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A9583
Injection, gadofosveset trisodium, 1 ml
1
12
A9606
Radium ra-223 dichloride, therapeutic, per microcurie
1
2
A9699
Radiopharmaceutical, therapeutic, not otherwise classified
1
18
A9700
Supply of injectable contrast material for use in echocardiography, per study
1
1
C2635
Brachytherapy source, non-stranded, high activity, paladium-103, greater than 2.2 mci (nist), per source
1
8
C2638
Brachytherapy source, stranded, iodine-125, per source
1
3
C2640
Brachytherapy source, stranded, palladium-103, per source
1
3
C2642
Brachytherapy source, stranded, cesium-131, per source
1
2
C5271
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
1
3
C5275
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
1
14
C9257
Injection, bevacizumab, 0.25 mg
1
113
C9447
Injection, phenylephrine and ketorolac, 4 ml vial
1
5
E0781
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient
1
5
E1399
Durable medical equipment, miscellaneous
1
145,393
G0008
Administration of influenza virus vaccine
1
89,220
G0009
Administration of pneumococcal vaccine
1
478
G0010
Administration of hepatitis b vaccine
1
20,057
G0101
Cervical or vaginal cancer screening; pelvic and clinical breast examination
1
1,062
G0102
Prostate cancer screening; digital rectal examination
1
8,192
G0103
Prostate cancer screening; prostate specific antigen test (psa)
1
330
G0109
Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
1
8
G0117
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
1
1
G0118
Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalomologist
1
1
G0120
Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
1
9,370
G0121
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
1
348
G0123
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
1
750
G0124
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
1
71
G0141
Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
1
4
G0143
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision
1
13
G0144
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision
1
394
G0145
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision
1
3
G0148
Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
1
179
G0166
External counterpulsation, per treatment session
1
118
G0168
Wound closure utilizing tissue adhesive(s) only
1
12,588
G0179
Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im
1
27,852
G0180
Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple
1
3,007
G0181
Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c
1
368
G0182
Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patien
1
3
G0186
Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)
1
20,239
G0202
Screening mammography, producing direct digital image, bilateral, all views
1
10,931
G0204
Diagnostic mammography, producing direct 2-d digital image, bilateral, all view
1
12,460
G0206
Diagnostic mammography, producing direct 2-d digital image, unilateral, all views
1
63
G0237
Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)
1
78
G0238
Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)
1
30
G0239
Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)
1
62
G0245
Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that cons
1
149
G0246
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a)
1
125
G0247
Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following i
1
47
G0248
Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to
1
1,595
G0250
Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent
1
3
G0271
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), group (2 or more individua
1
96
G0278
Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta
1
8
G0281
Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous statsis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as
1
20,189
G0283
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care
1
26
G0288
Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery
1
87
G0289
Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chrondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
1
231
G0297
Low dose ct scan (ldct) for lung cancer screening
1
94
G0306
Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count
1
71
G0307
Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)
1
7,450
G0328
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous
1
2,149
G0364
Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service
1
773
G0365
Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)
1
71
G0372
Physician service required to establish and document the need for a power mobility device
1
2,138
G0389
Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening
1
40
G0397
Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes
1
2,352
G0403
Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
1
50
G0404
Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
1
314
G0405
Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination
1
25
G0421
Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour
1
84
G0424
Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day
1
8
G0429
Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)
1
3,412
G0431
Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter
1
54
G0432
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening
1
18
G0433
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
1
6,730
G0434
Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter
1
3,035
G0436
Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
1
459
G0437
Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes
1
24,913
G0438
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
1
739
G0452
Molecular pathology procedure; physician interpretation and report
1
66
G0454
Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist
1
22
G0455
Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen
1
1
G0464
Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)
1
118
G0471
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)
1
22
G0473
Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes
1
12
G6003
Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: up to 5mev
1
6
G6004
Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 6-10mev
1
2
G6005
Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 11-19mev
1
2
G6006
Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20mev or greater
1
7
G6007
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5mev
1
1
G6008
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10mev
1
2
G6009
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19mev
1
69
G6011
Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5mev
1
1,078
G6012
Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10mev
1
870
G6013
Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19mev
1
135
G6014
Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20mev or greater
1
1,489
G6015
Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session
1
28
G6016
Compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator, convergent beam modulated fields, per treatment session
1
1
G6019
Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
1
64
G6021
Unlisted procedure, intestine
1
1
G6022
Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesions(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
1