HCPCS Codes Included in PFS Relativity Adjuster Calculation with Office-Based Rates from External  Sources 		
HCPCS	HCPCS_Description	"Notes: 
1. External source refers to one of the following: national median rate for contractor priced codes, National Limitation Amount (NLA), Clinical Lab Fee Schedule (CLFS), or ASP+6% (Average sales price plus six percent) "
77522	Proton trmt simple w/comp	
77523	Proton trmt intermediate	
86850	Rbc antibody screen	
86880	Coombs test direct	
86885	Coombs test indirect qual	
86886	Coombs test indirect titer	
86900	Blood typing serologic abo	
86901	Blood typing serologic rh(d)	
86902	Blood type antigen donor ea	
86904	Blood typing patient serum	
86905	Blood typing rbc antigens	
86906	Bld typing serologic rh phnt	
J0585	"Injection,onabotulinumtoxina"	
J0712	Ceftaroline fosamil inj	
J0881	"Darbepoetin alfa, non-esrd"	
J0897	Denosumab injection	
J1442	Inj filgrastim excl biosimil	
J1610	Glucagon hydrochloride/1 mg	
J2597	Inj desmopressin acetate	
J3300	Triamcinolone a inj prs-free	
J9025	Azacitidine injection	
J9041	Bortezomib injection	
J9055	Cetuximab injection	
J9217	Leuprolide acetate suspnsion	
J9280	Mitomycin injection	
Q0138	"Ferumoxytol, non-esrd"	
