HCPCS		Short Description	Major Category
70450		CT HEAD/BRAIN W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70460		CT HEAD/BRAIN W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70470		CT HEAD/BRAIN W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70480		CT ORBIT/EAR/FOSSA W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70481		CT ORBIT/EAR/FOSSA W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70482		CT ORBIT/EAR/FOSSA W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70486		CT MAXILLOFACIAL W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70487		CT MAXILLOFACIAL W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70488		CT MAXILLOFACIAL W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70490		CT SOFT TISSUE NECK W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70491		CT SOFT TISSUE NECK W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70492		CT SFT TSUE NCK W/O & W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70496		"CT ANGIOGRAPHY, HEAD "	Major Category I. A. - Computerized Axial Tomography (CT) Scans
70498		"CT ANGIOGRAPHY, NECK "	Major Category I. A. - Computerized Axial Tomography (CT) Scans
71250		CT THORAX W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
71260		CT THORAX W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
71270		CT THORAX W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
71275		"CT ANGIOGRAPHY, CHEST"	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72125		CT NECK SPINE W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72126		CT NECK SPINE W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72127		CT NECK SPINE W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72128		CT CHEST SPINE W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72129		CT CHEST SPINE W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72130		CT CHEST SPINE W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72131		CT LUMBAR SPINE W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72132		CT LUMBAR SPINE W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72133		CT LUMBAR SPINE W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72191		CT ANGIOGRAPH PELV W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72192		CT PELVIS W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72193		CT PELVIS W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
72194		CT PELVIS W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73200		CT UPPER EXTREMITY W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73201		CT UPPER EXTREMITY W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73202		CT UPPR EXTREMITY W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73206		CT ANGIO UPR EXTRM W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73700		CT LOWER EXTREMITY W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73701		CT LOWER EXTREMITY W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73702		CT LWR EXTREMITY W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
73706		CT ANGIO LWR EXTR W/O&W DYE 	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74150		CT ABDOMEN W/O DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74160		CT ABDOMEN W/DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74170		CT ABDOMEN W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74174		CT ANGIO ABD&PELV W/O&W/ DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74175		CT ANGIO ABDOM W/O&W DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74176		CT ABD & PELVIS W/O CONTRAST	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74177		CT ABDOMEN&PELVIS W/CONTRAST	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74178		CT ABD&PELV 1+ SECTION/REGNS	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74261		CT COLONOGRAPYHY DX 	Major Category I. A. - Computerized Axial Tomography (CT) Scans
74262		CT COLONOGRAPYHY DX W/ DYE	Major Category I. A. - Computerized Axial Tomography (CT) Scans
75635		CT ANGIO ABDOMINAL ARTERIES	Major Category I. A. - Computerized Axial Tomography (CT) Scans
76380		CAT SCAN FOLLOW-UP STUDY	Major Category I. A. - Computerized Axial Tomography (CT) Scans
76497		"UNLISTED COMPUTED TOMOGRAPHY PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)"	Major Category I. A. - Computerized Axial Tomography (CT) Scans
77011		CT STEREOSTATIC LOCALIZATION	Major Category I. A. - Computerized Axial Tomography (CT) Scans
77012		"CT, NEEDLE PLACEMENT"	Major Category I. A. - Computerized Axial Tomography (CT) Scans
77013		"CT, PARENCHYMAL TISS ABLATION"	Major Category I. A. - Computerized Axial Tomography (CT) Scans
77078		"CT BONE MINERAL DENSITY, AXIAL SKELETON"	Major Category I. A. - Computerized Axial Tomography (CT) Scans
77079		"CT BONE MINERAL DENSITY, APPEND SKELETON"	Major Category I. A. - Computerized Axial Tomography (CT) Scans
C9741		IMPL PRESSURE SENSOR W/ANGIO	"Major Category I. B. -
 Cardiac Catheterization"
33967		INSERT IA PERCUT DEVICE	"Major Category I. B. -
 Cardiac Catheterization"
33968		REMOVE AORTIC ASSIST DEVICE	"Major Category I. B. -
 Cardiac Catheterization"
93451		RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT	"Major Category I. B. -
 Cardiac Catheterization"
93452		L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93453		R & L HRT CATH W/NJX L VENTRICULOG IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93454		CATH PLMT & NJX CORONARY ART ANGIO IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93455		CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93456		CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93457		CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93458		CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93459		CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93460		R & L HRT CATH WINJX HRT ART& L VENTR IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93461		R&L HRT CATH W/INJEC HRT ART/GRFT&L VENT IMG S&I	"Major Category I. B. -
 Cardiac Catheterization"
93462		LEFT HEART CATH BY TRANSEPTAL PUNCTURE	"Major Category I. B. -
 Cardiac Catheterization"
93463		MEDICATION ADMIN & HEMODYNAMIC MEASURMENT	"Major Category I. B. -
 Cardiac Catheterization"
93464		PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASURE	"Major Category I. B. -
 Cardiac Catheterization"
93503		INSERT/PLACE HEART CATHETER	"Major Category I. B. -
 Cardiac Catheterization"
93505		ENDOMYOCARDIAL BIOPSY	"Major Category I. B. -
 Cardiac Catheterization"
93530		RT. HEART CATH.	"Major Category I. B. -
 Cardiac Catheterization"
93531		COMBINED RT. HEART CATH.	"Major Category I. B. -
 Cardiac Catheterization"
93532		COMBINED RT. HEART CATH.	"Major Category I. B. -
 Cardiac Catheterization"
93533		COMBINED RT. HEART CATH.	"Major Category I. B. -
 Cardiac Catheterization"
93555		"IMAGING, CARDIAC CATH"	"Major Category I. B. -
 Cardiac Catheterization"
93556		"IMAGING, CARDIAC CATH"	"Major Category I. B. -
 Cardiac Catheterization"
93561		CARDIAC OUTPUT MEASUREMENT	"Major Category I. B. -
 Cardiac Catheterization"
93562		CARDIAC OUTPUT MEASUREMENT	"Major Category I. B. -
 Cardiac Catheterization"
93563		NJX SEL HRT ART CONGENITAL HRT CATH W/S&I	"Major Category I. B. -
 Cardiac Catheterization"
93564		NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I	"Major Category I. B. -
 Cardiac Catheterization"
93565		NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I	"Major Category I. B. -
 Cardiac Catheterization"
93566		NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I	"Major Category I. B. -
 Cardiac Catheterization"
93567		NJX SUPRAVALV AORTOG HRT CATH W/S&I	"Major Category I. B. -
 Cardiac Catheterization"
93568		NJX PULMONARY ANGIO HRT CATH W/S&I	"Major Category I. B. -
 Cardiac Catheterization"
93571		HEART FLOW RESERVE MEASURE	"Major Category I. B. -
 Cardiac Catheterization"
93572		HEART FLOW RESERVE MEASURE	"Major Category I. B. -
 Cardiac Catheterization"
93600		BUNDLE OF HIS RECORDING	"Major Category I. B. -
 Cardiac Catheterization"
93602		INTRA ATRIAL RECORDING	"Major Category I. B. -
 Cardiac Catheterization"
93603		RIGHT VENTRICULAR RECORDING	"Major Category I. B. -
 Cardiac Catheterization"
93609		MAP TACHYCARDIA ADD ON	"Major Category I. B. -
 Cardiac Catheterization"
93610		INTRA ATRIAL PACING	"Major Category I. B. -
 Cardiac Catheterization"
93612		INTRAVENTRICULAR PACING	"Major Category I. B. -
 Cardiac Catheterization"
93613		ELECTROPHYS MAP 3D ADD	"Major Category I. B. -
 Cardiac Catheterization"
93615		ESOPHAGEAL RECORDING	"Major Category I. B. -
 Cardiac Catheterization"
93616		ESOPHAGEAL RECORDING	"Major Category I. B. -
 Cardiac Catheterization"
93618		HEART RHYTHM PACING	"Major Category I. B. -
 Cardiac Catheterization"
93619		ELECTROPHYSIOLOGY EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93620		ELECTROPHYSIOLOGY EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93621		ELECTROPHYSIOLOGY EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93622		ELECTROPHYSIOLOGY EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93623		STIMULATION PACING HEART	"Major Category I. B. -
 Cardiac Catheterization"
93624		ELECTROPHYSIOLOGIC STUDY	"Major Category I. B. -
 Cardiac Catheterization"
93631		HEART PACING MAPPING	"Major Category I. B. -
 Cardiac Catheterization"
93640		EVALUATION HEART DEVICE	"Major Category I. B. -
 Cardiac Catheterization"
93641		ELECTROPHYSIOLOGY EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93642		ELECTROPHYSIOLOGY EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93644		ELECTROPHYSIOLOGY EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93650		ABLATE HEART DYSRHYTHM FOCUS	"Major Category I. B. -
 Cardiac Catheterization"
93653		EP & ABLATE SUPRAVENT ARRHYT	"Major Category I. B. -
 Cardiac Catheterization"
93654		EP & ABLATE VENTRIC TACHY	"Major Category I. B. -
 Cardiac Catheterization"
93655		ABLATE ARRHYTHMIA ADD ON	"Major Category I. B. -
 Cardiac Catheterization"
93656		TX ATRIAL FIB PULM VEIN ISOL	"Major Category I. B. -
 Cardiac Catheterization"
93657		TX L/R ATRIAL FIB ADDL	"Major Category I. B. -
 Cardiac Catheterization"
93660		TILT TABLE EVALUATION	"Major Category I. B. -
 Cardiac Catheterization"
93662		INTRACARDIAC ECG (ICE)	"Major Category I. B. -
 Cardiac Catheterization"
70336		"MAGNETIC IMAGE, JAW JOINT"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70540		MRI ORBIT/FACE/NECK W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70542		MRI ORBIT/FACE/NECK W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70543		MRI ORBT/FAC/NCK W/O&W DYE 	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70544		MR ANGIOGRAPHY HEAD W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70545		MR ANGIOGRAPHY HEAD W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70546		MR ANGIOGRAPH HEAD W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70547		MR ANGIOGRAPHY NECK W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70548		MR ANGIOGRAPHY NECK W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70549		MR ANGIOGRAPH NECK W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70551		MRI BRAIN W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70552		MRI BRAIN W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70553		MRI BRAIN W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70554		MRI BRAIN FXNAL W/O PHYSICIAN	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70555		MRI BRAIN FXNAL W/ PHYSICIAN	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70557		MRI BRAIN W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70558		MRI BRAIN W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
70559		MRI BRAIN W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
71550		MRI CHEST W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
71551		MRI CHEST W/DYE 	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
71552		MRI CHEST W/O&W DYE 	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
71555		MRI ANGIO CHEST W OR W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72141		MRI NECK SPINE W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72142		MRI NECK SPINE W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72146		MRI CHEST SPINE W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72147		MRI CHEST SPINE W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72148		MRI LUMBAR SPINE W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72149		MRI LUMBAR SPINE W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72156		MRI NECK SPINE W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72157		MRI CHEST SPINE W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72158		MRI LUMBAR SPINE W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72195		MRI PELVIS W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72196		MRI PELVIS W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72197		MRI PELVIS W/O & W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
72198		MR ANGIO PELVIS W/O & W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73218		MRI UPPER EXTREMITY W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73219		MRI UPPER EXTREMITY W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73220		MRI UPPR EXTREMITY W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73221		MRI JOINT UPR EXTREM W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73222		MRI JOINT UPR EXTREM W/ DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73223		MRI JOINT UPR EXTR W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73718		MRI LOWER EXTREMITY W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73719		MRI LOWER EXTREMITY W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73720		MRI LWR EXTREMITY W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73721		MRI JOINT OF LWR EXTRE W/O D	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73722		MRI JOINT OF LWR EXTR W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73723		MRI JOINT LWR EXTR W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
73725		MR ANG LWR EXT W OR W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
74181		MRI ABDOMEN W/O DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
74182		MRI ABDOMEN W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
74183		MRI ABDOMEN W/O&W DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
74185		"MRI ANGIO, ABDOM W OR W/O DY"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75557		CARDIAC MRI FOR MORPH	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75559		CARDIAC MRI W/STRESS IMG	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75561		CARDIAC MRI FOR MORPH W/DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75563		CARD MRI W/STRESS IMG & DYE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75565		CARD MRI  FOR VELOCITC FLOW MAPPING	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75571		CT HRT W/O DYE W/CA TEST	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75572		CT HRT W/3D IMAGE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75573		"CT HRT W/3D IMAGE, CONGEN"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
75574		CT ANGIO HRT W/3D IMAGE	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
76390		MR SPECTROSCOPY	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
76498		"UNLISTED MAGNETIC RESONANCE PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
77021		"MAG RESON GUIDE, NEEDLE"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
77022		"MAG RESON GUIDE, NEEDLE"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
77058		"MRI BREAST, UNI"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
77059		"MRI BREAST, BI"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
77084		"MRI, BONE MARROW"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8900		"MRA W/CONT, ABD"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8901		"MRA W/O CONT, ABD"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8902		"MRA W/O FOL W/CONT, ABD"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8903		"MRI W/CONT, BREAST,  UNI"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8904		"MRI W/O CONT, BREAST, UNI"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8905		"MAGNETIC RESONANCE IMAGING (MRI) WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8906		"MAGNETIC RESONANCE IMAGING (MRI) WITH CONTRAST , BREAST; BILATERAL"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8907		"MAGNETIC RESONANCE IMAGING (MRI) WITHOUT CONTRAST , BREAST; BILATERAL"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8908		"MAGNETIC RESONANCE IMAGING (MRI) WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILATERAL"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8909		"MAGNETIC RESONANCE ANGIOGRAPHY (MRA) WITH CONTRAST, CHEST (EXCLUDING MYOCADIUM)"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8910		"MAGNETIC RESONANCE ANGIOGRAPHY (MRA) WITH CONTRAST, CHEST (EXCLUDING MYOCADIUM)"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8911		"MAGNETIC RESONANCE ANGIOGRAPHY (MRA) WITH CONTRAST, CHEST (EXCLUDING MYOCADIUM)"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8912		"MAGNETIC RESONANCE ANGIOGRAPHY (MRA) WITH CONTRAST, LOWER EXTREMITY"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8913		"MAGNETIC RESONANCE ANGIOGRAPHY (MRA) WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, LOWER EXTREMITY"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8914		"MAGNETIC RESONANCE ANGIOGRAPHY (MRA) WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, LOWER EXTREMITY"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8918		"MRA W/CONT, PELVIS"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8919		"MRA W/O CONT, PELVIS"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8920		"MRA W/O FOL W/CONT, PELVIS"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8931		"MRA, W/DYE, SPINAL CANAL"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8932		"MRA, W/O DYE, SPINAL CANAL "	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8933		"MRA, W/O & W/ DYE, SPINAL CANAL"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8934		"MRA, W/DYE, UPPER EXTREMITY"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
C8935		"MRA, W/0 DYE, UPPER EXTR"	"Major Category I. C. - 
Magnetic Resonance Imaging (MRI)"
19296		PLACE PO BREAST CATH FOR RAD	"Major Category I. D. - 
Radiation Therapy"
19297		PLACE BREAST CATH FOR RAD	"Major Category I. D. - 
Radiation Therapy"
77261		RADIATION THERAPY PLANNING	"Major Category I. D. - 
Radiation Therapy"
77262		RADIATION THERAPY PLANNING	"Major Category I. D. - 
Radiation Therapy"
77263		RADIATION THERAPY PLANNING	"Major Category I. D. - 
Radiation Therapy"
77280		SET RADIATION THERAPY FIELD	"Major Category I. D. - 
Radiation Therapy"
77285		SET RADIATION THERAPY FIELD	"Major Category I. D. - 
Radiation Therapy"
77290		SET RADIATION THERAPY FIELD	"Major Category I. D. - 
Radiation Therapy"
77295		SET RADIATION THERAPY FIELD	"Major Category I. D. - 
Radiation Therapy"
77299		RADIATION THERAPY PLANNING	"Major Category I. D. - 
Radiation Therapy"
77300		RADIATION THERAPY DOSE PLAN	"Major Category I. D. - 
Radiation Therapy"
77301		"RADIOLTHERAPY DOS PLAN, IMRT"	"Major Category I. D. - 
Radiation Therapy"
77305		RADIATION THERAPY DOSE PLAN	"Major Category I. D. - 
Radiation Therapy"
77310		RADIATION THERAPY DOSE PLAN	"Major Category I. D. - 
Radiation Therapy"
77315		RADIATION THERAPY DOSE PLAN	"Major Category I. D. - 
Radiation Therapy"
77321		RADIATION THERAPY PORT PLAN	"Major Category I. D. - 
Radiation Therapy"
77326		RADIATION THERAPY DOSE PLAN	"Major Category I. D. - 
Radiation Therapy"
77327		RADIATION THERAPY DOSE PLAN	"Major Category I. D. - 
Radiation Therapy"
77328		RADIATION THERAPY DOSE PLAN	"Major Category I. D. - 
Radiation Therapy"
77331		SPECIAL RADIATION DOSIMETRY	"Major Category I. D. - 
Radiation Therapy"
77332		RADIATION TREATMENT AID(S)	"Major Category I. D. - 
Radiation Therapy"
77333		RADIATION TREATMENT AID(S)	"Major Category I. D. - 
Radiation Therapy"
77334		RADIATION TREATMENT AID(S)	"Major Category I. D. - 
Radiation Therapy"
77336		RADIATION PHYSICS CONSULT	"Major Category I. D. - 
Radiation Therapy"
77338		DESIGN MLC DEVICE FOR IMRT	"Major Category I. D. - 
Radiation Therapy"
77370		RADIATION PHYSICS CONSULT	"Major Category I. D. - 
Radiation Therapy"
77371		SRS MULTISOURCE	"Major Category I. D. - 
Radiation Therapy"
77372		SRS LINEAR BASED	"Major Category I. D. - 
Radiation Therapy"
77373		SBRT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77385		NTSTY MODUL RAD TX DLVR SMPL	"Major Category I. D. - 
Radiation Therapy"
77386		NTSTY MODUL RAD TX DLVR CPLX	"Major Category I. D. - 
Radiation Therapy"
77399		EXTERNAL RADIATION DOSIMETRY	"Major Category I. D. - 
Radiation Therapy"
77401		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77402		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77403		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77404		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77406		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77407		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77408		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77409		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77411		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77412		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77413		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77414		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77416		RADIATION TREATMENT DELIVERY	"Major Category I. D. - 
Radiation Therapy"
77417		RADIOLOGY PORT FILM(S)	"Major Category I. D. - 
Radiation Therapy"
77418		"RADIATION TX DELIVERY, IMRT"	"Major Category I. D. - 
Radiation Therapy"
77421		STEREOSCOPIC X-RAY GUIDANCE	"Major Category I. D. - 
Radiation Therapy"
77427		"RADIATION TX MANAGEMENT, X5"	"Major Category I. D. - 
Radiation Therapy"
77431		RADIATION THERAPY MANAGEMENT	"Major Category I. D. - 
Radiation Therapy"
77432		STEREOTACTIC RADIATION TRMT	"Major Category I. D. - 
Radiation Therapy"
77470		SPECIAL RADIATION TREATMENT	"Major Category I. D. - 
Radiation Therapy"
77499		RADIATION THERAPY MANAGEMENT	"Major Category I. D. - 
Radiation Therapy"
77520		"PROTON TRMT, SIMPLE W/O COMP"	"Major Category I. D. - 
Radiation Therapy"
77522		"PROTON TRMT, SIMPLE W/COMP"	"Major Category I. D. - 
Radiation Therapy"
77523		"PROTON TRMT, INTERMEDIATE"	"Major Category I. D. - 
Radiation Therapy"
77525		"PROTON TREATMENT, COMPLEX"	"Major Category I. D. - 
Radiation Therapy"
77600		HYPERTHERMIA TREATMENT	"Major Category I. D. - 
Radiation Therapy"
77605		HYPERTHERMIA TREATMENT	"Major Category I. D. - 
Radiation Therapy"
77610		HYPERTHERMIA TREATMENT	"Major Category I. D. - 
Radiation Therapy"
77615		HYPERTHERMIA TREATMENT	"Major Category I. D. - 
Radiation Therapy"
77620		HYPERTHERMIA TREATMENT	"Major Category I. D. - 
Radiation Therapy"
77781		HIGH INTENSITY BRACHYTHERAPY	"Major Category I. D. - 
Radiation Therapy"
77782		HIGH INTENSITY BRACHYTHERAPY	"Major Category I. D. - 
Radiation Therapy"
77783		HIGH INTENSITY BRACHYTHERAPY	"Major Category I. D. - 
Radiation Therapy"
77784		HIGH INTENSITY BRACHYTHERAPY	"Major Category I. D. - 
Radiation Therapy"
77789		APPLY SURFACE RADIATION	"Major Category I. D. - 
Radiation Therapy"
77790		RADIATION HANDLING	"Major Category I. D. - 
Radiation Therapy"
77799		RADIUM/RADIOISOTOPE THERAPY	"Major Category I. D. - 
Radiation Therapy"
A4648		IMPLANTABLE TISSUE MARKER	"Major Category I. D. - 
Radiation Therapy"
A4650		IMPLANT RADIATION DOSIMETER	"Major Category I. D. - 
Radiation Therapy"
A9527		IODINE I-125 SODIUM IODIDE	"Major Category I. D. - 
Radiation Therapy"
C1715		BRACHYTHERAPY NEEDLE	"Major Category I. D. - 
Radiation Therapy"
C1716		BRACHYTHERAPY NEEDLE	"Major Category I. D. - 
Radiation Therapy"
C1717		"BRACHYTX SEED, HDR IR-192 "	"Major Category I. D. - 
Radiation Therapy"
C1719		"BRACHYTHERAPY SEED, HIGH DOSE RATE IRIDIUM 192"	"Major Category I. D. - 
Radiation Therapy"
C1728 		"CATH, BRACHYTX SEED ADM "	"Major Category I. D. - 
Radiation Therapy"
C2616		"SEALANT, PULMONARY, LIQUID"	"Major Category I. D. - 
Radiation Therapy"
C2634		"BRACHYTX SOURCE, HA, I-125"	"Major Category I. D. - 
Radiation Therapy"
C2635		"BRACHYTX SOURCE, HA, P-103"	"Major Category I. D. - 
Radiation Therapy"
C2636		"BRACHYTX LINEAR SOURCE, P-103"	"Major Category I. D. - 
Radiation Therapy"
C2637		"BRACHYTX, YTTERBIUM-169"	"Major Category I. D. - 
Radiation Therapy"
C2639		"BRACHYTX, NON-STRANDED,I-125"	"Major Category I. D. - 
Radiation Therapy"
C2641		"BRACHYTX, NON-STRANDED,P-103"	"Major Category I. D. - 
Radiation Therapy"
C2643		"BRACHYTX, NON-STRANDED,C-131"	"Major Category I. D. - 
Radiation Therapy"
C9725		PLACE ENDORECTAL APP	"Major Category I. D. - 
Radiation Therapy"
G0173		LINEAR ACC STEREO RADSUR COM	"Major Category I. D. - 
Radiation Therapy"
G0251		LINEAR ACCELERATOR BASED STEREOTACTIC RADIOSURGERY	"Major Category I. D. - 
Radiation Therapy"
G0339		"ROBOT LIN-RADSURG COM, FIRST"	"Major Category I. D. - 
Radiation Therapy"
G0340		ROBOT LINEAR STERORADIO MAX5	"Major Category I. D. - 
Radiation Therapy"
36598		"CONTRAST INJECTION, RADIOLOGIC EVAL OF EXISTING CENT VENOUS ACCESS DEVICE"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75600		CONTRAST X-RAY EXAM OF AORTA	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75605		CONTRAST X-RAY EXAM OF AORTA	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75625		CONTRAST X-RAY EXAM OF AORTA	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75630		"X-RAY AORTA, LEG ARTERIES"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75635		CT ANGIO ABDOMINAL ARTERIES	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75650		"ARTERY X-RAYS, HEAD & NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75658		"ARTERY X-RAYS, ARM"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75660		"ARTERY X-RAYS, HEAD & NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75662		"ARTERY X-RAYS, HEAD & NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75665		"ARTERY X-RAYS, HEAD & NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75671		"ARTERY X-RAYS, HEAD & NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75676		"ARTERY X-RAYS, NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75680		"ARTERY X-RAYS, NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75685		"ARTERY X-RAYS, SPINE"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75705		"ARTERY X-RAYS, SPINE"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75710		"ARTERY X-RAYS, ARM/LEG"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75716		"ARTERY X-RAYS, ARMS/LEGS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75722		"ARTERY X-RAYS, KIDNEY"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75724		"ARTERY X-RAYS, KIDNEYS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75726		"ARTERY X-RAYS, ABDOMEN"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75731		"ARTERY X-RAYS, ADRENAL GLAND"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75733		"ARTERY X-RAYS, ADRENALS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75736		"ARTERY X-RAYS, PELVIS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75741		"ARTERY X-RAYS, LUNG"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75743		"ARTERY X-RAYS, LUNGS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75746		"ARTERY X-RAYS, LUNG"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75756		"ARTERY X-RAYS, CHEST"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75774		"ARTERY X-RAY, EACH VESSEL"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75791		AV DIALYSIS SHUNT IMAGING	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75801		"LYMPH VESSEL X-RAY, ARM/LEG"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75803		"LYMPH VESSEL X-RAY,ARMS/LEGS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75805		"LYMPH VESSEL X-RAY, TRUNK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75807		"LYMPH VESSEL X-RAY, TRUNK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75809		"NONVASCULAR SHUNT, X-RAY"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75810		"VEIN X-RAY, SPLEEN/LIVER"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75820		"VEIN X-RAY, ARM/LEG"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75822		"VEIN X-RAY, ARMS/LEGS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75825		"VEIN X-RAY, TRUNK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75827		"VEIN X-RAY, CHEST"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75831		"VEIN X-RAY, KIDNEY"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75833		"VEIN X-RAY, KIDNEYS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75840		"VEIN X-RAY, ADRENAL GLAND"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75842		"VEIN X-RAY, ADRENAL GLANDS"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75860		"VEIN X-RAY, NECK"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75870		"VEIN X-RAY, SKULL"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75872		"VEIN X-RAY, SKULL"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75880		"VEIN X-RAY, EYE SOCKET"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75885		"VEIN X-RAY, LIVER"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75887		"VEIN X-RAY, LIVER"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75889		"VEIN X-RAY, LIVER"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75891		"VEIN X-RAY, LIVER"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75893		VENOUS SAMPLING BY CATHETER	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75894		"X-RAYS, TRANSCATH THERAPY"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75896		"X-RAYS, TRANSCATH THERAPY XREF 75894"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75898		FOLLOW-UP ANGIOGRAM	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75900		ARTERIAL CATHETER EXCHANGE	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75940		"X-RAY PLACEMENT, VEIN FILTER"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75960		"TRANSCATHETER INTRO, STENT"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75961		"RETRIEVAL, BROKEN CATHETER"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75962		REPAIR ARTERIAL BLOCKAGE	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75964		"REPAIR ARTERY BLOCKAGE, EACH"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75966		REPAIR ARTERIAL BLOCKAGE	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75968		"REPAIR ARTERY BLOCKAGE, EACH"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75970		VASCULAR BIOPSY	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75978		REPAIR VENOUS BLOCKAGE	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75980		CONTRAST XRAY EXAM BILE DUCT	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75982		CONTRAST XRAY EXAM BILE DUCT	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75992		"ATHERECTOMY, X-RAY EXAM"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75993		"ATHERECTOMY, X-RAY EXAM"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75994		"ATHERECTOMY, X-RAY EXAM"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75995		"ATHERECTOMY, X-RAY EXAM"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
75996		"ATHERECTOMY, X-RAY EXAM"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
G0269		PLACEMENT OF OCCLUSIVE DEVICE IN VEIN ART	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
G0275		"RENAL ARTERY ANGIO, CARDIAC CATH"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
G0278		"ILIAC ART ANGIO,CARDIAC CATH"	"Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures"
10040		ACNE SURGERY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
10060		DRAINAGE OF SKIN ABSCESS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
10080		DRAINAGE OF PILONIDAL CYST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
10120		REMOVE FOREIGN BODY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11040		"DEBRIDE SKIN, PARTIAL"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11041		"DEBRIDE SKIN, FULL"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11055		TRIM SKIN LESION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11056		"TRIM SKIN LESIONS, 2 TO 4"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11057		"TRIM SKIN LESIONS, OVER 4"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11100		BIOPSY SKIN LESION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11101		BIOPSY SKIN ADD-ON	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11200		REMOVAL OF SKIN TAGS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11201		REMOVAL OF SKIN TAGS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11300		SHAVE SKIN LESION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11305		SHAVE SKIN LESION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11400		REMOVAL OF SKIN LESION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11420		"EXCISION, BENIGN LESION"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11440		"EXCISION, OTHER BENIGN LESION"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11719		TRIM NAIL(S)	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11720		"DEBRIDE NAIL, 1-5"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11721		"DEBRIDE NAIL, 6 OR MORE"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11740		DRAIN BLOOD FROM UNDER NAIL	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11900		INJECTION INTO SKIN LESIONS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11901		ADDED SKIN LESIONS INJECTION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11920		CORRECT SKIN COLOR DEFECTS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11921		CORRECT SKIN COLOR DEFECTS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11922		CORRECT SKIN COLOR DEFECTS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11950		THERAPY FOR CONTOUR DEFECTS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11951		THERAPY FOR CONTOUR DEFECTS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11952		THERAPY FOR CONTOUR DEFECTS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11954		THERAPY FOR CONTOUR DEFECTS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11975		INSERT CONTRACEPTIVE CAP	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11976		REMOVAL OF CONTRACEPTIVE CAP	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
11977		REMOVAL/REINSERT CONTRA CAP	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15780		ABRASION TREATMENT OF SKIN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15781		ABRASION TREATMENT OF SKIN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15782		ABRASION TREATMENT OF SKIN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15783		ABRASION TREATMENT OF SKIN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15786		"ABRASION, LESION, SINGLE"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15787		"ABRASION, LESIONS, ADD-ON"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15788		"CHEMICAL PEEL, FACE, EPIDERM"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15789		"CHEMICAL PEEL, FACE, DERMAL"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15792		"CHEMICAL PEEL, NONFACIAL"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
15793		"CHEMICAL PEEL, NONFACIAL"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
16000		INITIAL TREATMENT OF BURN(S)	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
16020		TREATMENT OF BURN(S)	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17000		DESTROY BENIGN/PREMAL LESION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17003		"DESTROY LESIONS, 2-14"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17004		"DESTROY LESIONS, 15 OR MORE"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17110		"DESTRUCT LESION, 1-14"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17111		"DESTRUCT LESION, 15 OR MORE"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17250		"CHEMICAL CAUTERY, TISSUE"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17340		CRYOTHERAPY OF SKIN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17360		SKIN PEEL THERAPY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17380		HAIR REMOVAL BY ELECTROLYSIS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
17999		SKIN TISSUE PROCEDURE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20000		INCISION OF ABSCESS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20526		THER INJECTION CARPAL TUNNEL	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20550		"INJECTION(S); TENDON SHEATH, LIGAMENT"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20551		INJECT TENDON ORIGIN/INSERT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20552		INJECT TENDON ORIGIN/INSERT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20553		INJECT TENDON ORIGIN/INSERT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20974		ELECTRICAL BONE STIMULATION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
20979		US BONE STIMULATION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
21084		PREPARE FACE/ORAL PROSTHESIS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
21085		PREPARE FACE/ORAL PROSTHESIS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
21497		INTERDENTAL WIRING	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
26010		DRAINAGE OF FINGER ABSCESS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29058		APPLICATION OF SHOULDER CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29065		APPLICATION OF LONG ARM CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29075		APPLICATION OF FOREARM CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29085		APPLY HAND/WRIST CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29086		APPLY FINGER CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29105		APPLY LONG ARM SPLINT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29125		APPLY FOREARM SPLINT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29126		APPLY FOREARM SPLINT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29130		APPLICATION OF FINGER SPLINT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29131		APPLICATION OF FINGER SPLINT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29200		STRAPPING OF CHEST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29220		STRAPPING OF LOW BACK	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29240		STRAPPING OF SHOULDER	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29260		STRAPPING OF ELBOW OR WRIST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29280		STRAPPING OF HAND OR FINGER	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29345		APPLICATION OF LONG LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29355		APPLICATION OF LONG LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29358		APPLY LONG LEG CAST BRACE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29365		APPLICATION OF LONG LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29405		APPLY SHORT LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29425		APPLY SHORT LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29435		APPLY SHORT LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29440		ADDITION OF WALKER TO CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29445		APPLY RIGID LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29450		APPLICATION OF LEG CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29505		"APPLICATION, LONG LEG SPLINT"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29515		APPLICATION LOWER LEG SPLINT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29520		STRAPPING OF HIP	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29530		STRAPPING OF KNEE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29540		STRAPPING OF ANKLE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29550		STRAPPING OF TOES	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29590		APPLICATION OF FOOT SPLINT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29700		REMOVAL/REVISION OF CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29705		REMOVAL/REVISION OF CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29710		REMOVAL/REVISION OF CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29715		REMOVAL/REVISION OF CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29720		REPAIR OF BODY CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29730		WINDOWING OF CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29740		WEDGING OF CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29750		WEDGING OF CLUBFOOT CAST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
29799		CASTING/STRAPPING PROCEDURE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
30300		REMOVE NASAL FOREIGN BODY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
30901		CONTROL OF NOSEBLEED	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
31720		CLEARANCE OF AIRWAYS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
31725		CLEARANCE OF AIRWAYS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
31730		"INTRO, WINDPIPE WIRE/TUBE"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
32550		INSERT PLEURAL CATH	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
32551		INSERTION OF CHEST TUBE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36000		PLACE NEEDLE IN VEIN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36002		PSEUDOANEURYSM INJECTION TRT	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36140		ESTABLISH ACCESS TO ARTERY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36400		DRAWING BLOOD	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36405		DRAWING BLOOD	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36406		DRAWING BLOOD	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36415		COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36430		BLOOD TRANSFUSION SERVICE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36468		"INJECTION(S), SPIDER VEINS"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36469		"INJECTION(S), SPIDER VEINS"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36470		INJECTION THERAPY OF VEIN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36471		INJECTION THERAPY OF VEINS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36600		WITHDRAWAL OF ARTERIAL BLOOD	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36620		"INSERTION CATHETER, ARTERY"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
36680		"INSERT NEEDLE, BONE CAVITY"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
37195		"THROMBOLYSIS, CEREBRAL, BY INTRAVENOUS INFUSION"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51701		INSERT BLADDER CATHETER	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51702		INSERT TEMP BLADDER CATH	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51703		"INSERT BLADDER CATH, COMPLEX"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51772		URETHRA PRESSURE PROFILE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51784		ANAL/URINARY MUSCLE STUDY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51785		ANAL/URINARY MUSCLE STUDY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51792		URINARY REFLEX STUDY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51795		URINE VOIDING PRESSURE STUDY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51797		INTRAABDOMINAL PRESSURE TEST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
51798		MEASUREMENT OF POST-VOIDING RESIDUAL URINE AND/OR BLADDER CAPACITY BY U/S	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
53601		DILATE URETHRA STRICTURE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
53660		DILATION OF URETHRA	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
53661		DILATION OF URETHRA	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
54150		CIRCUMCISION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
54235		PENILE INJECTION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
54240		PENIS STUDY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
54250		PENIS STUDY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
55870		ELECTROEJACULATION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
57160		INSERT PESSARY/OTHER DEVICE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
57170		FITTING OF DIAPHRAGM/CAP	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
58301		REMOVE INTRAUTERINE DEVICE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
58321		ARTIFICIAL INSEMINATION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
58323		SPERM WASHING	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
59020		FETAL CONTRACT STRESS TEST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
59025		FETAL NON-STRESS TEST	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
59425		ANTEPARTUM CARE ONLY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
59426		ANTEPARTUM CARE ONLY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
59430		CARE AFTER DELIVERY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
62367		ANALYZE SPINE INFUSION PUMP	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
62368		ANALYZE SPINE INFUSION PUMP	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
65205		REMOVE FOREIGN BODY FROM EYE	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
69000		DRAIN EXTERNAL EAR LESION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
69200		CLEAR OUTER EAR CANAL	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
69210		REMOVE IMPACTED EAR WAX	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
91123		PULSED IRRIGATION OF FECAL IMPACTION	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
95970		"ANALYZE NEUROSTIM, NO PROG"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
95971		"ANALYZE NEUROSTIM, SIMPLE"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
95972		"ANALYZE NEUROSTIM, COMPLEX"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
95973		"ANALYZE NEUROSTIM, COMPLEX"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
95974		"CRANIAL NEUROSTIM, COMPLEX"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
95975		"CRANIAL NEUROSTIM, COMPLEX"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
95990		"CRANIAL NEUROSTIM, COMPLEX"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
99183		HYPERBARIC OXYGEN THERAPY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
G0127		TRIMMING DYSTROPHIC NAILS	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
G0168		WOUND CLOSURE UTILIZING TISSUE ADHESIVE(S) ONLY	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
G0268		REMOVAL OF IMPACTED CERUMEN	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
G0293		"NON-COVERED SURGICAL PROCEDURE, CLINICAL 
TRAIL"	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
G0294		NON-COVERED PROCEDURE NO ANESTHESIA	"Major Category I. F. - 
Outpatient Surgery and Related Procedures--INCLUSION"
A0425		"GROUND MILEAGE, PER STATUTE MILE"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0426		"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NON-EMERGENCY TRANSPORT, LEVEL 1 (ALS 1)"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0427		"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1(ALS1-EMERGENCY)"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0428		"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NON-EMERGENCY TRANSPORT, (BLS)"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0429		"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS-EMERGENCY)"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0430		"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (FIXED WING)"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0431		"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING)"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0432		"PARAMEDIC INTERCEPT (PI), RURAL AREA, TRANSPORT FURNISHED BY A VOLUNTEER AMBULANCE COMPANY WHICH IS PROHIBITED BY STATE LAW FROM BILLING THIRD PARTY PAYERS"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0433		"ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0434		SPECIALTY CARE TRANSPORT (SCT)	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0435		"FIXED WING AIR MILEAGE, PER STATUTE MILE"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0436		"ROTARY WING AIR MILEAGE, PER STATUTE MILE"	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
A0999		UNLISTED AMBULANCE SERVICE	"Major Category I. H. - 
Ambulance Trips--With Application to Major Category II"
92928		PRQ CARD STENT W/ANGIO 1 VSL	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92929		PRQ CARD STENT W/ANGIO ADDL	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92933		PRQ CARD STENT/ATH/ANGIO	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92934		PRQ CARD STENT/ATH/ANGIO	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92937		PRQ REVASC BYP GRAFT 1 VSL	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92938		PRQ REVASC BYP GRAFT ADDL	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92941		PRQ CARD REVASC MI 1 VSL	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92943		PRQ CARD REVASC CHRONIC 1VSL	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92944		PRQ CARD REVASC CHRONIC ADDL	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
92977		"THROMBOLYSIS, CORONARY; BY INTRAVENOUS INFUSION"	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9600		PERC DRUG-EL COR STENT SING	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9601		PERC DRUG-EL COR STENT BRAN	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9602		PERC D-E COR STENT ATHER S	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9603		PERC D-E COR STENT ATHER BR	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9604		PERC D-E COR REVASC T CABG S	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9605		PERC D-E COR REVASC T CABG B	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9606		PERC D-E COR REVASC W AMI S	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9607		PERC D-E COR REVASC CHRO SIN	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
C9608		PERC D-E COR REVASC CHRO ADD	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
G0259		INJECT FOR SACROILIAC JOINT	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
G0260		INJ FOR SACROILIAC JT ANESTH	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
G0364		BONE MARROW ASPIRATE &BIOPSY	"Major Category I. I. - 
Additional HCPCS EXCLUSIONS"
A4651		"CALIBRATED MICROCAPILLARY TUBE, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4652		MICROCAPILLARY TUBE SEALANT	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4653		PD CATHETER ANCHIOR BELT	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4657		"SYRINGE, WITH OR WITHOUT NEEDLE, FOR DIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4660		"SPHYGMOMANOMETER/BLOOD PRESSURE APPARATUS WITH CUFF AND STETHOSCOPE, FOR DIALYSIS"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4663		"BLOOD PRESSURE CUFF ONLY, FOR DIALYSIS"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4671		DISPOSABLE CYCLER SET	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4672		"DRAINAGE EXT LINE, DIALYSIS"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4673		EXT LINE W EASY LOCK CONNECT	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4674		"CHEM/ANTISEPT SOLUTION, 8OZ"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4680		"ACTIVATED CARBON FILTER FOR HEMODIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4690		"DIALYZER (ARTIFICIAL KIDNEYS), ALL TYPES, ALL SIZES, FOR HEMODIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4706		"BICARBONATE CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4707		"BICARBONATE CONCENTRATE, POWDER, FOR HEMODIALYSIS, PER PACKET"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4708		"ACETATE CONCENTRATE SOLUTION, FOR HEMODIALYSIS, PER GALLON"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4709		"ACID CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4714		"TREATED WATER (DEIONIZED, DISTILLED, OR REVERSE OSMOSIS) FOR PERITONEAL DIALYSIS, PER GALLON"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4719		"""Y SET"" TUBING FOR PERITONEAL DIALYSIS"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4720		DIALYSAT SOL FLD VOL > 249CC	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4721		DIALYSAT SOL FLD VOL > 999CC	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4722		DIALYS SOL FLD VOL > 1999CC	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4723		DIALYS SOL FLD VOL > 2999CC	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4724		DIALYS SOL FLD VOL > 3999CC	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4725		DIALYS SOL FLD VOL > 4999CC	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4726		DIALYS SOL FLD VOL > 5999CC	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4728		"DIALYSATE SOLUTION, NON-DEX"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4730		"FISTULA CANNULATION SET FOR HEMODIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4736		"TOPICAL ANESTHETIC, FOR DIALYSIS, PER GRAM"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4737		"INJECTABLE ANESTHETIC, FOR DIALYSIS, PER 10 ML"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4740		"SHUNT ACCESSORY, FOR HEMODIALYSIS, ANY TYPE, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4750		"BLOOD TUBING, ARTERIAL AND VENOUS, FOR HEMODIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4755		"BLOOD TUBING, ARTERIAL AND VENOUS COMBINED, FOR HEMODIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4760		"DIALYSATE SOLUTION TEST KIT, FOR PERITONEAL DIALYSIS, ANY TYPE, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4765		"DIALYSATE CONCENTRATE, POWDER, ADDITIVE FOR PERITONEAL DIALYSIS, PER PACKET"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4766		"DIALYSATE CONCENTRATE, SOLUTION, ADDITIVE FOR PERITONEAL DIALYSIS, PER 10 ML"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4770		"BLOOD COLLECTION TUBE, VACUUM, FOR DIALYSIS, PER 50"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4771		"SERUM CLOTTING TIME TUBE, FOR DIALYSIS, PER 50"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4772		"BLOOD GLUCOSE TEST STRIPS, FOR DIALYSIS, PER 50"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4773		"OCCULT BLOOD TEST STRIPS, FOR DIALYSIS, PER 50"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4774		"AMMONIA TEST STRIPS, FOR DIALYSIS, PER 50"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4802		"PROTAMINE SULFATE, FOR HEMODIALYSIS, PER 50 MG"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4860		"DISPOSABLE CATHETER TIPS FOR PERITONEAL DIALYSIS, PER 10"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4870		PLUMBING AND/OR ELECTRICAL WORK FOR HOME HEMODIALYSIS EQUIPMENT	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4890		"CONTRACTS, REPAIR AND MAINTENANCE, FOR HEMODIALYSIS EQUIPMENT"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4911		"PROTAMINE SULFATE, FOR HEMODIALYSIS, PER 50 MG"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4913		"MISCELLANEOUS DIALYSIS SUPPLIES, NOT OTHERWISE SPECIFIED"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4918		"VENOUS PRESSURE CLAMP, FOR HEMODIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4927		"GLOVES, NON-STERILE, FOR DIALYSIS, PER 100"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4928		"SURGICAL MASK, FOR DIALYSIS, PER 20"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4929		"TOURNIQUET FOR DIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4930		"STERILE, GLOVES PER PAIR"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
A4931		REUSABLE ORAL THERMOMETER	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1500		"CENTRIFUGE, FOR DIALYSIS"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1510		"KIDNEY, DIALYSATE DELIVERY SYST. KIDNEY MACHINE, "	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1520		HEPARIN INFUSION PUMP FOR DIALYSIS	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1530		AIR BUBBLE DETECTOR FOR DIALYSIS	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1540		PRESSURE ALARM FOR DIALYSIS	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1550		BATH CONDUCTIVITY METER FOR DIALYSIS	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1560		"BLOOD LEAK DETECTOR FOR DIALYSIS, EACH, REPLACEMENT"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1570		"ADJUSTABLE CHAIR, FOR ESRD PATIENTS"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1575		"TRANSDUCER PROTECTORS/FLUID BARRIERS, ANY SIZE, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1580		UNIPUNCTURE CONTROL SYSTEM FOR DIALYSIS	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1590		HEMODIALYSIS MACHINE	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1592		AUTOMATIC INTERMITTENT PERITIONEAL DIALYSIS SYSTEM	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1594		CYCLER DIALYSIS MACHINE FOR PERITONEAL DIALYSIS	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1600		DELIVERY AND/OR INSTALLATION CHARGES FOR RENAL DIALYSIS EQUIPMENT	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1610		REVERSE OSMOSIS WATER PURIFICATION SYSTEM	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1615		DEIONIZER WATER PURIFICATION SYSTEM	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1620		BLOOD PUMP FOR DIALYSIS	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1625		WATER SOFTENING SYSTEM	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1629		TABLO FOR DIALYSIS SERVICE	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1630		RECIPROCATING PERITONEAL DIALYSIS SYSTEM	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1632		WEARABLE ARTIFICAL KIDNEY	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1635		COMPACT (PORTABLE) TRAVEL HEMODIALYZER SYSTEM	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1636		"SORBENT CARTRIDGES, PER CASE"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1637		"HEMOSTATS, FOR DIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1639		"SCALE, FOR DIALYSIS, EACH"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
E1699		"DIALYSIS EQUIPMENT, UNSPECIFIED, BY REPORT"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
G0491		DIALYSIS ACU KIDNEY NO ESRD	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
J0604		"CINACALCET, ESRD ON DIALYSIS"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
J0606		"INJ, ETELCALCETIDE, 0.1 MG"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
J0879		"DIFELIKEFALIN, ESRD ON DIALY"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
J0882		"INJECTION, DARBEPOETIN ALFA, 1 MCG (FOR ESRD ON DIALYSIS)"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
J0884		ARGATROBAN ESRD DIALYSIS 1MG	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
J0886		"INJECTION, EPOETIN ALFA, 1,000 UNITS (FOR ESRD ON DIALYSIS)"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
J0899		"ARGATROBAN DIALYSIS, AUROMED"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
Q4081		"INJECTION, EPOETIN ALFA, 100 UNITS (FOR ESRD ON
 DIALYSIS)"	"Major Category II. A. - 
Dialysis, EPO, Aranesp, Other  Related Services for ESRD "
C9142		"INJ, ALYMSYS, 10 MG"	Major Category III. A. -Chemotherapy
J0641		"INJECTION,LEVOLEUCORVIN, NOS,0,5MG"	Major Category III. A. -Chemotherapy
J0642		"INJECTION,LEVOLEUCORVIN, KHAPZORY,0,5MG"	Major Category III. A. -Chemotherapy
J0894		DECITABINE INJ	Major Category III. A. -Chemotherapy
J9000		"DOXORUBICIN HCL, 10 MG"	Major Category III. A. -Chemotherapy
J9010		ALEMTUZUMAB INJECTION	Major Category III. A. -Chemotherapy
J9015		"ALDESLEUKIN, PER SINGLE USE VIAL"	Major Category III. A. -Chemotherapy
J9017		"ARSENIC TRIOXIDE, 1MG"	Major Category III. A. -Chemotherapy
J9019		"INJECTION, ASPARAGINASE (ERWINAZE), 1,000 IU"	Major Category III. A. -Chemotherapy
J9020		"ASPARAGINASE, 10,000 UNITS"	Major Category III. A. -Chemotherapy
J9021		"INJ, ASPARA, RYLAZE, 0.1 MG  "	Major Category III. A. -Chemotherapy
J9022		"INJ, ATEZOLIZUMAB, 10 MG"	Major Category III. A. -Chemotherapy
J9023		"INJ, AVELUMAB, 10 MG"	Major Category III. A. -Chemotherapy
J9025		"INJECTION, AZACITIDINE, 1 MG"	Major Category III. A. -Chemotherapy
J9027		"INJECTION, CLOFARABINE, 1 MG"	Major Category III. A. -Chemotherapy
J9030		BCG LIVE INTRAVESICAL INSTILLATION	Major Category III. A. -Chemotherapy
J9032		"INJECTION, BELINOSTAT, 10 MG"	Major Category III. A. -Chemotherapy
J9033		"INJECTION, TREANDA, 1 MG"	Major Category III. A. -Chemotherapy
J9034		"INJECTION, BENDEKA 1 MG"	Major Category III. A. -Chemotherapy
J9035		"BEVACIZUMAB, INJECTION"	Major Category III. A. -Chemotherapy
J9036		" INJECTION, BEDAMUSTINE HYDROCHLORIDE, 1MG"	Major Category III. A. -Chemotherapy
J9039		"INJECTION, BLINATUMOMAB, 1 MCG"	Major Category III. A. -Chemotherapy
J9040		"BLEOMYCIN SULFATE, 15 UNITS"	Major Category III. A. -Chemotherapy
J9041		"INJ., VELCADE 0.1 MG"	Major Category III. A. -Chemotherapy
J9042		"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG"	Major Category III. A. -Chemotherapy
J9043		" INJECTION, CABAZITAXEL, 1MB"	Major Category III. A. -Chemotherapy
J9044		"INJ., BORTEZOMIB, NOS, 0.1 MG"	Major Category III. A. -Chemotherapy
J9045		"CARBOPLATIN, 50 MG"	Major Category III. A. -Chemotherapy
J9047		"INJECTION, CARFILZOMIB, 1MG"	Major Category III. A. -Chemotherapy
J9050		"CARMUSTINE, 100 MG"	Major Category III. A. -Chemotherapy
J9055		CETUXIMAB INJECTION	Major Category III. A. -Chemotherapy
J9057		"INJECTION COPANLISIB, 1 MG"	Major Category III. A. -Chemotherapy
J9060		"CISPLATIN, POWDER OR S0LUTION, PER 10 MG"	Major Category III. A. -Chemotherapy
J9061		"INJ, AMIVANTAMAB-VMJW"	Major Category III. A. -Chemotherapy
J9065		"INJECTION, CLADRIBINE, PER 1 MG"	Major Category III. A. -Chemotherapy
J9070		"CYCLOPHOSPHAMIDE, 100 MG"	Major Category III. A. -Chemotherapy
J9071		INJ CYCLOPHOSPHAMD AUROMEDIC	Major Category III. A. -Chemotherapy
J9098		CYTARABINE LIPSOME	Major Category III. A. -Chemotherapy
J9100		"CYTARABINE, 100 MG"	Major Category III. A. -Chemotherapy
J9118		"INJECTION, CALASPARGASE PEGOL-MKLN, 10 UNITS"	Major Category III. A. -Chemotherapy
J9119		"INJECTION, CEMIPLIMAB-RWLC, 1MG"	Major Category III. A. -Chemotherapy
J9120		"DACTINOMYCIN, 0.5 MG"	Major Category III. A. -Chemotherapy
J9130		"DACARBAZINE, 100 MG"	Major Category III. A. -Chemotherapy
J9144		"DARATUMUMAB, HYALURONIDASE"	Major Category III. A. -Chemotherapy
J9145		"INJECTION, DARATUMUMAB 10 MG"	Major Category III. A. -Chemotherapy
J9150		"DAUNORUBICIN, 10 MG"	Major Category III. A. -Chemotherapy
J9151		"DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG"	Major Category III. A. -Chemotherapy
J9153		"INJECTION DAUNORUBICIN, CYTARABINE"	Major Category III. A. -Chemotherapy
J9160		"DENILEUKIN DIFTITOX, 300 MCG"	Major Category III. A. -Chemotherapy
J9171		"DOCETAXEL, 20 MG"	Major Category III. A. -Chemotherapy
J9173		"INJ., DURVALUMAB, 10 MG"	Major Category III. A. -Chemotherapy
J9175		ELLIOTTS B SOLUTION PER ML	Major Category III. A. -Chemotherapy
J9176		"INJECTION, ELOTUZUMAB, 1 MG"	Major Category III. A. -Chemotherapy
J9177		INJ ENFORT VEDO-EJFV 0.25MG	Major Category III. A. -Chemotherapy
J9178 		"INJ, EPIRUBICIN HCL, 2 MG"	Major Category III. A. -Chemotherapy
J9179		"INJECTION, ERIBULIN MESYLATE, 0.1 MG"	Major Category III. A. -Chemotherapy
J9181		"ETOPOSIDE, 10 MG"	Major Category III. A. -Chemotherapy
J9185		"FLUDARABINE PHOSPHATE, 50 MG"	Major Category III. A. -Chemotherapy
J9200		"FLOXURIDINE, 500 MG"	Major Category III. A. -Chemotherapy
J9201		"GEMCITABINE HCL, 200 MG"	Major Category III. A. -Chemotherapy
J9203		GEMTUZUMAB OZOGAMICIN 0.1 MG	Major Category III. A. -Chemotherapy
J9205		INJ IRINOTECAN LIPOSOME 1 MG	Major Category III. A. -Chemotherapy
J9206		"IRINOTECAN, 20 MG"	Major Category III. A. -Chemotherapy
J9207		"INJECTION, IXABEPILONE, 1 MG "	Major Category III. A. -Chemotherapy
J9208		"IFOSFAMIDE, 1 GM"	Major Category III. A. -Chemotherapy
J9211		"IDARUBICIN HYDROCHLORIDE, 5 MG"	Major Category III. A. -Chemotherapy
J9223		"INJ. LURBINECTEDIN, 0.1 MG"	Major Category III. A. -Chemotherapy
J9225		"HISTRELIN IMPLANT, 50MG"	Major Category III. A. -Chemotherapy
J9227		INJ. ISATUXIMAB-IRFC 10 MG	Major Category III. A. -Chemotherapy
J9228		IPILIMUMAB INJECTION	Major Category III. A. -Chemotherapy
J9229		INJECTION INOTUZUMAB OZOGAM 0.1 MG	Major Category III. A. -Chemotherapy
J9230		"MECHLORETHAMINE HYDROCHLORIDE, (NITROGEN MUSTARD), 10 MG"	Major Category III. A. -Chemotherapy
J9245		"INJECTION, MELPHALAN HYDROCHLORIDE, 50 MG"	Major Category III. A. -Chemotherapy
J9261		"INJECTION, NELARABINE, 50 MG "	Major Category III. A. -Chemotherapy
J9263		OXALIPLATIN	Major Category III. A. -Chemotherapy
J9264		PACLITAXEL PROTEIN BOUND	Major Category III. A. -Chemotherapy
J9247		"INJ, MELPHALAN FLUFENAMI 1MG"	Major Category III. A. -Chemotherapy
J9265		PACLITAXEL INJECTION	Major Category III. A. -Chemotherapy
J9266		"PEGASPARGASE, PER SINGLE DOSE VIAL"	Major Category III. A. -Chemotherapy
J9267		"INJECTION, PACLITAXEL, 1 MG"	Major Category III. A. -Chemotherapy
J9268		"PENTOSTATIN, PER 10 MG"	Major Category III. A. -Chemotherapy
J9269		"INJECTION, TAGRAXOFUSP-ERZS 10MCG"	Major Category III. A. -Chemotherapy
J9270		"PLICAMYCIN, 2.5 MG"	Major Category III. A. -Chemotherapy
J9271		"INJECTION, PEMBROLIZUMAB, 1 MG"	Major Category III. A. -Chemotherapy
J9272		"INJ, DOSTARLIMAB-GXLY, 10 MG"	Major Category III. A. -Chemotherapy
J9273		"INJ TISOTU VEDOTIN-TFTV, 1MG"	Major Category III. A. -Chemotherapy
J9274		"INJ, TEBENTAFUSP-TEBN, 1 MCG"	Major Category III. A. -Chemotherapy
J9280		"MITOMYCIN, 5 MG"	Major Category III. A. -Chemotherapy
J9281		MITOMYCIN INSTILLATION	Major Category III. A. -Chemotherapy
J9285		"INJ, OLARATUMAB, 10 MG"	Major Category III. A. -Chemotherapy
J9293		"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG"	Major Category III. A. -Chemotherapy
J9295		"INJECTION, NECITUMUMAB, 1 MG"	Major Category III. A. -Chemotherapy
J9298		INJ NIVOL RELATLIMAB 3MG/1MG	Major Category III. A. -Chemotherapy
J9299		"INECTION, NIVOLUMAB, 1 MG"	Major Category III. A. -Chemotherapy
J9300		GEMTUZUMAB OZOGAMICIN INJ	Major Category III. A. -Chemotherapy
J9301		"INJECTION, OBINUTUZUMAB, 10 MG"	Major Category III. A. -Chemotherapy
J9302		"OFATUMUMAB INJECTION, 10 MG"	Major Category III. A. -Chemotherapy
J9303		"INJECTION, PANITUMUMAB, 10 MCG"	Major Category III. A. -Chemotherapy
J9304		"INJ. PEMETREXED, 10 MG"	Major Category III. A. -Chemotherapy
J9305		ING. PEMETREXED NOS 10MG 	Major Category III. A. -Chemotherapy
J9306		"INJECTION, PERTUZUMAB, 1MG"	Major Category III. A. -Chemotherapy
J9307		"PRALATREXATE INJECTION, 1 MG"	Major Category III. A. -Chemotherapy
J9308		"INJECTION, RAMUCIRUMAB, 5 MG"	Major Category III. A. -Chemotherapy
J9309		"INJ, POLATUZUMAB VEDOTIN 1MG"	Major Category III. A. -Chemotherapy
J9310		RITUXIMAB INJECTION	Major Category III. A. -Chemotherapy
J9311		"INJECTION  RITUXIMAB, HYALURONIDASE"	Major Category III. A. -Chemotherapy
J9312		"INJECTION RITUXIMAB, 10MG"	Major Category III. A. -Chemotherapy
J9313		"INJECTION LUMOXITI, 0.01 MG"	Major Category III. A. -Chemotherapy
J9316		"PERTUZU, TRASTUZU, 10 MG"	Major Category III. A. -Chemotherapy
J9317		SACITUZUMAB GOVITECAN-HZIY	Major Category III. A. -Chemotherapy
J9318		INJ ROMIDEPSIN NON-LYO 0.1MG	Major Category III. A. -Chemotherapy
J9319		INJ ROMIDEPSIN LYOPHIL 0.1MG	Major Category III. A. -Chemotherapy
J9320		"STREPTOZOCIN, 1 GM"	Major Category III. A. -Chemotherapy
J9325		INJ TALIMOGENE LAHERPAREPVEC	Major Category III. A. -Chemotherapy
J9328		TEMOZOLOMIDE INJECTION	Major Category III. A. -Chemotherapy
J9330		"INJECTION, TEMSIROLIMUS, 1 MG "	Major Category III. A. -Chemotherapy
J9331		INJ SIROLIMUS PROT PART 1 MG	Major Category III. A. -Chemotherapy
J9332		INJ EFGARTIGIMOD 2MG	Major Category III. A. -Chemotherapy
J9340		"THIOTEPA, 15 MG"	Major Category III. A. -Chemotherapy
J9348		"INJ. NAXITAMAB-GQGK, 1 MG"	Major Category III. A. -Chemotherapy
J9349		"INJ., TAFASITAMAB-CXIX"	Major Category III. A. -Chemotherapy
J9351		"TOPOTECAN INJECTION, 0.1 MG"	Major Category III. A. -Chemotherapy
J9352		INJECTION TRABECTEDIN 0.1MG	Major Category III. A. -Chemotherapy
J9353		"INJ. MARGETUXIMAB-CMKB, 5 MG"	Major Category III. A. -Chemotherapy
J9354		"INJ, ADO-TRASTUZUMAB EMT 1MG"	Major Category III. A. -Chemotherapy
J9355		"INJECTION TRASTUZUMAB, EXCLUDES BIOSIMILAR"	Major Category III. A. -Chemotherapy
J9356		"TRASTUZUMAB,, 10 MG AND HYALURONIDASE-OYSK"	Major Category III. A. -Chemotherapy
J9357		"VALRUBICIN, INTRAVESICAL, 200 MG"	Major Category III. A. -Chemotherapy
J9358		INJ FAM-TRASTU DERU-NXKI 1MG	Major Category III. A. -Chemotherapy
J9359		INJ LON TESIRIN-LPYL 0.075MG	Major Category III. A. -Chemotherapy
J9360		"VINBLASTINE SULFATE, 1 MG"	Major Category III. A. -Chemotherapy
J9370		"VINCRISTINE SULFATE, 1 MG"	Major Category III. A. -Chemotherapy
J9371		"INJ, VINCRISTINE SUL LIP 1MG"	Major Category III. A. -Chemotherapy
J9390		VINORELBINE TARTRATE/10 MG	Major Category III. A. -Chemotherapy
J9395		"INJECTION, FULVESTRANT"	Major Category III. A. -Chemotherapy
J9400		"INJ, ZIV-AFLIBERCEPT, 1MG"	Major Category III. A. -Chemotherapy
J9600		PORFIMER SODIUM INJECTION	Major Category III. A. -Chemotherapy
Q2041		AXICABTAGENE CILOLEUCEL CAR+	Major Category III. A. -Chemotherapy
Q2042		TISAGENLECLEUCEL CAR-POS T 	Major Category III. A. -Chemotherapy
Q2050		"DOXORUBICIN INJ, 10MG "	Major Category III. A. -Chemotherapy
Q2056		"CILTACABTAGENE CAR-POS T
"	Major Category III. A. -Chemotherapy
Q5112		"INJECTION, TRASTUZUMAB-DTTB, BIOSIMILAR, (ONTRUZANT), 10MG"	Major Category III. A. -Chemotherapy
Q5113		"INJECTION, TRASTUZUMAB-PKRB, BIOSIMILAR, (HERZUMA), 10MG"	Major Category III. A. -Chemotherapy
Q5114		"INJECTION, TRASTUZUMAB-DKST, BIOSIMILAR, (OGIVRI)10MG"	Major Category III. A. -Chemotherapy
Q5115		"INJECTION, TRASTUZUMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10MG"	Major Category III. A. -Chemotherapy
Q5116		"INJECTION, TRASTUZUMAB-GYYP, BIOSIMILAR, (TRAZIMERA), 10MG"	Major Category III. A. -Chemotherapy
Q5117		"INJECTION, TRASTUZUMAB-ANNA, BIOSIMILAR, (KANJINTI), 10MG"	Major Category III. A. -Chemotherapy
Q5118		"INJECTION, TRASTUZUMAB-BVZR, BIOSIMILAR, (ZIRABEV), 10MG"	Major Category III. A. -Chemotherapy
Q5119		"INJ RUXIENCE, 10 MG"	Major Category III. A. -Chemotherapy
Q5107		INJECTION MVASI 10 MG	Major Category III. A. -Chemotherapy
Q5123		INJECTION RIABNI 10 MG	Major Category III. A. -Chemotherapy
36260		INSERTION OF INFUSION PUMP	Major Category III. B. -Chemotherapy Administration
36261		REVISION OF INFUSION PUMP	Major Category III. B. -Chemotherapy Administration
36262		REMOVAL OF INFUSION PUMP	Major Category III. B. -Chemotherapy Administration
36555		INSERT NON-TUNNEL CV CATH	Major Category III. B. -Chemotherapy Administration
36556		INSERT NON-TUNNEL CV CATH	Major Category III. B. -Chemotherapy Administration
36557		INSERT TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36558		INSERT TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36560		INSERT TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36561		INSERT TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36563		INSERT TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36565		INSERT TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36566		INSERT TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36568		INSERT PICC CATH	Major Category III. B. -Chemotherapy Administration
36569		INSERT PICC CATH	Major Category III. B. -Chemotherapy Administration
36570		INSERT PICVAD CATH	Major Category III. B. -Chemotherapy Administration
36571		INSERT PICVAD CATH	Major Category III. B. -Chemotherapy Administration
36575		REPAIR TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36576		REPAIR TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36578		REPLACE TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36580		REPLACE CVAD CATH	Major Category III. B. -Chemotherapy Administration
36581		REPLACE TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36582		REPLACE TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36583		REPLACE TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36584		REPLACE PICC CATH	Major Category III. B. -Chemotherapy Administration
36585		REPLACE PICVAD CATH	Major Category III. B. -Chemotherapy Administration
36589		DECLOT VASCULAR DEVICE	Major Category III. B. -Chemotherapy Administration
36590		REMOVAL TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36595		MECH REMOV TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36596		MECH REMOV TUNNELED CV CATH	Major Category III. B. -Chemotherapy Administration
36597		REPOSITION VENOUS CATHETER	Major Category III. B. -Chemotherapy Administration
36640		"INSERTION CATHETER, ARTERY"	Major Category III. B. -Chemotherapy Administration
36823		INSERTION OF CANNULA(S)	Major Category III. B. -Chemotherapy Administration
96405		INTRALESIONAL CHEMO ADMIN	Major Category III. B. -Chemotherapy Administration
96406		INTRALESIONAL CHEMO ADMIN	Major Category III. B. -Chemotherapy Administration
96409		"CHEMO ADMIN; IV, PUSH; SINGLE/INITIAL DRUG"	Major Category III. B. -Chemotherapy Administration
96411		"CHEMO ADMIN; IV, PUSH; EACH ADDL DRUG"	Major Category III. B. -Chemotherapy Administration
96413		"CHEMO ADMIN; IV, INFUSION; UP TO 1 HR; SINGLE/INITIAL DRUG"	Major Category III. B. -Chemotherapy Administration
96415		"CHEMO ADMIN; IV, INFUSION; EACH ADDL HR, 1-8 HRS"	Major Category III. B. -Chemotherapy Administration
96416		"CHEMO ADMIN; IV, INFUSION; INITIATION OF PROLONGED CHEMO, REQUIRING PUMP"	Major Category III. B. -Chemotherapy Administration
96417		"CHEMO ADMIN; IV INFUSION; EACH ADDL SEQUENTIAL INFUSION, UP TO 1 HR"	Major Category III. B. -Chemotherapy Administration
96420		"CHEMOTHERAPY, PUSH TECHNIQUE"	Major Category III. B. -Chemotherapy Administration
96422		"CHEMOTHERAPY,INFUSION METHOD"	Major Category III. B. -Chemotherapy Administration
96423		"CHEMO, INFUSE METHOD ADD-ON"	Major Category III. B. -Chemotherapy Administration
96425		"CHEMOTHERAPY,INFUSION METHOD"	Major Category III. B. -Chemotherapy Administration
96440		"CHEMOTHERAPY, INTRACAVITARY"	Major Category III. B. -Chemotherapy Administration
96445		"CHEMOTHERAPY, INTRACAVITARY"	Major Category III. B. -Chemotherapy Administration
96446		CHEMOTX ADMN PRTL CAVITY PORT/CATH	Major Category III. B. -Chemotherapy Administration
96450		CHEMOTHERAPY INTO CNS	Major Category III. B. -Chemotherapy Administration
96521		REFILL/MAINT PORTABLE PUMP	Major Category III. B. -Chemotherapy Administration
96522		REFILL/MAINT PUMP/RESVR SYST	Major Category III. B. -Chemotherapy Administration
96523		IRRIG DRUG DELIVERY DEVICE	Major Category III. B. -Chemotherapy Administration
96542		CHEMOTHERAPY INJECTION	Major Category III. B. -Chemotherapy Administration
Q0083		"CHEMOTHERAPY ADMINISTRATION BY OTHER THAN INFUSION TECHNIQUE ONLY (EG SUBCUTANEOUS, INTRAMUSCULAR, PUSH), PER VISIT"	Major Category III. B. -Chemotherapy Administration
Q0084		"CHEMOTHERAPY ADMINISTRATION BY INFUSION TECHNIQUE ONLY, PER VISIT"	Major Category III. B. -Chemotherapy Administration
Q0085		"CHEMOTHERAPY ADMINISTRATION BY BOTH INFUSION TECHNIQUE AND OTHER TECHIQUE(S) (EG SUBCUTANEOUS, INTRAMUSCULAR, PUSH), PER VISIT"	Major Category III. B. -Chemotherapy Administration
Q2042		TISAGENLECLEUCEL CAR-POS T	Major Category III. B. -Chemotherapy Administration
A9595		"PIFLU F-18, DIA 1 MILLICURIE  "	Major Category III. C. -Radioisotopes and their Administration
A9596		GALLIUM ILLUCCIX 1 MILLICURE 	Major Category III. C. -Radioisotopes and their Administration
A9601		FLORTAUCIPIR INJ 1 MILLICURI 	Major Category III. C. -Radioisotopes and their Administration
A9602		FLUORODOPA F-18 DIAG PER MCI	Major Category III. C. -Radioisotopes and their Administration
A9607		LUTETIUM LU 177 VIPIVOTIDE	Major Category III. C. -Radioisotopes and their Administration
A9800		GALLIUM LOCAMETZ 1 MILLICURI	Major Category III. C. -Radioisotopes and their Administration
77014		"CT, PLACE RADIATION FIELDS"	Major Category III. C. -Radioisotopes and their Administration
77750		INFUSE RADIOACTIVE MATERIALS	Major Category III. C. -Radioisotopes and their Administration
77770		HDR RDNCL NTRSTL/ICAV BRCHTX	Major Category III. C. -Radioisotopes and their Administration
77771		HDR RDNCL NTRSTL/ICAV BRCHTX	Major Category III. C. -Radioisotopes and their Administration
77772		HDR RDNCL NTRSTL/ICAV BRCHTX	Major Category III. C. -Radioisotopes and their Administration
77761		APPLY INTRCAV RADIAT SIMPLE	Major Category III. C. -Radioisotopes and their Administration
77762		APPLY INTRCAV RADIAT INTERM	Major Category III. C. -Radioisotopes and their Administration
77763		APPLY INTRCAV RADIAT COMPL	Major Category III. C. -Radioisotopes and their Administration
77776		APPLY INTERSTIT RADIAT SIMPL	Major Category III. C. -Radioisotopes and their Administration
77777		APPLY INTERSTIT RADIAT INTER	Major Category III. C. -Radioisotopes and their Administration
77778		APPLY ITERSTIT RADIAT COMPL	Major Category III. C. -Radioisotopes and their Administration
77789		APPLY SURFACE RADIATION	Major Category III. C. -Radioisotopes and their Administration
77790		RADIATION HANDLING	Major Category III. C. -Radioisotopes and their Administration
77799		RADIUM/RADIOISOTOPE THERAPY	Major Category III. C. -Radioisotopes and their Administration
78804		TUMOR IMAGING (3D)	Major Category III. C. -Radioisotopes and their Administration
79005		NUCLEAR RX ORAL ADMIN	Major Category III. C. -Radioisotopes and their Administration
79101		NUCLEAR RX IV ADMIN	Major Category III. C. -Radioisotopes and their Administration
79200		INTRACAVITARY NUCLEAR TRMT	Major Category III. C. -Radioisotopes and their Administration
79300		INTERSTITIAL NUCLEAR THERAPY	Major Category III. C. -Radioisotopes and their Administration
79403		NONHEMATO NUCLEAR THERAPY	Major Category III. C. -Radioisotopes and their Administration
79440		NUCLEAR JOINT THERAPY	Major Category III. C. -Radioisotopes and their Administration
79445		NUCLEAR RX INTRA-ARTERIAL	Major Category III. C. -Radioisotopes and their Administration
A9530		TH I131 SO IODIDE SOL MILLIC	Major Category III. C. -Radioisotopes and their Administration
A9542		"IN111 IBRITUMOMAB, DX"	Major Category III. C. -Radioisotopes and their Administration
A9543		"Y90 IBRITUMOMAB, RX"	Major Category III. C. -Radioisotopes and their Administration
A9591		FLUOROESTRADIOL F 18	Major Category III. C. -Radioisotopes and their Administration
A9606		RADIUM RA223 DICHLORIDE THER	Major Category III. C. -Radioisotopes and their Administration
G3001		ADMINI +SUPPLY  TOSITUMOMAB 	Major Category III. C. -Radioisotopes and their Administration
L5050		"ANKLE, SYMES, MOLDED SOCKET, SACH FOOT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5060		"ANKLE, SYMES, METAL FRAME, MOLDED LEATHER SOCKET, ARTICULATED ANKLE/FOOT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5100		"BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5105		PLAST SOCKET JTS/THGH LACER	"Major Category III. D. - 
Customized Prosthetic Devices"
L5150		MOLD SCKT EXT KNEE SHIN SACH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5160		MOLD SOCKET BENT KNEE SHIN S	"Major Category III. D. - 
Customized Prosthetic Devices"
L5200		KNE SING AXIS FRIC SHIN SACH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5210		NO KNEE/ANKLE JOINTS W/ FT B	"Major Category III. D. - 
Customized Prosthetic Devices"
L5220		NO KNEE JOINT WITH ARTIC ALI	"Major Category III. D. - 
Customized Prosthetic Devices"
L5230		FEM FOCAL DEFIC CONSTANT FRI	"Major Category III. D. - 
Customized Prosthetic Devices"
L5250		HIP CANAD SING AXI CONS FRIC	"Major Category III. D. - 
Customized Prosthetic Devices"
L5270		TILT TABLE LOCKING HIP SING	"Major Category III. D. - 
Customized Prosthetic Devices"
L5280		HEMIPELVECT CANAD SING AXIS	"Major Category III. D. - 
Customized Prosthetic Devices"
L5301		BK MOLD SOCKET SACH FT ENDO	"Major Category III. D. - 
Customized Prosthetic Devices"
L5311		"KNEE DISARTICULATION (OR THROUGH KNEE), MOLDED SOCKET, EXTERNAL KNEE JOINTS, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5312		"KNEE DISART, SACH FT, ENDO"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5321		AK OPEN END SACH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5331		HIP DISART CANADIAN SACH FT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5341		HEMIPELVECTOMY CANADIAN SACH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5500		INIT BK PTB PLASTER DIRECT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5505		INIT AK ISCHAL PLSTR DIRECT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5510		PREP BK PTB PLASTER MOLDED	"Major Category III. D. - 
Customized Prosthetic Devices"
L5520		PERP BK PTB THERMOPLS DIRECT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5530		PREP BK PTB THERMOPLS MOLDED	"Major Category III. D. - 
Customized Prosthetic Devices"
L5535		PREP BK PTB OPEN END SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5540		PREP BK PTB LAMINATED SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5560		PREP AK ISCHIAL PLAST MOLDED	"Major Category III. D. - 
Customized Prosthetic Devices"
L5570		PREP AK ISCHIAL DIRECT FORM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5580		PREP AK ISCHIAL THERMO MOLD	"Major Category III. D. - 
Customized Prosthetic Devices"
L5585		PREP AK ISCHIAL OPEN END	"Major Category III. D. - 
Customized Prosthetic Devices"
L5590		PREP AK ISCHIAL LAMINATED	"Major Category III. D. - 
Customized Prosthetic Devices"
L5595		HIP DISARTIC SACH THERMOPLS	"Major Category III. D. - 
Customized Prosthetic Devices"
L5600		HIP DISART SACH LAMINAT MOLD	"Major Category III. D. - 
Customized Prosthetic Devices"
L5610		ABOVE KNEE HYDRACADENCE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5611		AK 4 BAR LINK W/FRIC SWING	"Major Category III. D. - 
Customized Prosthetic Devices"
L5613		AK 4 BAR LING W/HYDRAUL SWIG	"Major Category III. D. - 
Customized Prosthetic Devices"
L5614		4-BAR LINK ABOVE KNEE W/SWNG	"Major Category III. D. - 
Customized Prosthetic Devices"
L5616		AK UNIV MULTIPLEX SYS FRICT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5617		AK/BK SELF-ALIGNING UNIT EA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5618		TEST SOCKET SYMES	"Major Category III. D. - 
Customized Prosthetic Devices"
L5620		TEST SOCKET BELOW KNEE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5622		TEST SOCKET KNEE DISARTICULA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5624		TEST SOCKET ABOVE KNEE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5626		TEST SOCKET HIP DISARTICULAT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5628		TEST SOCKET HEMIPELVECTOMY	"Major Category III. D. - 
Customized Prosthetic Devices"
L5629		BELOW KNEE ACRYLIC SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5630		SYME TYP EXPANDABL WALL SCKT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5631		AK/KNEE DISARTIC ACRYLIC SOC	"Major Category III. D. - 
Customized Prosthetic Devices"
L5632		SYMES TYPE PTB BRIM DESIGN S	"Major Category III. D. - 
Customized Prosthetic Devices"
L5634		SYMES TYPE POSTER OPENING SO	"Major Category III. D. - 
Customized Prosthetic Devices"
L5636		SYMES TYPE MEDIAL OPENING SO	"Major Category III. D. - 
Customized Prosthetic Devices"
L5637		BELOW KNEE TOTAL CONTACT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5638		BELOW KNEE LEATHER SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5639		BELOW KNEE WOOD SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5640		KNEE DISARTICULAT LEATHER SO	"Major Category III. D. - 
Customized Prosthetic Devices"
L5642		ABOVE KNEE LEATHER SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5643		HIP FLEX INNER SOCKET EXT FR	"Major Category III. D. - 
Customized Prosthetic Devices"
L5644		ABOVE KNEE WOOD SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5645		BK FLEX INNER SOCKET EXT FRA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5646		BELOW KNEE CUSHION SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5647		BELOW KNEE SUCTION SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5648		ABOVE KNEE CUSHION SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L5649		ISCH CONTAINMT/NARROW M-L SO	"Major Category III. D. - 
Customized Prosthetic Devices"
L5650		TOT CONTACT AK/KNEE DISART S	"Major Category III. D. - 
Customized Prosthetic Devices"
L5651		AK FLEX INNER SOCKET EXT FRA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5652		SUCTION SUSP AK/KNEE DISART	"Major Category III. D. - 
Customized Prosthetic Devices"
L5653		KNEE DISART EXPAND WALL SOCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L5654		SOCKET INSERT SYMES	"Major Category III. D. - 
Customized Prosthetic Devices"
L5655		SOCKET INSERT BELOW KNEE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5656		SOCKET INSERT KNEE ARTICULAT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5658		SOCKET INSERT ABOVE KNEE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5661		MULTI-DUROMETER SYMES	"Major Category III. D. - 
Customized Prosthetic Devices"
L5665		MULTI-DUROMETER BELOW KNEE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5666		BELOW KNEE CUFF SUSPENSION	"Major Category III. D. - 
Customized Prosthetic Devices"
L5668		BK MOLDED DISTAL CUSHION	"Major Category III. D. - 
Customized Prosthetic Devices"
L5670		BK MOLDED SUPRACONDYLAR SUSP	"Major Category III. D. - 
Customized Prosthetic Devices"
L5671		BK/AK LOCKING MECHANISM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5672		BK REMOVABLE MEDIAL BRIM SUS	"Major Category III. D. - 
Customized Prosthetic Devices"
L5673		SOCKET INSERT W LOCK MECH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5676		BK KNEE JOINTS SINGLE AXIS P	"Major Category III. D. - 
Customized Prosthetic Devices"
L5677		BK KNEE JOINTS POLYCENTRIC P	"Major Category III. D. - 
Customized Prosthetic Devices"
L5678		BK JOINT COVERS PAIR	"Major Category III. D. - 
Customized Prosthetic Devices"
L5679		SOCKET INSERT W/O LOCK MECH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5680		BK THIGH LACER NON-MOLDED	"Major Category III. D. - 
Customized Prosthetic Devices"
L5681		INTL CUSTM CONG/LATYP INSERT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5682		BK THIGH LACER GLUT/ISCHIA M	"Major Category III. D. - 
Customized Prosthetic Devices"
L5683		INITIAL CUSTOM SOCKET INSERT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5684		BK FORK STRAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L5685		BELOW KNEE SUS/SEAL SLEEVE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5686		BK BACK CHECK	"Major Category III. D. - 
Customized Prosthetic Devices"
L5688		BK WAIST BELT WEBBING	"Major Category III. D. - 
Customized Prosthetic Devices"
L5690		BK WAIST BELT PADDED AND LIN	"Major Category III. D. - 
Customized Prosthetic Devices"
L5692		AK PELVIC CONTROL BELT LIGHT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5694		AK PELVIC CONTROL BELT PAD/L	"Major Category III. D. - 
Customized Prosthetic Devices"
L5695		AK SLEEVE SUSP NEOPRENE/EQUA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5696		AK/KNEE DISARTIC PELVIC JOIN	"Major Category III. D. - 
Customized Prosthetic Devices"
L5697		AK/KNEE DISARTIC PELVIC BAND	"Major Category III. D. - 
Customized Prosthetic Devices"
L5698		AK/KNEE DISARTIC SILESIAN BA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5699		SHOULDER HARNESS	"Major Category III. D. - 
Customized Prosthetic Devices"
L5700		REPLACE SOCKET BELOW KNEE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5701		REPLACE SOCKET ABOVE KNEE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5702		REPLACE SOCKET HIP	"Major Category III. D. - 
Customized Prosthetic Devices"
L5703		SYMES ANKLE W/O (SACH) FOOT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5704		CUSTOM SHAPE COVER BK	"Major Category III. D. - 
Customized Prosthetic Devices"
L5705		CUSTOM SHAPE COVER AK	"Major Category III. D. - 
Customized Prosthetic Devices"
L5706		CUSTOM SHAPE CVR KNEE DISART	"Major Category III. D. - 
Customized Prosthetic Devices"
L5707		CUSTOM SHAPE CVR HIP DISART	"Major Category III. D. - 
Customized Prosthetic Devices"
L5710		KNE-SHIN EXO SNG AXI MNL LOC	"Major Category III. D. - 
Customized Prosthetic Devices"
L5711		KNEE-SHIN EXO MNL LOCK ULTRA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5712		KNEE-SHIN EXO FRICT SWG & ST	"Major Category III. D. - 
Customized Prosthetic Devices"
L5714		KNEE-SHIN EXO VARIABLE FRICT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5716		KNEE-SHIN EXO MECH STANCE PH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5718		KNEE-SHIN EXO FRCT SWG & STA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5722		KNEE-SHIN PNEUM SWG FRCT EXO	"Major Category III. D. - 
Customized Prosthetic Devices"
L5724		KNEE-SHIN EXO FLUID SWING PH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5726		KNEE-SHIN EXT JNTS FLD SWG E	"Major Category III. D. - 
Customized Prosthetic Devices"
L5728		KNEE-SHIN FLUID SWG & STANCE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5780		KNEE-SHIN PNEUM/HYDRA PNEUM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5781		LOWER LIMB PROS VACUUM PUMP	"Major Category III. D. - 
Customized Prosthetic Devices"
L5782		HD LOW LIMB PROS VACUUM PUMP	"Major Category III. D. - 
Customized Prosthetic Devices"
L5785		EXOSKELETAL BK ULTRALT MATER	"Major Category III. D. - 
Customized Prosthetic Devices"
L5790		EXOSKELETAL AK ULTRA-LIGHT M	"Major Category III. D. - 
Customized Prosthetic Devices"
L5795		EXOSKEL HIP ULTRA-LIGHT MATE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5810		ENDOSKEL KNEE-SHIN MNL LOCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L5811		ENDO KNEE-SHIN MNL LCK ULTRA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5812		ENDO KNEE-SHIN FRCT SWG & ST	"Major Category III. D. - 
Customized Prosthetic Devices"
L5814		ENDO KNEE-SHIN HYDRAL SWG PH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5816		ENDO KNEE-SHIN POLYC MCH STA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5818		ENDO KNEE-SHIN FRCT SWG & ST	"Major Category III. D. - 
Customized Prosthetic Devices"
L5822		ENDO KNEE-SHIN PNEUM SWG FRC	"Major Category III. D. - 
Customized Prosthetic Devices"
L5824		ENDO KNEE-SHIN FLUID SWING P	"Major Category III. D. - 
Customized Prosthetic Devices"
L5826		MINIATURE KNEE JOINT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5828		ENDO KNEE-SHIN FLUID SWG/STA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5830		ENDO KNEE-SHIN PNEUM/SWG PHA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5840		MULTI-AXIAL KNEE/SHIN SYSTEM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5845		KNEE-SHIN SYS STANCE FLEXION	"Major Category III. D. - 
Customized Prosthetic Devices"
L5848		KNEE-SHIN SYS HYDRAUL STANCE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5850		ENDO AK/HIP KNEE EXTENS ASSI	"Major Category III. D. - 
Customized Prosthetic Devices"
L5855		MECH HIP EXTENSION ASSIST	"Major Category III. D. - 
Customized Prosthetic Devices"
L5856		ELEC KNEE-SHIN SWING/STANCE	"Major Category III. D. - 
Customized Prosthetic Devices"
L5857		ELEC KNEE-SHIN SWING ONLY	"Major Category III. D. - 
Customized Prosthetic Devices"
L5858		STANCE PHASE ONLY	"Major Category III. D. - 
Customized Prosthetic Devices"
L5859		ENDO BELOW KNEE ALIGNABLE SY	"Major Category III. D. - 
Customized Prosthetic Devices"
L5910		ENDO AK/HIP ALIGNABLE SYSTEM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5920		ABOVE KNEE MANUAL LOCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L5925		HIGH ACTIVITY KNEE FRAME	"Major Category III. D. - 
Customized Prosthetic Devices"
L5930		ENDO BK ULTRA-LIGHT MATERIAL	"Major Category III. D. - 
Customized Prosthetic Devices"
L5940		ENDO AK ULTRA-LIGHT MATERIAL	"Major Category III. D. - 
Customized Prosthetic Devices"
L5950		ENDO HIP ULTRA-LIGHT MATERIA	"Major Category III. D. - 
Customized Prosthetic Devices"
L5960		"ENDO POLY HIP, PNEU/HYD/ROT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5961		BELOW KNEE FLEX COVER SYSTEM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5962		ABOVE KNEE FLEX COVER SYSTEM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5964		HIP FLEXIBLE COVER SYSTEM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5966		MULTIAXIAL ANKLE W DORSIFLEX	"Major Category III. D. - 
Customized Prosthetic Devices"
L5968		FOOT EXTERNAL KEEL SACH FOOT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5969		AK/FT POWER ASST INCL MOTORS	"Major Category III. D. - 
Customized Prosthetic Devices"
L5970		"SACH FOOT, REPLACEMENT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5971		FLEXIBLE KEEL FOOT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5972		ANK-FOOT SYS DORS-PLANT FLEX	"Major Category III. D. - 
Customized Prosthetic Devices"
L5973		FOOT SINGLE AXIS ANKLE/FOOT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5974		COMBO ANKLE/FOOT PROSTHESIS	"Major Category III. D. - 
Customized Prosthetic Devices"
L5975		ENERGY STORING FOOT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5976		FT PROSTH MULTIAXIAL ANKL/FT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5978		MULTI-AXIAL ANKLE/FT PROSTH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5979		FLEX FOOT SYSTEM	"Major Category III. D. - 
Customized Prosthetic Devices"
L5980		FLEX-WALK SYS LOW EXT PROSTH	"Major Category III. D. - 
Customized Prosthetic Devices"
L5981		EXOSKELETAL AXIAL ROTATION U	"Major Category III. D. - 
Customized Prosthetic Devices"
L5982		ENDOSKELETAL AXIAL ROTATION	"Major Category III. D. - 
Customized Prosthetic Devices"
L5984		LWR EXT DYNAMIC PROSTH PYLON	"Major Category III. D. - 
Customized Prosthetic Devices"
L5985		MULTI-AXIAL ROTATION UNIT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5986		SHANK FT W VERT LOAD PYLON	"Major Category III. D. - 
Customized Prosthetic Devices"
L5988		VERTICAL SHOCK REDUCING PYLO	"Major Category III. D. - 
Customized Prosthetic Devices"
L5990		USER ADJUSTABLE HEEL HEIGHT	"Major Category III. D. - 
Customized Prosthetic Devices"
L5993		"HEAVY DUTY FEATURE, FOOT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5994		"HEAVY DUTY FEATURE, KNEE"	"Major Category III. D. - 
Customized Prosthetic Devices"
L5995		"HEAVY DUTY FEATURE, OTHER THAN FOOT OR 
KNEE"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6050		WRST MLD SCK FLX HNG TRI PAD	"Major Category III. D. - 
Customized Prosthetic Devices"
L6055		WRST MOLD SOCK W/EXP INTERFA	"Major Category III. D. - 
Customized Prosthetic Devices"
L6100		ELB MOLD SOCK FLEX HINGE PAD	"Major Category III. D. - 
Customized Prosthetic Devices"
L6110		ELBOW MOLD SOCK SUSPENSION T	"Major Category III. D. - 
Customized Prosthetic Devices"
L6120		ELBOW MOLD DOUB SPLT SOC STE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6130		ELBOW STUMP ACTIVATED LOCK H	"Major Category III. D. - 
Customized Prosthetic Devices"
L6200		ELBOW MOLD OUTSID LOCK HINGE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6205		ELBOW MOLDED W/ EXPAND INTER	"Major Category III. D. - 
Customized Prosthetic Devices"
L6250		ELBOW INTER LOC ELBOW FORARM	"Major Category III. D. - 
Customized Prosthetic Devices"
L6300		SHLDER DISART INT LOCK ELBOW	"Major Category III. D. - 
Customized Prosthetic Devices"
L6310		SHOULDER PASSIVE RESTOR COMP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6320		SHOULDER PASSIVE RESTOR CAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6350		THORACIC INTERN LOCK ELBOW	"Major Category III. D. - 
Customized Prosthetic Devices"
L6360		THORACIC PASSIVE RESTOR COMP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6370		THORACIC PASSIVE RESTOR CAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6400		BELOW ELBOW PROSTH TISS SHAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6450		ELB DISART PROSTH TISS SHAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6500		ABOVE ELBOW PROSTH TISS SHAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6550		SHLDR DISAR PROSTH TISS SHAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6570		SCAP THORAC PROSTH TISS SHAP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6580		WRIST/ELBOW BOWDEN CABLE MOL	"Major Category III. D. - 
Customized Prosthetic Devices"
L6582		WRIST/ELBOW BOWDEN CBL DIR F	"Major Category III. D. - 
Customized Prosthetic Devices"
L6584		ELBOW FAIR LEAD CABLE MOLDED	"Major Category III. D. - 
Customized Prosthetic Devices"
L6586		ELBOW FAIR LEAD CABLE DIR FO	"Major Category III. D. - 
Customized Prosthetic Devices"
L6588		SHDR FAIR LEAD CABLE MOLDED	"Major Category III. D. - 
Customized Prosthetic Devices"
L6590		SHDR FAIR LEAD CABLE DIRECT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6600		POLYCENTRIC HINGE PAIR	"Major Category III. D. - 
Customized Prosthetic Devices"
L6605		SINGLE PIVOT HINGE PAIR	"Major Category III. D. - 
Customized Prosthetic Devices"
L6610		FLEXIBLE METAL HINGE PAIR	"Major Category III. D. - 
Customized Prosthetic Devices"
L6611		"ADDITIONAL SWITCH, EXT POWER"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6615		DISCONNECT LOCKING WRIST UNI	"Major Category III. D. - 
Customized Prosthetic Devices"
L6616		DISCONNECT INSERT LOCKING WR	"Major Category III. D. - 
Customized Prosthetic Devices"
L6620		FLEXION/EXTENSION WRIST UNIT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6621		FLEX/EXT WRIST W/WO FRICTION	"Major Category III. D. - 
Customized Prosthetic Devices"
L6623		SPRING-ASS ROT WRST W/ LATCH	"Major Category III. D. - 
Customized Prosthetic Devices"
L6624		FLEX/EXT/ROTATION WRIST UNIT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6625		ROTATION WRST W/ CABLE LOCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L6628		QUICK DISCONN HOOK ADAPTER O	"Major Category III. D. - 
Customized Prosthetic Devices"
L6629		LAMINATION COLLAR W/ COUPLIN	"Major Category III. D. - 
Customized Prosthetic Devices"
L6630		STAINLESS STEEL ANY WRIST	"Major Category III. D. - 
Customized Prosthetic Devices"
L6632		LATEX SUSPENSION SLEEVE EACH	"Major Category III. D. - 
Customized Prosthetic Devices"
L6635		LIFT ASSIST FOR ELBOW	"Major Category III. D. - 
Customized Prosthetic Devices"
L6637		NUDGE CONTROL ELBOW LOCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L6638		ELEC LOCK ON MANUAL PW ELBOW	"Major Category III. D. - 
Customized Prosthetic Devices"
L6640		SHOULDER ABDUCTION JOINT PAI	"Major Category III. D. - 
Customized Prosthetic Devices"
L6641		EXCURSION AMPLIFIER PULLEY T	"Major Category III. D. - 
Customized Prosthetic Devices"
L6642		EXCURSION AMPLIFIER LEVER TY	"Major Category III. D. - 
Customized Prosthetic Devices"
L6645		SHOULDER FLEXION-ABDUCTION J	"Major Category III. D. - 
Customized Prosthetic Devices"
L6646		MULTIPO LOCKING SHOULDER JNT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6647		SHOULDER LOCK ACTUATOR	"Major Category III. D. - 
Customized Prosthetic Devices"
L6648		EXT PWRD SHLDER LOCK/UNLOCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L6650		SHOULDER UNIVERSAL JOINT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6655		STANDARD CONTROL CABLE EXTRA	"Major Category III. D. - 
Customized Prosthetic Devices"
L6660		HEAVY DUTY CONTROL CABLE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6665		TEFLON OR EQUAL CABLE LINING	"Major Category III. D. - 
Customized Prosthetic Devices"
L6670		HOOK TO HAND CABLE ADAPTER	"Major Category III. D. - 
Customized Prosthetic Devices"
L6672		HARNESS CHEST/SHLDER SADDLE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6675		HARNESS FIGURE OF 8 SING CON	"Major Category III. D. - 
Customized Prosthetic Devices"
L6676		HARNESS FIGURE OF 8 DUAL CON	"Major Category III. D. - 
Customized Prosthetic Devices"
L6677		UE TRIPLE CONTROL HARNESS	"Major Category III. D. - 
Customized Prosthetic Devices"
L6680		TEST SOCK WRIST DISART/BEL E	"Major Category III. D. - 
Customized Prosthetic Devices"
L6682		TEST SOCK ELBW DISART/ABOVE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6684		TEST SOCKET SHLDR DISART/THO	"Major Category III. D. - 
Customized Prosthetic Devices"
L6686		SUCTION SOCKET	"Major Category III. D. - 
Customized Prosthetic Devices"
L6687		FRAME TYP SOCKET BEL ELBOW/W	"Major Category III. D. - 
Customized Prosthetic Devices"
L6688		FRAME TYP SOCK ABOVE ELB/DIS	"Major Category III. D. - 
Customized Prosthetic Devices"
L6689		FRAME TYP SOCKET SHOULDER DI	"Major Category III. D. - 
Customized Prosthetic Devices"
L6690		FRAME TYP SOCK INTERSCAP-THO	"Major Category III. D. - 
Customized Prosthetic Devices"
L6691		REMOVABLE INSERT EACH	"Major Category III. D. - 
Customized Prosthetic Devices"
L6692		SILICONE GEL INSERT OR EQUAL	"Major Category III. D. - 
Customized Prosthetic Devices"
L6693		LOCKINGELBOW FOREARM CNTRBAL	"Major Category III. D. - 
Customized Prosthetic Devices"
L6694		ELBOW SOCKET INS USE W/LOCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L6695		ELBOW SOCKET INS USE W/O LCK	"Major Category III. D. - 
Customized Prosthetic Devices"
L6696		CUS ELBO SKT IN FOR CON/ATYP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6697		CUS ELBO SKT IN NOT CON/ATYP	"Major Category III. D. - 
Customized Prosthetic Devices"
L6698		BELOW/ABOVE ELBOW LOCK MECH	"Major Category III. D. - 
Customized Prosthetic Devices"
L6703		"TERM DEVICE, PASSIVE HAND MITT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6704		"TERM DEVICE, SPORT/REC/WORK ATT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6706		TERM DEV MECH HOOK VOL OPEN	"Major Category III. D. - 
Customized Prosthetic Devices"
L6707		TERM DEV MECH HOOK VOL CLOSE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6708		TERM DEV MECH HAND VOL OPEN	"Major Category III. D. - 
Customized Prosthetic Devices"
L6709		TERM DEV MECH HAND VOL CLOSE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6711		"PED TERM DEV, HOOK, VOL OPEN"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6712		"PED TERM DEV, HOOK, VOL CLOS"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6713		"PED TERM DEV, HAND, VOL OPEN"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6714		"PED TERM DEV, HAND, VOL CLOS"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6715		"TERM DEVICE, MULTI ART DIGIT"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6721		"HOOK/HAND, HVY DTY, VOL OPEN"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6722		"HOOK/HAND, HVY DTY, VOL CLOS"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6805		TERM DEV MODIFIER WRIST UNIT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6810		TERM DEV PRECISION PINCH DEV	"Major Category III. D. - 
Customized Prosthetic Devices"
L6880		"ELECTRIC HAND, IND ART DIGITS"	"Major Category III. D. - 
Customized Prosthetic Devices"
L6881		TERM DEV AUTO GRASP FEATURE	"Major Category III. D. - 
Customized Prosthetic Devices"
L6882		MICROPROCESSOR CONTROL UPLMB	"Major Category III. D. - 
Customized Prosthetic Devices"
L6883		REPLC SOCKT BELOW E/W DISA	"Major Category III. D. - 
Customized Prosthetic Devices"
L6884		REPLC SOCKT ABOVE ELBOW DISA	"Major Category III. D. - 
Customized Prosthetic Devices"
L6885		REPLC SOCKT SHLDR DIS/INTERC	"Major Category III. D. - 
Customized Prosthetic Devices"
L6920		WRIST DISARTICUL SWITCH CTRL	"Major Category III. D. - 
Customized Prosthetic Devices"
L6925		WRIST DISART MYOELECTRONIC C	"Major Category III. D. - 
Customized Prosthetic Devices"
L6930		BELOW ELBOW SWITCH CONTROL	"Major Category III. D. - 
Customized Prosthetic Devices"
L6935		BELOW ELBOW MYOELECTRONIC CT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6940		ELBOW DISARTICULATION SWITCH	"Major Category III. D. - 
Customized Prosthetic Devices"
L6945		ELBOW DISART MYOELECTRONIC C	"Major Category III. D. - 
Customized Prosthetic Devices"
L6950		ABOVE ELBOW SWITCH CONTROL	"Major Category III. D. - 
Customized Prosthetic Devices"
L6955		ABOVE ELBOW MYOELECTRONIC CT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6960		SHLDR DISARTIC SWITCH CONTRO	"Major Category III. D. - 
Customized Prosthetic Devices"
L6965		SHLDR DISARTIC MYOELECTRONIC	"Major Category III. D. - 
Customized Prosthetic Devices"
L6970		INTERSCAPULAR-THOR SWITCH CT	"Major Category III. D. - 
Customized Prosthetic Devices"
L6975		INTERSCAP-THOR MYOELECTRONIC	"Major Category III. D. - 
Customized Prosthetic Devices"
L7007		ADULT ELECTRIC HAND	"Major Category III. D. - 
Customized Prosthetic Devices"
L7008		PEDIATRIC ELECTRIC HAND	"Major Category III. D. - 
Customized Prosthetic Devices"
L7009		ADULT ELECTRIC HOOK	"Major Category III. D. - 
Customized Prosthetic Devices"
L7040		PREHENSILE ACTUATOR	"Major Category III. D. - 
Customized Prosthetic Devices"
L7045		PEDIATRIC ELECTRIC HOOK	"Major Category III. D. - 
Customized Prosthetic Devices"
L7170		ELECTRONIC ELBOW HOSMER SWIT	"Major Category III. D. - 
Customized Prosthetic Devices"
L7180		ELECTRONIC ELBOW SEQUENTIAL	"Major Category III. D. - 
Customized Prosthetic Devices"
L7181		ELECTRONIC ELBO SIMULTANEOUS	"Major Category III. D. - 
Customized Prosthetic Devices"
L7185		ELECTRON ELBOW ADOLESCENT SW	"Major Category III. D. - 
Customized Prosthetic Devices"
L7186		ELECTRON ELBOW CHILD SWITCH	"Major Category III. D. - 
Customized Prosthetic Devices"
L7190		ELBOW ADOLESCENT MYOELECTRON	"Major Category III. D. - 
Customized Prosthetic Devices"
L7191		ELBOW CHILD MYOELECTRONIC CT	"Major Category III. D. - 
Customized Prosthetic Devices"
L7260		ELECTRON WRIST ROTATOR OTTO	"Major Category III. D. - 
Customized Prosthetic Devices"
L7261		"ELECTRONIC WRIST ROTATOR, FOR UTAH ARM"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7266		"SERVO CONTROL, STEEPER OR EQUAL"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7272		"ANALOGUE CONTROL, UNB OR EQUAL"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7274		"PROPORTIONAL CONTROL, 6-12 VOLT, LIBERTY, UTAH OR EQUAL"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7362		"BATTERY CHARGER, SIX VOLT, OTTO BOCK OR EQUAL"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7364		"TWELVE VOLT BATTERY, UTAH OR EQUAL, EACH"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7366		"BATTERY CHARGER, TWELVE VOLT, UTAH OR EQUAL"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7367		REPLACEMNT LITHIUM IONBATTER	"Major Category III. D. - 
Customized Prosthetic Devices"
L7368		LITHIUM ION BATTERY CHARGER	"Major Category III. D. - 
Customized Prosthetic Devices"
L7400		"ADD UE PROST BE/WD, ULTLITE"	"Major Category III. D. - 
Customized Prosthetic Devices"
L7401		ADD UE PROST A/E ULTLITE MAT	"Major Category III. D. - 
Customized Prosthetic Devices"
L7402		ADD UE PROST S/D ULTLITE MAT	"Major Category III. D. - 
Customized Prosthetic Devices"
L7403		ADD UE PROST B/E ACRYLIC	"Major Category III. D. - 
Customized Prosthetic Devices"
L7404		ADD UE PROST A/E ACRYLIC	"Major Category III. D. - 
Customized Prosthetic Devices"
L7405		ADD UE PROST S/D ACRYLIC	"Major Category III. D. - 
Customized Prosthetic Devices"
L8701		POW UE ROM DEV EWH UPRT CUST	"Major Category III. D. - 
Customized Prosthetic Devices"
L8702		POW UE ROM DEV EWHF UPRT CUS	"Major Category III. D. - 
Customized Prosthetic Devices"
J7170		"INJ., EMICIZUMAB-KXWH 0.5 MG"	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7175		"INJ, FACTOR X, (HUMAN), 1IU"	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7177		"INJ., FIBRYGA, 1 MG"	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7178		INJ HUMAN FIBRINOGEN CON NOS	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7179		VONVENDI INJ 1 IU VWF:RCO	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7180		FACTOR XIII ANTI-HEM FACTOR	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7181		FACTOR XIII RECOMB A-SUBUNIT	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7182		FACTOR VIII RECOMB NOVOEIGHT	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7183		WILATE INJECTION	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7185		XYNTHA INJ	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7186		ANTIHEMOPHILIC VIII/VWF COMP	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7187		"HUMATE-P, INJ"	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7188		FACTOR VIII RECOMB OBIZUR	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7189		FACTOR VIIA RECOMB NOVOSEVEN	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7190		FACTOR VIII	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7191		FACTOR VIII (PORCINE)	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7192		FACTOR VIII RECOMBINANT NOS	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7193		FACTOR IX NON-RECOMBINANT	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7194		FACTOR IX COMPLEX	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7195		FACTOR IX RECOMBINANT NOS	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7196		ANTITHROMBIN RECOMBINANT	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7197		ANTITHROMBIN III INJECTION	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7198		ANTI-INHIBITOR	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7199		HEMOPHILIA CLOT FACTOR NOC	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7200		FACTOR IX RECOMBINAN RIXUBIS	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7201		FACTOR IX ALPROLIX RECOMB	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7202		FACTOR IX IDELVION INJ	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7203		FACTOR IX RECOMB GLY REBINYN	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7204		"FACTOR VIII, RECOMB, ESPEROCT, GLYCOPEGYLATED-EXEI
"	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7205		FACTOR VIII FC FUSION RECOMB	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7207		FACTOR VIII PEGYLATED RECOMB	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7209		FACTOR VIII NUWIQ RECOMB 1IU	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7210		"INJ, AFSTYLA, 1 I.U."	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7211		"INJ, KOVALTRY, 1 I.U."	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
J7212		FACTOR VIIA RECOMB SEVENFACT	"Major Category III. E. - 
E. Certain blood clotting factors indicated for the treatment of hemophilia and other bleeding disorders"
77067		SCR MAMMO BI INCL CAD	Major Category IV. A. - Mammography Screening
90630		FLU VACC IIV4 NO PRESERV ID	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90653		IIV ADJUVANT VACCINE IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90654		FLU VACCINE NO PRESERV ID	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90655		IIV3 VACC NO PRSV 0.25 ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90656		"FLU VACCINE, 3 YRS, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90657		"FLU VACCINE, 6-35 MO, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90660		FLU VACCINE NASAL	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90661		CCIIV3 VAC NO PRSV 0.5 ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90662		FLU VACC PRSV FREE INC ANTIG	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90670		PNEUMOCOCCAL VACC 13 VAL IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90672		LAIV4 VACCINE INTRANASAL	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90673		RIV3 VACCINE NO PRESERV IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90674		"FLU VAC, QUAD (ccIIV), IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90677		PCV20 VACCINE IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90682		RIV4 VACC RECOMBINANT DNA IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90685		IIV4 VACC NO PRSV 0.25 ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90686		IIV4 VACC NO PRSV 0.5 ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90687		IIV4 VACCINE SPLT 0.25 ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90688		IIV4 VACCINE SPLT 0.5 ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90689		VACC IIV4 NO PRSRV 0.25ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90694		VACC AIIV4 NO PRSRV 0.5ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90732		"PNEUMOCOCCAL VACC, ADULT/ILL"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90740		"HEPB VACC, ILL PAT 3 DOSE IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90743		"HEP B VACC, ADOL, 2 DOSE, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90744		HEPB VACC PED/ADOL 3 DOSE IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90746		"HEP B VACCINE, ADULT, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90747		"HEPB VACC, ILL PAT 4 DOSE IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
90756		CCIIV4 VACC ABX FREE IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91300		SARSCOV2 VAC 30MCG/0.3ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91301		SARSCOV2 VAC 100MCG/0.5ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91302		SARSCOV2 VAC 5X10^10VP/.5MLIM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91303		SARSCOV2 VAC AD26 .5ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91304		SARSCOV2 VAC 5MCG/0.5ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91305		SARSCOV2 VAC 30 MCG TRS-SUCR	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91306		SARSCOV2 VAC 50MCG/0.25ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91311		SARSCOV2 VAC 25MCG/0.25ML IM	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91312		SARSCOV2 VAC BVL 30MCG/0.3ML	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91313		SARSCOV2 VAC BVL 50MCG/0.5ML	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91314		SARSCOV2 VAC BVL 25MCG/.25ML	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
91315		SARSCOV2 VAC BVL 10MCG/0.2ML	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
Q2033		"INFLUENZA VACCINE, (FLUBLOK)"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
Q2035		"AFLURIA VACC, 3 YRS & >, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
Q2036		"FLULAVAL VACC, 3 YRS & >, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
Q2037		"FLUVIRIN VACC, 3 YRS & >, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
Q2038		"FLUZONE VACC, 3 YRS & >, IM"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
Q2039		"INFLUENZA VIRUS VACCINE, NOS"	"Major Category IV. B. - 
Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)"
0001A		ADM SARSCOV2 30MCG/0.3ML 1ST	"Major Category IV. C. - 
Vaccine Administration"
0002A		ADM SARSCOV2 30MCG/0.3ML 2ND	"Major Category IV. C. - 
Vaccine Administration"
0003A		ADM SARSCOV2 30MCG/0.3ML 3RD	"Major Category IV. C. - 
Vaccine Administration"
0004A		ADM SARSCOV2 30MCG/0.3ML BST	"Major Category IV. C. - 
Vaccine Administration"
0011A		ADM SARSCOV2 100MCG/0.5ML1ST	"Major Category IV. C. - 
Vaccine Administration"
0012A		ADM SARSCOV2 100MCG/0.5ML2ND	"Major Category IV. C. - 
Vaccine Administration"
0013A		ADM SARSCOV2 100MCG/0.5ML3RD	"Major Category IV. C. - 
Vaccine Administration"
0021A		ADM SARSCOV2 5X10^10VP/.5ML 1	"Major Category IV. C. - 
Vaccine Administration"
0022A		ADM SARSCOV2 5X10^10VP/.5ML 2	"Major Category IV. C. - 
Vaccine Administration"
0031A		ADM SARSCOV2 VAC AD26 .5ML	"Major Category IV. C. - 
Vaccine Administration"
0041A		ADM SARSCOV2 5MCG/0.5ML 1ST	"Major Category IV. C. - 
Vaccine Administration"
0042A		ADM SARSCOV2 5MCG/0.5ML 2ND	"Major Category IV. C. - 
Vaccine Administration"
0051A		ADM SARSCV2 30MCG TRS-SUCR 1	"Major Category IV. C. - 
Vaccine Administration"
0052A		ADM SARSCV2 30MCG TRS-SUCR 2	"Major Category IV. C. - 
Vaccine Administration"
0053A		ADM SARSCV2 30MCG TRS-SUCR 3	"Major Category IV. C. - 
Vaccine Administration"
0054A		ADM SARSCV2 30MCG TRS-SUCR B	"Major Category IV. C. - 
Vaccine Administration"
0064A		ADM SARSCOV2 50MCG/0.25MLBST	"Major Category IV. C. - 
Vaccine Administration"
0091A		ADM SARSCOV2 50 MCG/.5 ML1ST	"Major Category IV. C. - 
Vaccine Administration"
0092A		ADM SARSCOV2 50 MCG/.5 ML2ND	"Major Category IV. C. - 
Vaccine Administration"
0093A		ADM SARSCOV2 50 MCG/.5 ML3RD	"Major Category IV. C. - 
Vaccine Administration"
0111A		ADM SARSCOV2 25MCG/0.25ML1ST	"Major Category IV. C. - 
Vaccine Administration"
0112A		ADM SARSCOV2 25MCG/0.25ML2ND	"Major Category IV. C. - 
Vaccine Administration"
0113A		ADM SARSCOV2 25MCG/0.25ML3RD	"Major Category IV. C. - 
Vaccine Administration"
0124A		ADM SARSCV2 BVL 30MCG/.3ML B	"Major Category IV. C. - 
Vaccine Administration"
0134A		ADM SARSCV2 BVL 50MCG/.5ML B	"Major Category IV. C. - 
Vaccine Administration"
0144A		ADM SRSCV2 BVL 25MCG/.25ML B	"Major Category IV. C. - 
Vaccine Administration"
0154A		ADM SARSCV2 BVL 10MCG/.2ML B	"Major Category IV. C. - 
Vaccine Administration"
90465		"IMMUNE ADMIN 1 INJ, < 8 YRS"	"Major Category IV. C. - 
Vaccine Administration"
90466		"IMMUNE ADMIN ADDL INJ, < 8 Y"	"Major Category IV. C. - 
Vaccine Administration"
90467		"IMMUNE ADMIN O OR N, < 8 YRS"	"Major Category IV. C. - 
Vaccine Administration"
90468		"IMMUNE ADMIN O/N, ADDL < 8 Y"	"Major Category IV. C. - 
Vaccine Administration"
G0008		ADMINISTRATION OF INFLUENZA VIRUS VACCINE	"Major Category IV. C. - 
Vaccine Administration"
G0009		ADMINISTRATION OF PNEUMOCOCCAL VACCINE	"Major Category IV. C. - 
Vaccine Administration"
G0010		ADMINISTRATION OF HEPATITIS B VACCINE	"Major Category IV. C. - 
Vaccine Administration"
G9141		"INFLUENZA A H1N1,ADMIN W COU"	"Major Category IV. C. - 
Vaccine Administration"
G0101		CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
G0123		SCREEN CERV/VAG THIN LAYER	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
G0143		"SCR C/V CYTO,THINLAYER,RESCR"	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
G0144		"SCR C/V CYTO,THINLAYER,RESCR"	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
G0145		"SCR C/V CYTO,THINLAYER,RESCR"	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
G0147		"SCR C/V CYTO, AUTOMATED SYS"	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
G0148		"SCR C/V CYTO, AUTOSYS, RESCR"	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
P3000		SCREEN PAP BY TECH W MD SUPV	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
Q0091		OBTAINING SCREEN PAP SMEAR	"Major Category IV. D. - 
Screening Pap Smear and Pelvic Exams"
82270		"FECAL-OCCULT BLOOD TESTS, 1-3 SIMULTANEOUS 
DETERMINATIONS"	"Major Category IV. E. - 
Colorectal  Screening  Services"
G0104		COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY	"Major Category IV. E. - 
Colorectal  Screening  Services"
G0105		COLORECTAL SCRN; HI RISK IND	"Major Category IV. E. - 
Colorectal  Screening  Services"
G0106		COLON CA SCREEN;BARIUM ENEMA	"Major Category IV. E. - 
Colorectal  Screening  Services"
G0120		"COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0105, SCREENING COLONOSCOPY, BARIUM ENEMA."	"Major Category IV. E. - 
Colorectal  Screening  Services"
G0121		COLON CA SCRN NOT HI RSK IND	"Major Category IV. E. - 
Colorectal  Screening  Services"
G0328		FECAL BLOOD SCRN IMMUNOASSAY	"Major Category IV. E. - 
Colorectal  Screening  Services"
G0102		PROSTATE CANCER SCREENING; DIGITAL RECTAL EXAMINATION	"Major Category IV. F. - 
Prostate Cancer Screening"
G0103		"PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA), TOTAL"	"Major Category IV. F. - 
Prostate Cancer Screening"
G0117		GLAUCOMA SCRN HGH RISK DIREC	"Major Category IV. G. - 
Glaucoma Screening"
G0118		GLAUCOMA SCRN HGH RISK DIREC	"Major Category IV. G. - 
Glaucoma Screening"
82947		"ASSAY, GLUCOSE, BLOOD QUANT"	"Major Category IV. H. - 
Diabetic Screening"
82950		GLUCOSE; POST GLUCOSE DOSE	"Major Category IV. H. - 
Diabetic Screening"
82951		GLUCOSE TOLERANCE TEST (GTT)	"Major Category IV. H. - 
Diabetic Screening"
80061		LIPID PANEL	Major Category IV. I. -Cardiovascular Screening
82465		"ASSAY, BLD/SERUM CHOLESTEROL"	Major Category IV. I. -Cardiovascular Screening
83718		ASSAY OF LIPOPROTEIN	Major Category IV. I. -Cardiovascular Screening
84478		ASSAY OF TRIGLYCERIDES	Major Category IV. I. -Cardiovascular Screening
76706		ULTRASOUND EXAM AAA SCREEN	"Major Category IV. K. - 
Abdominal Aortic Aneurysms (AAA) Screening "
29580		PASTE/UNNA BOOT	"Major Category V. A. - 
Therapies - INCLUSION"
29581		LOWER EXTREMITY APPLICATION OF STRAPPING	"Major Category V. A. - 
Therapies - INCLUSION"
29584		APPLICATION OF MULTI COMPRESSION SYSTEMS 	"Major Category V. A. - 
Therapies - INCLUSION"
90901		"BIOFEEDBACK TRAIN, ANY METH"	"Major Category V. A. - 
Therapies - INCLUSION"
90912		BFB TRAINING 1ST 15 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
90913		BFB TRAINING EA ADDL 15 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
92507		SPEECH/HEARING THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
92508		SPEECH/HEARING THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
92520		"LARYNGEAL FUNCTION STUDIES (IE, AERODYNAMIC TESTING AND ACOUSTIC TESTING)."	"Major Category V. A. - 
Therapies - INCLUSION"
92521		"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)"	"Major Category V. A. - 
Therapies - INCLUSION"
92522		"EVALUATION OF SPEECH SOUND PRODUCTION (EG, ARTICULATION, PHONOLOGICAL PROCESS, APRAXIA, DYSARTHRIA);"	"Major Category V. A. - 
Therapies - INCLUSION"
92523		"WITH EVALUATION OF LANGUAGE COMPREHENSION AND EXPRESSION (EG, RECEPTIVE AND EXPRESSIVE LANGUAGE)"	"Major Category V. A. - 
Therapies - INCLUSION"
92524		BEHAVIORAL AND QUALITATIVE ANALYSIS OF VOICE AND RESONANCE	"Major Category V. A. - 
Therapies - INCLUSION"
92526		ORAL FUNCTION THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
92597		EVAL FOR USE AND/OR FITTIG VOICE PROSTHETIC DEVICE TO SUPPLEMENT ORAL SPEECH	"Major Category V. A. - 
Therapies - INCLUSION"
92605	^	EVAL FOR NONSPEECH DEVICE RX	"Major Category V. A. - 
Therapies - INCLUSION"
92606	^	NON-SPEECH DEVICE SERVICE	"Major Category V. A. - 
Therapies - INCLUSION"
92607		"EX FOR SPEECH DEVICE RX, 1 HR"	"Major Category V. A. - 
Therapies - INCLUSION"
92608		EX FOR SPEECH DEVICE RX ADDL	"Major Category V. A. - 
Therapies - INCLUSION"
92609		USE OF SPEECH DEVICE SERVICE	"Major Category V. A. - 
Therapies - INCLUSION"
92610		EVALUATE SWALLOWING FUNCTION	"Major Category V. A. - 
Therapies - INCLUSION"
92611		MOTION FLUROSCOPY/SWALLOW	"Major Category V. A. - 
Therapies - INCLUSION"
92612		ENDOSCOPY SWALLOW TST (FEES)	"Major Category V. A. - 
Therapies - INCLUSION"
92614		LARYNGOSCOPIC SENSORY TEST	"Major Category V. A. - 
Therapies - INCLUSION"
92616		FEES W/LARYNGEAL SENSE TEST	"Major Category V. A. - 
Therapies - INCLUSION"
95851		RANGE OF MOTION MEASUREMENTS	"Major Category V. A. - 
Therapies - INCLUSION"
95852		RANGE OF MOTION MEASUREMENTS	"Major Category V. A. - 
Therapies - INCLUSION"
95992		"CANALITH REPOSITIONING PROCEDURE(S) (E.G. 
EPLEY MANEUVER, SEMONT MANEUVER), PER DAY"	"Major Category V. A. - 
Therapies - INCLUSION"
96105		ASSESSMENT OF APHASIA	"Major Category V. A. - 
Therapies - INCLUSION"
96110		"DEVELOPMENT TESTING, LIMITED"	"Major Category V. A. - 
Therapies - INCLUSION"
96125		STANDARD COGNITIVE PERFORMANCE TESTING	"Major Category V. A. - 
Therapies - INCLUSION"
97010	^	HOT OR COLD PACKS THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97012		MECHANICAL TRACTION THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97016		VASOPNEUMATIC DEVICE THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97018		PARAFFIN BATH THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97022		WHIRLPOOL THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97024		DIATHERMY TREATMENT AND/OR MICROWAVE THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97026		INFRARED THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97028		ULTRAVIOLET THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97032		ELECTRICAL STIMULATION	"Major Category V. A. - 
Therapies - INCLUSION"
97033		ELECTRIC CURRENT THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97034		CONTRAST BATH THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97035		ULTRASOUND THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97036		HYDROTHERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97039		PHYSICAL THERAPY TREATMENT	"Major Category V. A. - 
Therapies - INCLUSION"
97110		THERAPEUTIC EXERCISES	"Major Category V. A. - 
Therapies - INCLUSION"
97112		NEUROMUSCULAR REEDUCATION	"Major Category V. A. - 
Therapies - INCLUSION"
97113		AQUATIC THERAPY/EXERCISES	"Major Category V. A. - 
Therapies - INCLUSION"
97116		GAIT TRAINING THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97124		MASSAGE THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97129		THER IVNTJ 1ST 15 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97130		THER IVNTJ EA ADDL 15 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97139		PHYSICAL MEDICINE PROCEDURE	"Major Category V. A. - 
Therapies - INCLUSION"
97140		MANUAL THERAPY	"Major Category V. A. - 
Therapies - INCLUSION"
97150		GROUP THERAPEUTIC PROCEDURES	"Major Category V. A. - 
Therapies - INCLUSION"
97161		PT EVAL LOW COMPLEX 20 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97162		PT EVAL MOD COMPLEX 30 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97163		PT EVAL HIGH COMPLEX 45 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97164		PT RE-EVAL EST PLAN CARE	"Major Category V. A. - 
Therapies - INCLUSION"
97165		OT EVAL LOW COMPLEX 30 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97166		OT EVAL MOD COMPLEX 45 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97167		OT EVAL HIGH COMPLEX 60 MIN	"Major Category V. A. - 
Therapies - INCLUSION"
97168		OT RE-EVAL EST PLAN CARE	"Major Category V. A. - 
Therapies - INCLUSION"
97530		THERAPEUTIC ACTIVITIES	"Major Category V. A. - 
Therapies - INCLUSION"
97533		SENSORY INTEGRATION	"Major Category V. A. - 
Therapies - INCLUSION"
97535		SELF CARE MNGMENT TRAINING	"Major Category V. A. - 
Therapies - INCLUSION"
97537		COMMUNITY/WORK REINTEGRATION	"Major Category V. A. - 
Therapies - INCLUSION"
97542		WHEELCHAIR MNGMENT TRAINING	"Major Category V. A. - 
Therapies - INCLUSION"
97597		DEBRIDEMENT; SURFACE AREA LESS THAN OR EQUAL TO 20 SQUARE CENTIMETERS	"Major Category V. A. - 
Therapies - INCLUSION"
97598		DEBRIDEMENT; TOTAL WOUND(S) SURFACE AREA GREATER THAN 20 SQUARE CENTIMETERS	"Major Category V. A. - 
Therapies - INCLUSION"
97602	^	WOUND(S) CARE NON-SELECTIVE	"Major Category V. A. - 
Therapies - INCLUSION"
97605		NEG PRESS WOUND TX < 50 CM	"Major Category V. A. - 
Therapies - INCLUSION"
97606		NEG PRESS WOUND TX > 50 CM	"Major Category V. A. - 
Therapies - INCLUSION"
97607		NEG PRESS WND TX </=50 SQ CM	"Major Category V. A. - 
Therapies - INCLUSION"
97608		NEG PRESS WOUND TX >50 CM	"Major Category V. A. - 
Therapies - INCLUSION"
97610		LOW FREQUENCY NON-THERMAL US	"Major Category V. A. - 
Therapies - INCLUSION"
97750		PHYSICAL PERFORMANCE TEST	"Major Category V. A. - 
Therapies - INCLUSION"
97755		ASSISTIVE TECHNOLOGY ASSESS	"Major Category V. A. - 
Therapies - INCLUSION"
97760		ORTHOTIC TRAINING (FORMERLY 97504)	"Major Category V. A. - 
Therapies - INCLUSION"
97761		PROSTHETIC TRAINING (FORMERLY 97520)	"Major Category V. A. - 
Therapies - INCLUSION"
97763		ORTHC/PROSTC MGMT SBSQ ENC	"Major Category V. A. - 
Therapies - INCLUSION"
97799		PHYSICAL MEDICINE PROCEDURE	"Major Category V. A. - 
Therapies - INCLUSION"
G0281		ELEC STIM UNATTEND FOR PRESS	"Major Category V. A. - 
Therapies - INCLUSION"
G0283		ELEC STIM OTHER THAN WOUND	"Major Category V. A. - 
Therapies - INCLUSION"
G0329		ELECTROMAGNETIC THERAPY FOR ULCERS	"Major Category V. A. - 
Therapies - INCLUSION"
NOTES ON CODES ABOVES:			
			
			
"* These chemotherapy administration codes are included in SNF PPS  payment for beneficiaries in a Part A stay when performed alone or with other surgery, but are excluded if they occur with the same line item date of service as an excluded  chemotherapy agent."			
			
			
			
^  Payment for these codes is bundled with other rehabilitation services.  They may be bundled with any therapy code.  No payment can be made for these codes.			
			
			
			
