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3
A9521
Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
1
40
A9526
Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries
1
48
A9538
Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries
1
2,351
A9552
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries
1
1,088
A9555
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries
1
2,739
A9575
Injection, gadoterate meglumine, 0.1 ml
1
268
A9576
Injection, gadoteridol, (prohance multipack), per ml
1
146
A9581
Injection, gadoxetate disodium, 1 ml
1
3
A9582
Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
1
130
A9584
Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
1
2,982
A9585
Injection, gadobutrol, 0.1 ml
1
9
A9586
Florbetapir f18, diagnostic, per study dose, up to 10 millicuries
1
67
A9587
Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
1
238
A9588
Fluciclovine f-18, diagnostic, 1 millicurie
1
9
A9589
Instillation, hexaminolevulinate hydrochloride, 100 mg
1
2
A9592
Copper cu-64, dotatate, diagnostic, 1 millicurie
1
31
A9597
Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
1
1
C1824
Generator, cardiac contractility modulation (implantable)
1
1
C1839
Iris prosthesis
1
8
C2639
Brachytherapy source, non-stranded, iodine-125, per source
1
2
C2641
Brachytherapy source, non-stranded, palladium-103, per source
1
5
C2643
Brachytherapy source, non-stranded, cesium-131, per source
1
7
C9046
Cocaine hydrochloride nasal solution for topical administration, 1 mg
1
2
C9250
Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml
1
382
C9290
Injection, bupivacaine liposome, 1 mg
1
5
C9399
Unclassified drugs or biologicals
1
33
C9600
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
1
5
C9602
Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch
1
2
C9604
Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed;
1
2
C9728
Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple
1
1
C9739
Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants
1
177
C9740
Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants
1
7
C9752
Destruction of intraosseous basivertebral nerve, first two vertebral bodies, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum
1
1
C9771
Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral
1
1
D7140
Extraction, erupted tooth or exposed root (elevation and/or forceps removal)
1
3
E0746
Electromyography (emg), biofeedback device
1
29
G0068
Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each inf
1
10
G0069
Professional services for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
1
15
G0070
Professional services for the administration of intravenous chemotherapy or other intravenous highly complex drug or biological infusion for each infusion drug administration calendar day in the individual's home, each 15 minutes
1
2
G0071
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or m
1
1
G0077
Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
1
1
G0082
Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
1
1
G0083
Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
1
6
G0088
Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biologic
1
6
G0089
Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
1
8
G0090
Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
1
24
G0104
Colorectal cancer screening; flexible sigmoidoscopy
1
8,571
G0105
Colorectal cancer screening; colonoscopy on individual at high risk
1
1,310
G0108
Diabetes outpatient self-management training services, individual, per 30 minutes
1
3,106
G0127
Trimming of dystrophic nails, any number
1
10
G0130
Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)
1
90
G0249
Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the
1
909
G0260
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
1
2,391
G0268
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
1
118
G0270
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face wi
1
70
G0277
Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval
1
10,979
G0279
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)
1
836
G0296
Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)
1
62
G0339
Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment
1
93
G0340
Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatme
1
405
G0396
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes
1
69
G0398
Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation
1
1,337
G0399
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation
1
125
G0400
Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels
1
13,177
G0402
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
1
165
G0406
Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth
1
263
G0407
Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth
1
208
G0408
Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth
1
1
G0409
Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)
1
1
G0410
Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes
1
5
G0413
Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)
1
2
G0414
Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)
1
2,390
G0416
Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
1
80
G0420
Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
1
40
G0422
Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session
1
40
G0423
Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session
1
555
G0425
Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
1
537
G0426
Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
1
323
G0427
Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth
1
3
G0435
Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
1
97,774
G0439
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
1
8,235
G0442
Annual alcohol misuse screening, 15 minutes
1
28
G0443
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
1
23,295
G0444
Annual depression screening, 15 minutes
1
22
G0445
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes
1
2,921
G0446
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
1
3,118
G0447
Face-to-face behavioral counseling for obesity, 15 minutes
1
9
G0451
Development testing, with interpretation and report, per standardized instrument form
1
480
G0453
Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)
1
39
G0459
Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
1
680
G0472
Hepatitis c antibody screening, for individual at high risk and other covered indication(s)
1
80
G0475
Hiv antigen/antibody, combination assay, screening
1
107
G0476
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test
1
1,394
G0480
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms
1
1,552
G0481
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms
1
1,579
G0482
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms
1
1,259
G0483
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms
1
886
G0498
Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l
1
17
G0499
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when perfor
1
3,560
G0500
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito
1