HCPCS Index 2017

Rackstand, oxygen,   E1355
Radiesse,   Q2026
Radioelements for brachytherapy,   Q3001
Radiology service,   R0070 - R0076
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen   R0070
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen   R0075
Transportation of portable ekg to facility or location, per patient   R0076
Radiopharmaceutical diagnostic and therapeutic imaging agent,   A4641, A4642, A9500 - A9699
Fluciclovine f-18, diagnostic, 1 millicurie   A9588
Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified   A9598
Choline c-11, diagnostic, per study dose up to 20 millicuries   A9515
Gallium ga-68, dotatate, diagnostic, 01 millicurie   A9587
Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified   A9597
Technetium tc-99m sestamibi, diagnostic, per study dose   A9500
Technetium tc-99m teboroxime, diagnostic, per study dose   A9501
Technetium tc-99m tetrofosmin, diagnostic, per study dose   A9502
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries   A9503
Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries   A9504
Thallium tl-201 thallous chloride, diagnostic, per millicurie   A9505
Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries   A9507
Iodine i-131 iobenguane sulfate, diagnostic, per 05 millicurie   A9508
Iodine i-123 sodium iodide, diagnostic, per millicurie   A9509
Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries   A9510
Technetium tc-99m pertechnetate, diagnostic, per millicurie   A9512
Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries   A9516
Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie   A9517
Technetium tc-99m tilmanocept, diagnostic, up to 05 millicuries   A9520
Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries   A9521
Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries   A9524
Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries   A9526
Iodine i-125, sodium iodide solution, therapeutic, per millicurie   A9527
Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie   A9528
Iodine i-131 sodium iodide solution, diagnostic, per millicurie   A9529
Iodine i-131 sodium iodide solution, therapeutic, per millicurie   A9530
Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)   A9531
Iodine i-125 serum albumin, diagnostic, per 5 microcuries   A9532
Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries   A9536
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries   A9537
Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries   A9538
Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries   A9539
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries   A9540
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries   A9541
Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries   A9542
Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries   A9543
Cobalt co-5758, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie   A9546
Indium in-111 oxyquinoline, diagnostic, per 05 millicurie   A9547
Indium in-111 pentetate, diagnostic, per 05 millicurie   A9548
Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie   A9550
Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries   A9551
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries   A9552
Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries   A9553
Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries   A9554
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries   A9555
Gallium ga-67 citrate, diagnostic, per millicurie   A9556
Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries   A9557
Xenon xe-133 gas, diagnostic, per 10 millicuries   A9558
Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie   A9559
Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries   A9560
Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries   A9561
Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries   A9562
Sodium phosphate p-32, therapeutic, per millicurie   A9563
Chromic phosphate p-32 suspension, therapeutic, per millicurie   A9564
Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries   A9566
Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries   A9567
Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries   A9568
Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose   A9569
Indium in-111 labeled autologous white blood cells, diagnostic, per study dose   A9570
Indium in-111 labeled autologous platelets, diagnostic, per study dose   A9571
Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries   A9572
Injection, gadoterate meglumine, 01 ml   A9575
Injection, gadoteridol, (prohance multipack), per ml   A9576
Injection, gadobenate dimeglumine (multihance), per ml   A9577
Injection, gadobenate dimeglumine (multihance multipack), per ml   A9578
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml   A9579
Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries   A9580
Injection, gadoxetate disodium, 1 ml   A9581
Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries   A9582
Injection, gadofosveset trisodium, 1 ml   A9583
Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries   A9584
Injection, gadobutrol, 01 ml   A9585
Florbetapir f18, diagnostic, per study dose, up to 10 millicuries   A9586
Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified   A9599
Strontium sr-89 chloride, therapeutic, per millicurie   A9600
Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries   A9604
Radium ra-223 dichloride, therapeutic, per microcurie   A9606
Non-radioactive contrast imaging material, not otherwise classified, per study   A9698
Radiopharmaceutical, therapeutic, not otherwise classified   A9699
bathtub,   E0241, E0242, E0246
bed,   E0305, E0310
toilet,   E0243
Ranibizumab,   J2778
Rasburicase,   J2783
Reachinggrabbing device,   A9281
Reagent strip,   A4252
Reciprocating peritoneal dialysis system,   E1630
Reclast,   J348
Red blood cells,   P9021, P9022
Regadenoson,   J2785
Regular insulin,   J182
Regulator, oxygen,   E1353
contract, ESRD,   A4890
durable medical equipment,   E134
maxillofacial prosthesis,   L8049
orthosis,   L4000 - L4130
Replace girdle for spinal orthosis (ctlso or so)   L4000
Replacement strap, any orthosis, includes all components, any length, any type   L4002
Replace trilateral socket brim   L4010
Replace quadrilateral socket brim, molded to patient model   L4020
Replace quadrilateral socket brim, custom fitted   L4030
Replace molded thigh lacer, for custom fabricated orthosis only   L4040
Replace non-molded thigh lacer, for custom fabricated orthosis only   L4045
Replace molded calf lacer, for custom fabricated orthosis only   L4050
Replace non-molded calf lacer, for custom fabricated orthosis only   L4055
Replace high roll cuff   L4060
Replace proximal and distal upright for kafo   L4070
Replace metal bands kafo, proximal thigh   L4080
Replace metal bands kafo-afo, calf or distal thigh   L4090
Replace leather cuff kafo, proximal thigh   L4100
Replace leather cuff kafo-afo, calf or distal thigh   L4110
Replace pretibial shell   L4130
prosthetic,   L7500, L7510
battery,   A4630
pad (alternating pressure),   A4640
tanks, dialysis,   A488
tip for cane, crutches, walker,   A4637
underarm pad for crutches,   A4635
Reslizumab,   J2786
Restraint, any type,   E0710
Reteplase,   J2993
Rho(D) immune globulin, human,   J2788, J2790, J2791, J2792
Rib belt, thoracic,   A4572, L0220
Rilanocept,   J2793
RimabotulinumtoxinB,   J0587
Ringers lactate infusion,   J7120
Ring, ostomy,   A4404
Risperidone,   J2794
Rituximab,   J9310
Robin-Aids,   L6000, L6010, L6020, L6855, L6860
Rocking bed,   E0462
Rolapitant,   J8670
Rollabout chair,   E1031
Romidepsin,   J9315
Romiplostim,   J2796
Ropivacaine HCl,   J2795
Rubidium Rb-82,   A9555