HCPCSQ0000–Q9999

HCPCS Q — Temporary Codes

CMS's holding pen: drugs, supplies and services that need a code now and a permanent one later. Contrast agents and injectables dominate.

639 codes in the current CMS release, 584 of them still active.

Q0035Cardiokymography
Q0081Infusion therapy, using other than chemotherapeutic drugs, per visit
Q0083Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit
Q0084Chemotherapy administration by infusion technique only, per visit
Q0085Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit
Q0091Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
Q0092Set-up portable x-ray equipment
Q0111Wet mounts, including preparations of vaginal, cervical or skin specimens
Q0112All potassium hydroxide (koh) preparations
Q0113Pinworm examinations
Q0114Fern test
Q0115Post-coital direct, qualitative examinations of vaginal or cervical mucous
Q0138Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)
Q0139Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)
Q0144Azithromycin dihydrate, oral, capsules/powder, 1 gram
Q0155Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0161Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0162Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0163Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen
Q0164Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0166Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen
Q0167Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0169Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0173Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0174Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenterminated
Q0175Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0177Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0180Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen
Q0181Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0220Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mgterminated
Q0221Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mgterminated
Q0222Injection, bebtelovimab, 175 mgterminated
Q0224Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg
Q0234Injection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, 1 mg
Q0235Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, not otherwise classified, 1 mg
Q0237Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Q0238Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Q0239Injection, bamlanivimab-xxxx, 700 mgterminated
Q0240Injection, casirivimab and imdevimab, 600 mgterminated
Q0243Injection, casirivimab and imdevimab, 2400 mgterminated
Q0244Injection, casirivimab and imdevimab, 1200 mgterminated
Q0245Injection, bamlanivimab and etesevimab, 2100 mgterminated
Q0247Injection, sotrovimab, 500 mgterminated
Q0249Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Q0477Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0478Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type
Q0479Power module for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0480Driver for use with pneumatic ventricular assist device, replacement only
Q0481Microprocessor control unit for use with electric ventricular assist device, replacement only
Q0482Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only
Q0483Monitor/display module for use with electric ventricular assist device, replacement only
Q0484Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0485Monitor control cable for use with electric ventricular assist device, replacement only
Q0486Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only
Q0487Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only
Q0488Power pack base for use with electric ventricular assist device, replacement only
Q0489Power pack base for use with electric/pneumatic ventricular assist device, replacement only
Q0490Emergency power source for use with electric ventricular assist device, replacement only
Q0491Emergency power source for use with electric/pneumatic ventricular assist device, replacement only
Q0492Emergency power supply cable for use with electric ventricular assist device, replacement only
Q0493Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only
Q0494Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0495Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0496Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0497Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0498Holster for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0499Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only
Q0500Filters for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0501Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0502Mobility cart for pneumatic ventricular assist device, replacement only
Q0503Battery for pneumatic ventricular assist device, replacement only, each
Q0504Power adapter for pneumatic ventricular assist device, replacement only, vehicle type
Q0506Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0507Miscellaneous supply or accessory for use with an external ventricular assist device
Q0508Miscellaneous supply or accessory for use with an implanted ventricular assist device
Q0509Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a
Q0510Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant
Q0511Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period
Q0512Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period
Q0513Pharmacy dispensing fee for inhalation drug(s); per 30 days
Q0514Pharmacy dispensing fee for inhalation drug(s); per 90 days
Q0515Injection, sermorelin acetate, 1 microgram
Q0516Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 30-daysterminated
Q0517Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 60-daysterminated
Q0518Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 90-daysterminated
Q0519Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 30-daysterminated
Q0520Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 60-daysterminated
Q0521Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription
Q1004New technology intraocular lens category 4 as defined in federal register notice
Q1005New technology intraocular lens category 5 as defined in federal register notice
Q2004Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml
Q2009Injection, fosphenytoin, 50 mg phenytoin equivalent
Q2017Injection, teniposide, 50 mgterminated
Q2026Injection, radiesse, 0.1 ml
Q2028Injection, sculptra, 0.5 mg
Q2034Influenza virus vaccine, split virus, for intramuscular use (agriflu)
Q2035Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)
Q2036Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)
Q2038Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)
Q2039Influenza virus vaccine, not otherwise specified
Q2040Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusionterminated
Q2041Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2042Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2043Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion
Q2049Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg
Q2050Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg
Q2052Services, supplies and accessories used in the home for the administration of intravenous immune globulin (ivig)
Q2053Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2054Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2055Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2056Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2057Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2058Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion
Q3001Radioelements for brachytherapy, any type, each
Q3014Telehealth originating site facility fee
Q3027Injection, interferon beta-1a, 1 mcg for intramuscular use
Q3028Injection, interferon beta-1a, 1 mcg for subcutaneous use
Q3031Collagen skin test
Q4001Casting supplies, body cast adult, with or without head, plaster
Q4002Cast supplies, body cast adult, with or without head, fiberglass
Q4003Cast supplies, shoulder cast, adult (11 years +), plaster
Q4004Cast supplies, shoulder cast, adult (11 years +), fiberglass
Q4005Cast supplies, long arm cast, adult (11 years +), plaster
Q4006Cast supplies, long arm cast, adult (11 years +), fiberglass
Q4007Cast supplies, long arm cast, pediatric (0-10 years), plaster
Q4008Cast supplies, long arm cast, pediatric (0-10 years), fiberglass
Q4009Cast supplies, short arm cast, adult (11 years +), plaster
Q4010Cast supplies, short arm cast, adult (11 years +), fiberglass
Q4011Cast supplies, short arm cast, pediatric (0-10 years), plaster
Q4012Cast supplies, short arm cast, pediatric (0-10 years), fiberglass
Q4013Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster
Q4014Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass
Q4015Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster
Q4016Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass
Q4017Cast supplies, long arm splint, adult (11 years +), plaster
Q4018Cast supplies, long arm splint, adult (11 years +), fiberglass
Q4019Cast supplies, long arm splint, pediatric (0-10 years), plaster
Q4020Cast supplies, long arm splint, pediatric (0-10 years), fiberglass
Q4021Cast supplies, short arm splint, adult (11 years +), plaster
Q4022Cast supplies, short arm splint, adult (11 years +), fiberglass
Q4023Cast supplies, short arm splint, pediatric (0-10 years), plaster
Q4024Cast supplies, short arm splint, pediatric (0-10 years), fiberglass
Q4025Cast supplies, hip spica (one or both legs), adult (11 years +), plaster
Q4026Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass
Q4027Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster
Q4028Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass
Q4029Cast supplies, long leg cast, adult (11 years +), plaster
Q4030Cast supplies, long leg cast, adult (11 years +), fiberglass
Q4031Cast supplies, long leg cast, pediatric (0-10 years), plaster
Q4032Cast supplies, long leg cast, pediatric (0-10 years), fiberglass
Q4033Cast supplies, long leg cylinder cast, adult (11 years +), plaster
Q4034Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass
Q4035Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster
Q4036Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass
Q4037Cast supplies, short leg cast, adult (11 years +), plaster
Q4038Cast supplies, short leg cast, adult (11 years +), fiberglass
Q4039Cast supplies, short leg cast, pediatric (0-10 years), plaster
Q4040Cast supplies, short leg cast, pediatric (0-10 years), fiberglass
Q4041Cast supplies, long leg splint, adult (11 years +), plaster
Q4042Cast supplies, long leg splint, adult (11 years +), fiberglass
Q4043Cast supplies, long leg splint, pediatric (0-10 years), plaster
Q4044Cast supplies, long leg splint, pediatric (0-10 years), fiberglass
Q4045Cast supplies, short leg splint, adult (11 years +), plaster
Q4046Cast supplies, short leg splint, adult (11 years +), fiberglass
Q4047Cast supplies, short leg splint, pediatric (0-10 years), plaster
Q4048Cast supplies, short leg splint, pediatric (0-10 years), fiberglass
Q4049Finger splint, static
Q4050Cast supplies, for unlisted types and materials of casts
Q4051Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)
Q4074Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms
Q4081Injection, epoetin alfa, 100 units (for esrd on dialysis)
Q4082Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap)
Q4100Skin substitute, not otherwise specifiedterminated
Q4101Apligraf, per square centimeter (add-on, list separately in addition to primary procedure)
Q4102Oasis wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4103Oasis burn matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4104Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure)
Q4105Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4106Dermagraft, per square centimeterterminated
Q4107Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure)
Q4108Integra matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4110Primatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4111Gammagraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4112Cymetra, injectable, 1 cc
Q4113Graftjacket xpress, injectable, 1 cc
Q4114Integra flowable wound matrix, injectable, 1 cc
Q4115Alloskin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4116Alloderm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4117Hyalomatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4118Matristem micromatrix, 1 mg
Q4119Matristem wound matrix, per square centimeterterminated
Q4120Matristem burn matrix, per square centimeterterminated
Q4121Theraskin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4122Dermacell, dermacell awm or dermacell awm porous, per square centimeter (add-on, list separately in addition to primary procedure)
Q4123Alloskin rt, per square centimeter (add-on, list separately in addition to primary procedure)
Q4124Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4125Arthroflex, per square centimeter (add-on, list separately in addition to primary procedure)
Q4126Memoderm, dermaspan, tranzgraft or integuply, per square centimeter (add-on, list separately in addition to primary procedure)
Q4127Talymed, per square centimeter (add-on, list separately in addition to primary procedure)
Q4128Flex hd, or allopatch hd, per square centimeter (add-on, list separately in addition to primary procedure)
Q4129Unite biomatrix, per square centimeterterminated
Q4130Strattice tm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4131Epifix or epicord, per square centimeterterminated
Q4132Grafix core and grafixpl core, per square centimeter (add-on, list separately in addition to primary procedure)
Q4133Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4134Hmatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4135Mediskin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4136Ez-derm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4137Amnioexcel, amnioexcel plus or biodexcel, per square centimeter (add-on, list separately in addition to primary procedure)
Q4138Biodfence dryflex, per square centimeter (add-on, list separately in addition to primary procedure)
Q4139Amniomatrix or biodmatrix, injectable, 1 cc
Q4140Biodfence, per square centimeter (add-on, list separately in addition to primary procedure)
Q4141Alloskin ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4142Xcm biologic tissue matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4143Repriza, per square centimeter (add-on, list separately in addition to primary procedure)
Q4145Epifix, injectable, 1 mg
Q4146Tensix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4147Architect, architect px, or architect fx, extracellular matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4148Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter (add-on, list separately in addition to primary procedure)
Q4149Excellagen, 0.1 cc
Q4150Allowrap ds or dry, per square centimeter (add-on, list separately in addition to primary procedure)
Q4151Amnioband or guardian, per square centimeter (add-on, list separately in addition to primary procedure)
Q4152Dermapure, per square centimeter (add-on, list separately in addition to primary procedure)
Q4153Dermavest and plurivest, per square centimeter (add-on, list separately in addition to primary procedure)
Q4154Biovance, per square centimeter (add-on, list separately in addition to primary procedure)
Q4155Neoxflo or clarixflo, 1 mg
Q4156Neox 100 or clarix 100, per square centimeter (add-on, list separately in addition to primary procedure)
Q4157Revitalon, per square centimeter (add-on, list separately in addition to primary procedure)
Q4158Kerecis omega3, per square centimeter (add-on, list separately in addition to primary procedure)
Q4159Affinity, per square centimeter (add-on, list separately in addition to primary procedure)
Q4160Nushield, per square centimeter (add-on, list separately in addition to primary procedure)
Q4161Bio-connekt wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4162Woundex flow, bioskin flow, 0.5 cc
Q4163Woundex, bioskin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4164Helicoll, per square centimeter (add-on, list separately in addition to primary procedure)
Q4165Keramatrix or kerasorb, per square centimeter (add-on, list separately in addition to primary procedure)
Q4166Cytal, per square centimeter (add-on, list separately in addition to primary procedure)
Q4167Truskin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4168Amnioband, 1 mg
Q4169Artacent wound, per square centimeter (add-on, list separately in addition to primary procedure)
Q4170Cygnus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4171Interfyl, 1 mg
Q4172Puraply or puraply am, per square centimeterterminated
Q4173Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4174Palingen or promatrx, 0.36 mg per 0.25 cc
Q4175Miroderm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4176Neopatch or therion, per square centimeter (add-on, list separately in addition to primary procedure)
Q4177Floweramnioflo, 0.1 cc
Q4178Floweramniopatch, per square centimeter (add-on, list separately in addition to primary procedure)
Q4179Flowerderm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4180Revita, per square centimeter (add-on, list separately in addition to primary procedure)
Q4181Amnio wound, per square centimeter (add-on, list separately in addition to primary procedure)
Q4182Transcyte, per square centimeter (add-on, list separately in addition to primary procedure)
Q4183Surgigraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4184Cellesta or cellesta duo, per square centimeter (add-on, list separately in addition to primary procedure)
Q4185Cellesta flowable amnion (25 mg per cc); per 0.5 cc
Q4186Epifix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4187Epicord, per square centimeter (add-on, list separately in addition to primary procedure)
Q4188Amnioarmor, per square centimeter (add-on, list separately in addition to primary procedure)
Q4189Artacent ac, 1 mg
Q4190Artacent ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4191Restorigin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4192Restorigin, 1 cc
Q4193Coll-e-derm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4194Novachor, per square centimeter (add-on, list separately in addition to primary procedure)
Q4195Puraply, per square centimeter (add-on, list separately in addition to primary procedure)
Q4196Puraply am, per square centimeter (add-on, list separately in addition to primary procedure)
Q4197Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure)
Q4198Genesis amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4199Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4200Skin te, per square centimeter (add-on, list separately in addition to primary procedure)
Q4201Matrion, per square centimeter (add-on, list separately in addition to primary procedure)
Q4202Keroxx (2.5g/cc), 1cc
Q4203Derma-gide, per square centimeter (add-on, list separately in addition to primary procedure)
Q4204Xwrap, per square centimeter (add-on, list separately in addition to primary procedure)
Q4205Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)
Q4206Fluid flow or fluid gf, 1 cc
Q4208Novafix, per square cenitmeter (add-on, list separately in addition to primary procedure)
Q4209Surgraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4210Axolotl graft or axolotl dualgraft, per square centimeterterminated
Q4211Amnion bio or axobiomembrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4212Allogen, per cc
Q4213Ascent, 0.5 mg
Q4214Cellesta cord, per square centimeter (add-on, list separately in addition to primary procedure)
Q4215Axolotl ambient or axolotl cryo, 0.1 mg
Q4216Artacent cord, per square centimeter (add-on, list separately in addition to primary procedure)
Q4217Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4218Surgicord, per square centimeter (add-on, list separately in addition to primary procedure)
Q4219Surgigraft-dual, per square centimeter (add-on, list separately in addition to primary procedure)
Q4220Bellacell hd or surederm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4221Amniowrap2, per square centimeter (add-on, list separately in addition to primary procedure)
Q4222Progenamatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4224Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)
Q4225Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4226Myown skin, includes harvesting and preparation procedures, per square centimeter
Q4227Amniocore, per square centimeter (add-on, list separately in addition to primary procedure)
Q4228Bionextpatch, per square centimeterterminated
Q4229Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4230Cogenex flowable amnion, per 0.5 cc
Q4231Corplex p, per ccterminated
Q4232Corplex, per square centimeter (add-on, list separately in addition to primary procedure)
Q4233Surfactor or nudyn, per 0.5 cc
Q4234Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure)
Q4235Amniorepair or altiply, per square centimeter (add-on, list separately in addition to primary procedure)
Q4236Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)
Q4237Cryo-cord, per square centimeter (add-on, list separately in addition to primary procedure)
Q4238Derm-maxx, per square centimeter (add-on, list separately in addition to primary procedure)
Q4239Amnio-maxx or amnio-maxx lite, per square centimeter (add-on, list separately in addition to primary procedure)
Q4240Corecyte, for topical use only, per 0.5 cc
Q4241Polycyte, for topical use only, per 0.5 cc
Q4242Amniocyte plus, per 0.5 cc
Q4244Procenta, per 200 mgterminated
Q4245Amniotext, per cc
Q4246Coretext or protext, per cc
Q4247Amniotext patch, per square centimeter (add-on, list separately in addition to primary procedure)
Q4248Dermacyte amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4249Amniply, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure)
Q4250Amnioamp-mp, per square centimeter (add-on, list separately in addition to primary procedure)
Q4251Vim, per square centimeter (add-on, list separately in addition to primary procedure)
Q4252Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)
Q4253Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4254Novafix dl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4255Reguard, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure)
Q4256Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)
Q4257Relese, per square centimeter (add-on, list separately in addition to primary procedure)
Q4258Enverse, per square centimeter (add-on, list separately in addition to primary procedure)
Q4259Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4260Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)
Q4261Tag, per square centimeter (add-on, list separately in addition to primary procedure)
Q4262Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4263Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4264Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4265Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4266Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4267Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4268Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4269Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)
Q4270Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4271Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4272Esano a, per square centimeter (add-on, list separately in addition to primary procedure)
Q4273Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)
Q4274Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4275Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)
Q4276Orion, per square centimeter (add-on, list separately in addition to primary procedure)
Q4277Woundplus membrane or e-graft, per square centimeterterminated
Q4278Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)
Q4279Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4280Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4281Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4282Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)
Q4283Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)
Q4284Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4285Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)
Q4286Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)
Q4287Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4288Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)
Q4289Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)
Q4290Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)
Q4291Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)
Q4292Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)
Q4293Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4294Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)
Q4295Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)
Q4296Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4297Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4298Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)
Q4299Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)
Q4300Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4301Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4302Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)
Q4303Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)
Q4304Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4305American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)
Q4306American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4307American amnion, per square centimeter (add-on, list separately in addition to primary procedure)
Q4308Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)
Q4309Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4310Procenta, per 100 mg
Q4311Acesso, per square centimeter (add-on, list separately in addition to primary procedure)
Q4312Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4313Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4314Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)
Q4315Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4316Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)
Q4317Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4318E-graft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4319Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4320Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4321Renograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4322Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4323Alloply, per square centimeter (add-on, list separately in addition to primary procedure)
Q4324Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)
Q4325Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)
Q4326Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4327Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)
Q4328Most, per square centimeter (add-on, list separately in addition to primary procedure)
Q4329Singlay, per square centimeter (add-on, list separately in addition to primary procedure)
Q4330Total, per square centimeter (add-on, list separately in addition to primary procedure)
Q4331Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4332Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4333Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4334Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)
Q4335Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)
Q4336Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)
Q4337Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)
Q4338Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)
Q4339Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)
Q4340Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4341Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)
Q4342Theramend, per square centimeter (add-on, list separately in addition to primary procedure)
Q4343Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4344Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)
Q4345Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)
Q4346Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4347Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4348Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4349Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4350Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4351Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4352Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4353Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4354Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4355Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4356Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4357Xwrap plus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4358Xwrap dual, per square centimeter (add-on, list separately in addition to primary procedure)
Q4359Choriply, per square centimeter (add-on, list separately in addition to primary procedure)
Q4360Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)
Q4361Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)
Q4362Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)
Q4363Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4364Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4365Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4366Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4367Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4368Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)
Q4369Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)
Q4370Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)
Q4371Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)
Q4372Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)
Q4373Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)
Q4375Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4376Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)
Q4377Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4378Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4379Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4380Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)
Q4382Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)
Q4383Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)
Q4384Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)
Q4385Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4386Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)
Q4387Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4388Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)
Q4389Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)
Q4390Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)
Q4391Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)
Q4392Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)
Q4393Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4394Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)
Q4395Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4396Natalin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4397Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)
Q4398Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4399Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)
Q4400Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4401Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4402Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)
Q4403Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4404Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4405Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4406Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)
Q4407Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4408Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)
Q4409Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4410Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4411Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4412Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4413Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)
Q4414Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)
Q4415Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)
Q4416Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)
Q4417Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)
Q4418Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)
Q4419Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)
Q4420Nuform, per square centimeter (add-on, list separately in addition to primary procedure)
Q4421Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)
Q4422A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)
Q4423Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)
Q4424Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4425Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4426Dermabind tl + or dermabind tl x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4427Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4428Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4429Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4431Pma skin substitute product, not otherwise specified (list in addition to primary procedure)
Q4432510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)
Q4433361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)
Q4435Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4436Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4437Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4438Pretect, per square centimeter (add-on, list separately in addition to primary procedure)
Q4439Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4440Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q5001Hospice or home health care provided in patient's home/residence
Q5002Hospice or home health care provided in assisted living facility
Q5003Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf)
Q5004Hospice care provided in skilled nursing facility (snf)
Q5005Hospice care provided in inpatient hospital
Q5006Hospice care provided in inpatient hospice facility
Q5007Hospice care provided in long term care facility
Q5008Hospice care provided in inpatient psychiatric facility
Q5009Hospice or home health care provided in place not otherwise specified (nos)
Q5010Hospice home care provided in a hospice facility
Q5098Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg
Q5099Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg
Q5100Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg
Q5101Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram
Q5102Injection, infliximab, biosimilar, 10 mgterminated
Q5103Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg
Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg
Q5108Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg
Q5109Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mgterminated
Q5110Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram
Q5111Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg
Q5112Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg
Q5113Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg
Q5114Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg
Q5115Injection, rituximab-abbs, biosimilar, (truxima), 10 mg
Q5116Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
Q5117Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg
Q5118Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg
Q5119Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg
Q5120Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg
Q5121Injection, infliximab-axxq, biosimilar, (avsola), 10 mg
Q5122Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg
Q5123Injection, rituximab-arrx, biosimilar, (riabni), 10 mg
Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg
Q5125Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram
Q5126Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg
Q5127Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg
Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg
Q5129Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg
Q5130Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg
Q5131Injection, adalimumab-aacf (idacio), biosimilar, 20 mgterminated
Q5132Injection, adalimumab-afzb (abrilada), biosimilar, 10 mgterminated
Q5133Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg
Q5134Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg
Q5135Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg
Q5136Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg
Q5137Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg
Q5138Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg
Q5139Injection, eculizumab-aeeb (bkemv), biosimilar, 10 mgterminated
Q5140Injection, adalimumab-fkjp, biosimilar, 1 mg
Q5141Injection, adalimumab-aaty, biosimilar, 1 mg
Q5142Injection, adalimumab-ryvk biosimilar, 1 mg
Q5143Injection, adalimumab-adbm, biosimilar, 1 mg
Q5144Injection, adalimumab-aacf (idacio), biosimilar, 1 mg
Q5145Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg
Q5146Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg
Q5147Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg
Q5148Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram
Q5149Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg
Q5150Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg
Q5151Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg
Q5152Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg
Q5153Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg
Q5154Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg
Q5155Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg
Q5156Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg
Q5157Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg
Q5158Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg
Q5159Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg
Q5160Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg
Q5161Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg
Q5162Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg
Q5164Injection, ustekinumab-hmny (starjemza), biosimilar, 1 mg
Q5165Injection, denosumab-mobz (oziltus), biosimilar, 1 mg
Q5166Injection, denosumab-desu (osvyrti/jubereq), biosimilar, 1 mg
Q5167Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mg
Q5168Injection, ranibizumab-leyk (nufymco), biosimilar, 0.1 mg
Q5169Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg
Q5170Injection, aflibercept-boav (eydenzelt), biosimilar, 1 mg
Q5171Injection, denosumab-mobz (boncresa), biosimilar, 1 mg
Q9001Assessment by chaplain services
Q9002Counseling, individual, by chaplain services
Q9003Counseling, group, by chaplain services
Q9004Department of veterans affairs whole health partner services
Q9950Injection, sulfur hexafluoride lipid microspheres, per ml
Q9951Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
Q9953Injection, iron-based magnetic resonance contrast agent, per ml
Q9954Oral magnetic resonance contrast agent, per 100 ml
Q9955Injection, perflexane lipid microspheres, per ml
Q9956Injection, octafluoropropane microspheres, per ml
Q9957Injection, perflutren lipid microspheres, per ml
Q9958High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml
Q9959High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml
Q9960High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml
Q9961High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml
Q9962High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml
Q9963High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
Q9964High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
Q9965Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
Q9966Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml
Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
Q9968Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg
Q9969Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study doseterminated
Q9970Injection, ferric carboxymaltose, 1mgterminated
Q9972Injection, epoetin beta, 1 microgram, (for esrd on dialysis)terminated
Q9973Injection, epoetin beta, 1 microgram, (non-esrd use)terminated
Q9974Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mgterminated
Q9975Injection, factor viii fc fusion protein (recombinant), per iuterminated
Q9976Injection, ferric pyrophosphate citrate solution, 0.1 mg of ironterminated
Q9977Compounded drug, not otherwise classifiedterminated
Q9978Netupitant 300 mg and palonosetron 0.5 mgterminated
Q9979Injection, alemtuzumab, 1 mgterminated
Q9980Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mgterminated
Q9981Rolapitant, oral, 1 mgterminated
Q9982Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries
Q9983Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries
Q9984Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mgterminated
Q9985Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mgterminated
Q9986Injection, hydroxyprogesterone caproate, (makena), 10 mgterminated
Q9987Pathogen(s) test for plateletsterminated
Q9988Platelets, pheresis, pathogen-reduced, each unitterminated
Q9989Ustekinumab, for intravenous injection, 1 mgterminated
Q9991Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
Q9992Injection, buprenorphine extended-release (sublocade), greater than 100 mg
Q9993Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mgterminated
Q9994In-line cartridge containing digestive enzyme(s) for enteral feeding, eachterminated
Q9995Injection, emicizumab-kxwh, 0.5 mgterminated
Q9996Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg
Q9997Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg
Q9998Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg
Q9999Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg