DX HEAD/NECK EXT UNKNOWN |
G9113 |
$0.00 |
HCPCS / CPT® |
ONC DX OVARIAN STG1A-B NO PR |
G9114 |
$0.00 |
HCPCS / CPT® |
ONC DX OVARIAN STG1A-B OR 2 |
G9115 |
$0.00 |
HCPCS / CPT® |
ONC DX OVARIAN STG3/4 NOPROG |
G9116 |
$0.00 |
HCPCS / CPT® |
ONC DX OVARIAN RECURRENCE |
G9117 |
$0.00 |
HCPCS / CPT® |
ONC DX OVARIAN UNKNOWN NOS |
G9123 |
$0.00 |
HCPCS / CPT® |
ONC DX CML CHRONIC PHASE |
G9124 |
$0.00 |
HCPCS / CPT® |
ONC DX CML ACCELER PHASE |
G9125 |
$0.00 |
HCPCS / CPT® |
ONC DX CML BLAST PHASE |
G9126 |
$0.00 |
HCPCS / CPT® |
ONC DX CML REMISSION |
G9128 |
$0.00 |
HCPCS / CPT® |
ONC DX MULTI MYELOMA STAGE I |
G9129 |
$0.00 |
HCPCS / CPT® |
ONC DX MULT MYELOMA STG2 HIG |
G9130 |
$0.00 |
HCPCS / CPT® |
ONC DX MULTI MYELOMA UNKNOWN |
G9131 |
$0.00 |
HCPCS / CPT® |
ONC DX BRST UNKNOWN NOS |
G9132 |
$0.00 |
HCPCS / CPT® |
ONC DX PROSTATE METS NO CAST |
G9133 |
$0.00 |
HCPCS / CPT® |
ONC DX PROSTATE CLINICAL MET |
G9134 |
$0.00 |
HCPCS / CPT® |
ONC NHLSTG 1-2 NO RELAP NO |
G9135 |
$0.00 |
HCPCS / CPT® |
ONC DX NHL STG 3-4 NOT RELAP |
G9136 |
$0.00 |
HCPCS / CPT® |
ONC DX NHL TRANS TO LG BCELL |
G9137 |
$0.00 |
HCPCS / CPT® |
ONC DX NHL RELAPSE/REFRACTOR |
G9138 |
$0.00 |
HCPCS / CPT® |
ONC DX NHL STG UNKNOWN |
G9139 |
$0.00 |
HCPCS / CPT® |
ONC DX CML DX STATUS UNKNOWN |
G9140 |
$0.00 |
HCPCS / CPT® |
FRONTIER EXTENDED STAY DEMO |
G9143 |
$0.00 |
HCPCS / CPT® |
WARFARIN RESPON GENETIC TEST |
G9147 |
$0.00 |
HCPCS / CPT® |
OUTPT IV INSULIN TX ANY MEA |
G9148 |
$0.00 |
HCPCS / CPT® |
MEDICAL HOME LEVEL 1 |
G9149 |
$0.00 |
HCPCS / CPT® |
MEDICAL HOME LEVEL II |
G9150 |
$0.00 |
HCPCS / CPT® |
MEDICAL HOME LEVEL III |
G9151 |
$0.00 |
HCPCS / CPT® |
MAPCP DEMO STATE |
G9152 |
$0.00 |
HCPCS / CPT® |
MAPCP DEMO COMMUNITY |
G9153 |
$0.00 |
HCPCS / CPT® |
MAPCP DEMO PHYSICIAN |
G9156 |
$0.00 |
HCPCS / CPT® |
EVALUATION FOR WHEELCHAIR |
G9157 |
$0.00 |
HCPCS / CPT® |
TRANSESOPH DOPPL CARDIAC MON |
G9158 |
$0.00 |
HCPCS / CPT® |
MOTOR SPEECH D/C STATUS |
G9159 |
$0.00 |
HCPCS / CPT® |
LANG COMP CURRENT STATUS |
G9160 |
$0.00 |
HCPCS / CPT® |
LANG COMP GOAL STATUS |
G9161 |
$0.00 |
HCPCS / CPT® |
LANG COMP D/C STATUS |
G9162 |
$0.00 |
HCPCS / CPT® |
LANG EXPRESS CURRENT STATUS |
G9163 |
$0.00 |
HCPCS / CPT® |
LANG EXPRESS GOAL STATUS |
G9164 |
$0.00 |
HCPCS / CPT® |
LANG EXPRESS D/C STATUS |
G9165 |
$0.00 |
HCPCS / CPT® |
ATTEN CURRENT STATUS |
G9166 |
$0.00 |
HCPCS / CPT® |
ATTEN GOAL STATUS |
G9167 |
$0.00 |
HCPCS / CPT® |
ATTEN D/C STATUS |
G9168 |
$0.00 |
HCPCS / CPT® |
MEMORY CURRENT STATUS |
G9169 |
$0.00 |
HCPCS / CPT® |
MEMORY GOAL STATUS |
G9170 |
$0.00 |
HCPCS / CPT® |
MEMORY D/C STATUS |
G9171 |
$0.00 |
HCPCS / CPT® |
VOICE CURRENT STATUS |
G9172 |
$0.00 |
HCPCS / CPT® |
VOICE GOAL STATUS |
G9173 |
$0.00 |
HCPCS / CPT® |
VOICE D/C STATUS |
G9174 |
$0.00 |
HCPCS / CPT® |
SPEECH LANG CURRENT STATUS |
G9175 |
$0.00 |
HCPCS / CPT® |
SPEECH LANG GOAL STATUS |
G9176 |
$0.00 |
HCPCS / CPT® |
SPEECH LANG D/C STATUS |
G9186 |
$0.00 |
HCPCS / CPT® |
MOTOR SPEECH GOAL STATUS |
G9187 |
$0.00 |
HCPCS / CPT® |
BPCI HOME VISIT |
G9188 |
$0.00 |
HCPCS / CPT® |
BETA NOT GIVEN NO REASON |
G9189 |
$0.00 |
HCPCS / CPT® |
BETA PRES OR ALREADY TAKING |
G9190 |
$0.00 |
HCPCS / CPT® |
MEDICAL REASON FOR NO BETA |
G9191 |
$0.00 |
HCPCS / CPT® |
PT REASON FOR NO BETA |
G9192 |
$0.00 |
HCPCS / CPT® |
SYSTEM REASON FOR NO BETA |
G9196 |
$0.00 |
HCPCS / CPT® |
MED REASON FOR NO CEPH |
G9197 |
$0.00 |
HCPCS / CPT® |
ORDER FOR CEPH |
G9198 |
$0.00 |
HCPCS / CPT® |
NO ORDER FOR CEPH NO REASON |
G9212 |
$0.00 |
HCPCS / CPT® |
DOC OF DSM-IV INIT EVAL |
G9213 |
$0.00 |
HCPCS / CPT® |
NO DOC OF DSM-IV |
G9223 |
$0.00 |
HCPCS / CPT® |
PJP PROPH ORDERED CD4 LOW |
G9225 |
$0.00 |
HCPCS / CPT® |
NORSN NO FOOT EXAM |
G9226 |
$0.00 |
HCPCS / CPT® |
3 COMP FOOT EXAM COMPLETED |
G9227 |
$0.00 |
HCPCS / CPT® |
DOCRSN NO CARE PLAN |
G9228 |
$0.00 |
HCPCS / CPT® |
GC CHL SYP DOCUMENTED |
G9229 |
$0.00 |
HCPCS / CPT® |
PTRSN NO GC CHL SYP TEST |
G9230 |
$0.00 |
HCPCS / CPT® |
NORSN FOR GC CHL SYP TEST |
G9231 |
$0.00 |
HCPCS / CPT® |
DOC ESRD DIA TRANS PREG |
G9232 |
$0.00 |
HCPCS / CPT® |
PTRSN NO COMM COMORBID |
G9239 |
$0.00 |
HCPCS / CPT® |
DOC RSN HEMOD & CATH ACC |
G9240 |
$0.00 |
HCPCS / CPT® |
DOC PT W CATH MAINT DIA |
G9241 |
$0.00 |
HCPCS / CPT® |
DOC PT W OUT CATH MAINT DIA |
G9242 |
$0.00 |
HCPCS / CPT® |
DOC VIRAL LOAD >=200 |
G9243 |
$0.00 |
HCPCS / CPT® |
DOC VIRAL LOAD <200 |
G9246 |
$0.00 |
HCPCS / CPT® |
NO MED VISIT IN 24MO |
G9247 |
$0.00 |
HCPCS / CPT® |
1 MED VISIT IN 24MO |
G9250 |
$0.00 |
HCPCS / CPT® |
DOC OF PAIN COMFORT 48HR |
G9251 |
$0.00 |
HCPCS / CPT® |
DOC NO PAIN COMFORT 48HR |
G9254 |
$0.00 |
HCPCS / CPT® |
DOC PT DISCHG >2D |
G9255 |
$0.00 |
HCPCS / CPT® |
DOC PT DISCHG <=2D |
G9256 |
$0.00 |
HCPCS / CPT® |
DOC DEATH AFTER CAS |
G9257 |
$0.00 |
HCPCS / CPT® |
DOC STROKE AFTER CAS |
G9258 |
$0.00 |
HCPCS / CPT® |
DOC STROKE AFTER CEA |
G9259 |
$0.00 |
HCPCS / CPT® |
DOC SURV NO STROKE AFTER CAS |
G9260 |
$0.00 |
HCPCS / CPT® |
DOC DEATH AFTER CEA |
G9261 |
$0.00 |
HCPCS / CPT® |
DOC SURV NO STROKE AFTER CEA |
G9262 |
$0.00 |
HCPCS / CPT® |
DOC DEATH IN HOSP AAA REPAIR |
G9263 |
$0.00 |
HCPCS / CPT® |
DOC SURV IN HOSP AAA REPAIR |
G9264 |
$0.00 |
HCPCS / CPT® |
DOC RSN HEMOD W/CATH >=90D |
G9265 |
$0.00 |
HCPCS / CPT® |
DOC CATH >90D FOR MAINT DIA |
G9266 |
$0.00 |
HCPCS / CPT® |
NORSN PT CATH >=90D |
G9267 |
$0.00 |
HCPCS / CPT® |
DOC COMP OR MORT W IN 30D |
G9268 |
$0.00 |
HCPCS / CPT® |
DOC COMP OR MORT W IN 90D |
G9269 |
$0.00 |
HCPCS / CPT® |
DOC NO COMP OR MORT W IN 30D |
G9270 |
$0.00 |
HCPCS / CPT® |
DOC NO COMP OR MORT W IN 90D |
G9273 |
$0.00 |
HCPCS / CPT® |
SYS <140 AND DIA <90 |
G9274 |
$0.00 |
HCPCS / CPT® |
BP OUT OF NRML LIMITS |
G9275 |
$0.00 |
HCPCS / CPT® |
DOC OF NON TOBACCO USER |
G9276 |
$0.00 |
HCPCS / CPT® |
DOC OF TOBACCO USER |
G9277 |
$0.00 |
HCPCS / CPT® |
DOC DAILY ASPIRIN OR CONTRA |
G9278 |
$0.00 |
HCPCS / CPT® |
DOC NO DAILY ASPIRIN |
G9279 |
$0.00 |
HCPCS / CPT® |
PNE SCRN DONE DOC VAC DONE |
G9280 |
$0.00 |
HCPCS / CPT® |
PNE NOT GIVEN NORSN |
G9281 |
$0.00 |
HCPCS / CPT® |
PNE SCRN DONE DOC NOT IND |
G9282 |
$0.00 |
HCPCS / CPT® |
DOC MEDRSN NO HISTO TYPE |
G9283 |
$0.00 |
HCPCS / CPT® |
HIST TYPE DOC ON REPORT |
G9284 |
$0.00 |
HCPCS / CPT® |
NO HIST TYPE DOC ON REPORT |
G9285 |
$0.00 |
HCPCS / CPT® |
SITE NOT SMALL CELL LUNG CA |
G9286 |
$0.00 |
HCPCS / CPT® |
ANTIBIO RX W IN 10D OF SYMPT |
G9287 |
$0.00 |
HCPCS / CPT® |
NO ANTIBIO W IN 10D OF SYMPT |
G9288 |
$0.00 |
HCPCS / CPT® |
DOC MEDRSN NO HIST TYPE RPT |
G9289 |
$0.00 |
HCPCS / CPT® |
DOC TYPE NSM LUNG CA |
G9290 |
$0.00 |
HCPCS / CPT® |
NO DOC TYPE NSM LUNG CA |
G9291 |
$0.00 |
HCPCS / CPT® |
NOT NSM LUNG CA |
G9292 |
$0.00 |
HCPCS / CPT® |
MEDRSN NO PT CATEGORY |
G9293 |
$0.00 |
HCPCS / CPT® |
NO PT CATEGORY ON REPORT |
G9294 |
$0.00 |
HCPCS / CPT® |
PT CAT AND THCK ON REPORT |
G9295 |
$0.00 |
HCPCS / CPT® |
NON CUTANEOUS LOC |
G9296 |
$0.00 |
HCPCS / CPT® |
DOC SHARE DEC PRIOR PROC |
G9297 |
$0.00 |
HCPCS / CPT® |
NO DOC SHARE DEC PRIOR PROC |
G9298 |
$0.00 |
HCPCS / CPT® |
EVAL RISK VTE CARD 30D PRIOR |
G9299 |
$0.00 |
HCPCS / CPT® |
NO EVAL RISKK VTE CARD PRIOR |
G9300 |
$0.00 |
HCPCS / CPT® |
DOC MEDRSN NO COMPL ANTIBIO |
G9301 |
$0.00 |
HCPCS / CPT® |
DOC COMPL INF ANTIBIO |
G9302 |
$0.00 |
HCPCS / CPT® |
NORSN INCOMP INF ANTIBIO |
G9303 |
$0.00 |
HCPCS / CPT® |
NORSN NO PROS INFO OP RPT |
G9304 |
$0.00 |
HCPCS / CPT® |
PROS INFO OP RPT |
G9305 |
$0.00 |
HCPCS / CPT® |
NO INTERV REQ FOR LEAK |
G9306 |
$0.00 |
HCPCS / CPT® |
INTERV REQ FOR LEAK |
G9307 |
$0.00 |
HCPCS / CPT® |
NO RET FOR SURG W IN 30D |
G9308 |
$0.00 |
HCPCS / CPT® |
UNPL RET OR W/COMPL W/IN 30D |
G9309 |
$0.00 |
HCPCS / CPT® |
NO UNPLND HOSP READM IN 30D |
G9310 |
$0.00 |
HCPCS / CPT® |
UNPLND HOSP READM IN 30D |
G9311 |
$0.00 |
HCPCS / CPT® |
NO SURG SITE INFECTION |
G9312 |
$0.00 |
HCPCS / CPT® |
SURGICAL SITE INFECTION |
G9313 |
$0.00 |
HCPCS / CPT® |
DOCRSN NOT FIRST LINE AMOX |
G9314 |
$0.00 |
HCPCS / CPT® |
NORSN NOT FIRST LINE AMOX |
G9315 |
$0.00 |
HCPCS / CPT® |
DOC FIRST LINE AMOX |
G9316 |
$0.00 |
HCPCS / CPT® |
DOC COMM RISK CALC |
G9317 |
$0.00 |
HCPCS / CPT® |
NO DOC COMM RISK CALC |
G9318 |
$0.00 |
HCPCS / CPT® |
IMAGE STD NOMENCLATURE |
G9319 |
$0.00 |
HCPCS / CPT® |
IMAGE NOT STD NOMENCLATURE |
G9321 |
$0.00 |
HCPCS / CPT® |
DOC COUNT OF CT IN 12MO |
G9322 |
$0.00 |
HCPCS / CPT® |
NO DOC COUNT OF CT IN 12MO |
G9326 |
$0.00 |
HCPCS / CPT® |
CT DONE NO RAD DS INDEX, NRG |
G9327 |
$0.00 |
HCPCS / CPT® |
CT DONE RAD DS INDEX |
G9329 |
$0.00 |
HCPCS / CPT® |
NORSN NO DICOM FORMAT DOC |
G9340 |
$0.00 |
HCPCS / CPT® |
DICOM FORMAT DOC ON RPT |
G9341 |
$0.00 |
HCPCS / CPT® |
SRCH FOR CT W IN 12 MOS |
G9342 |
$0.00 |
HCPCS / CPT® |
NO SRCH FOR CT IN 12MO NORSN |
G9344 |
$0.00 |
HCPCS / CPT® |
SYSRSN NO DICOM SRCH |
G9345 |
$0.00 |
HCPCS / CPT® |
FOLLOW UP PULM NOD |
G9347 |
$0.00 |
HCPCS / CPT® |
NO FOLLOW UP PULM NOD NORSN |
G9348 |
$0.00 |
HCPCS / CPT® |
DOCRSN NO SINUS CT DX |
G9349 |
$0.00 |
HCPCS / CPT® |
DOC SINUS CT 28D |
G9350 |
$0.00 |
HCPCS / CPT® |
NO DOC SINUS CT 28D OR DX |
G9351 |
$0.00 |
HCPCS / CPT® |
DOC >1 SINUS CT W 90D DX |
G9352 |
$0.00 |
HCPCS / CPT® |
NOT >1 SINUS CT W 90D DX |
G9353 |
$0.00 |
HCPCS / CPT® |
MEDRSN >1 SINUS CT W 90D DX |
G9354 |
$0.00 |
HCPCS / CPT® |
1 OR NO CT SINUS W/IN 90D DX |
G9355 |
$0.00 |
HCPCS / CPT® |
NO EARLY IND/DELIVERY |
G9356 |
$0.00 |
HCPCS / CPT® |
EARLY IND/DELIVERY |
G9357 |
$0.00 |
HCPCS / CPT® |
PP EVAL/EDU PERF |
G9358 |
$0.00 |
HCPCS / CPT® |
PP EVAL/EDU NOT PERF |
G9359 |
$0.00 |
HCPCS / CPT® |
DOC OF NEG OR MAN POS TB SCN |
G9360 |
$0.00 |
HCPCS / CPT® |
NO DOC OF NEG OR MAN POS TB |
G9361 |
$0.00 |
HCPCS / CPT® |
DOC RSN ELECT C-SEC/INDUCT |
G9364 |
$0.00 |
HCPCS / CPT® |
SINUS CAUS BAC INX |
G9365 |
$0.00 |
HCPCS / CPT® |
1HIGH RISK MED ORD |
G9366 |
$0.00 |
HCPCS / CPT® |
1HIGH RISK NO ORD |
G9367 |
$0.00 |
HCPCS / CPT® |
2HIGH RISK MED ORD |
G9368 |
$0.00 |
HCPCS / CPT® |
2HIGH RISK NO ORD |
G9380 |
$0.00 |
HCPCS / CPT® |
OFF ASSIS EOL ISS |
G9381 |
$0.00 |
HCPCS / CPT® |
DOC MED REAS NO OFFER EOL |
G9382 |
$0.00 |
HCPCS / CPT® |
NO OFF ASSIS EOL |
G9383 |
$0.00 |
HCPCS / CPT® |
RECD SCRN HCV INFEC |
G9384 |
$0.00 |
HCPCS / CPT® |
DOC MED REAS |