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Viewing:  Dec 13, 2019

Type of Service (TOS) Indicator 4: Diagnostic Radiology

CPT codes

CodeDescription

CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more.  CPT code information is copyright by the AMA.

Access to this feature is available in the following products:
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0028T  CPT Code
0042T  CPT Code
0042U  CPT Code
0043T  CPT Code
0067T  CPT Code
0067U  CPT Code
0068T  CPT Code
0068U  CPT Code
0069T  CPT Code
0069U  CPT Code
00700  CPT Code
00702  CPT Code
0070T  CPT Code
0073T  CPT Code
0145T  CPT Code
01462  CPT Code
01464  CPT Code
0146T  CPT Code
01470  CPT Code
01472  CPT Code
01474  CPT Code
0147T  CPT Code
01480  CPT Code
01482  CPT Code
01484  CPT Code
01486  CPT Code
0148T  CPT Code
01490  CPT Code
0149T  CPT Code
01500  CPT Code
01502  CPT Code
0150T  CPT Code
0151T  CPT Code
01520  CPT Code
01522  CPT Code
0154T  CPT Code
0159T  CPT Code
0174T  CPT Code
01756  CPT Code
01758  CPT Code
0175T  CPT Code
0223T  CPT Code
0224T  CPT Code
0225T  CPT Code
0330T  CPT Code
0331T  CPT Code
0332T  CPT Code
70010  CPT Code
70015  CPT Code
70030  CPT Code
70100  CPT Code
7010F  CPT Code
70110  CPT Code
70120  CPT Code
70130  CPT Code
70134  CPT Code
70140  CPT Code
70150  CPT Code
70160  CPT Code
70170  CPT Code
70190  CPT Code
70200  CPT Code
7020F  CPT Code
70210  CPT Code
70220  CPT Code
70240  CPT Code
70250  CPT Code
7025F  CPT Code
70260  CPT Code
70300  CPT Code
70310  CPT Code
70320  CPT Code
70328  CPT Code
70330  CPT Code
70332  CPT Code
70336  CPT Code
70350  CPT Code
70355  CPT Code
70360  CPT Code
70370  CPT Code
70371  CPT Code
70373  CPT Code
70380  CPT Code
70390  CPT Code
70450  CPT Code
70460  CPT Code
70470  CPT Code
70480  CPT Code
70481  CPT Code
70482  CPT Code
70486  CPT Code
70487  CPT Code
70488  CPT Code
70490  CPT Code
70491  CPT Code
70492  CPT Code
70496  CPT Code
70498  CPT Code
70540  CPT Code
70542  CPT Code
70543  CPT Code
70544  CPT Code
70545  CPT Code
70546  CPT Code
70547  CPT Code
70548  CPT Code
70549  CPT Code
70551  CPT Code
70552  CPT Code
70553  CPT Code
70554  CPT Code
70555  CPT Code
70557  CPT Code
70558  CPT Code
70559  CPT Code
71010  CPT Code
71015  CPT Code
71020  CPT Code
71021  CPT Code
71022  CPT Code
71023  CPT Code
71030  CPT Code
71034  CPT Code
71035  CPT Code
71040  CPT Code
71045  CPT Code
71046  CPT Code
71047  CPT Code
71048  CPT Code
71060  CPT Code
71090  CPT Code
71100  CPT Code
71101  CPT Code
71110  CPT Code
71111  CPT Code
71120  CPT Code
71130  CPT Code
71250  CPT Code
71260  CPT Code
71270  CPT Code
71275  CPT Code
71550  CPT Code
71551  CPT Code
71552  CPT Code
71555  CPT Code
72010  CPT Code
72020  CPT Code
72040  CPT Code
72050  CPT Code
72052  CPT Code
72069  CPT Code
72070  CPT Code
72072  CPT Code
72074  CPT Code
72080  CPT Code
72081  CPT Code
72082  CPT Code
72083  CPT Code
72084  CPT Code
72090  CPT Code
72100  CPT Code
72110  CPT Code
72114  CPT Code
72120  CPT Code
72125  CPT Code
72126  CPT Code
72127  CPT Code
72128  CPT Code
72129  CPT Code
72130  CPT Code
72131  CPT Code
72132  CPT Code
72133  CPT Code
72141  CPT Code
72142  CPT Code
72146  CPT Code
72147  CPT Code
72148  CPT Code
72149  CPT Code
72156  CPT Code
72157  CPT Code
72158  CPT Code
72159  CPT Code
72170  CPT Code
72190  CPT Code
72191  CPT Code
72192  CPT Code
72193  CPT Code
72194  CPT Code
72195  CPT Code
72196  CPT Code
72197  CPT Code
72198  CPT Code
72200  CPT Code
72202  CPT Code
72220  CPT Code
72240  CPT Code
72255  CPT Code
72265  CPT Code
72270  CPT Code
72275  CPT Code
72285  CPT Code
72291  CPT Code
72292  CPT Code
72295  CPT Code
73000  CPT Code
73010  CPT Code
73020  CPT Code
73030  CPT Code
73040  CPT Code
73050  CPT Code
73060  CPT Code
73070  CPT Code
73080  CPT Code
73085  CPT Code
73090  CPT Code
73092  CPT Code
73100  CPT Code
73110  CPT Code
73115  CPT Code
73120  CPT Code
73130  CPT Code
73140  CPT Code
73200  CPT Code
73201  CPT Code
73202  CPT Code
73206  CPT Code
73218  CPT Code
73219  CPT Code
73220  CPT Code
73221  CPT Code
73222  CPT Code
73223  CPT Code
73225  CPT Code
73500  CPT Code
73501  CPT Code
73502  CPT Code
73503  CPT Code
73510  CPT Code
73520  CPT Code
73521  CPT Code
73522  CPT Code
73523  CPT Code
73525  CPT Code
73530  CPT Code
73540  CPT Code
73542  CPT Code
73550  CPT Code
73551  CPT Code
73552  CPT Code
73560  CPT Code
73562  CPT Code
73564  CPT Code
73565  CPT Code
73580  CPT Code
73590  CPT Code
73592  CPT Code
73600  CPT Code
73610  CPT Code
73615  CPT Code
73620  CPT Code
73630  CPT Code
73650  CPT Code
73660  CPT Code
73700  CPT Code
73701  CPT Code
73702  CPT Code
73706  CPT Code
73718  CPT Code
73719  CPT Code
73720  CPT Code
73721  CPT Code
73722  CPT Code
73723  CPT Code
73725  CPT Code
74000  CPT Code
74010  CPT Code
74018  CPT Code
74019  CPT Code
74020  CPT Code
74021  CPT Code
74022  CPT Code
74150  CPT Code
74160  CPT Code
74170  CPT Code
74174  CPT Code
74175  CPT Code
74176  CPT Code
74177  CPT Code
74178  CPT Code
74181  CPT Code
74182  CPT Code
74183  CPT Code
74185  CPT Code
74190  CPT Code
74210  CPT Code
74220  CPT Code
74230  CPT Code
74235  CPT Code
74240  CPT Code
74241  CPT Code
74245  CPT Code
74246  CPT Code
74247  CPT Code
74249  CPT Code
74250  CPT Code
74251  CPT Code
74260  CPT Code
74261  CPT Code
74262  CPT Code
74263  CPT Code
74270  CPT Code
74280  CPT Code
74283  CPT Code
74290  CPT Code
74291  CPT Code
74300  CPT Code
74301  CPT Code
74305  CPT Code
74320  CPT Code
74327  CPT Code
74328  CPT Code
74329  CPT Code
74330  CPT Code
74340  CPT Code
74350  CPT Code
74355  CPT Code
74360  CPT Code
74363  CPT Code
74400  CPT Code
74410  CPT Code
74415  CPT Code
74420  CPT Code
74425  CPT Code
74430  CPT Code
74440  CPT Code
74445  CPT Code
74450  CPT Code
74455  CPT Code
74470  CPT Code
74475  CPT Code
74480  CPT Code
74485  CPT Code
74710  CPT Code
74712  CPT Code
74713  CPT Code
74740  CPT Code
74742  CPT Code
74775  CPT Code
75552  CPT Code
75553  CPT Code
75554  CPT Code
75555  CPT Code
75556  CPT Code
75557  CPT Code
75558  CPT Code
75559  CPT Code
75560  CPT Code
75561  CPT Code
75562  CPT Code
75563  CPT Code
75564  CPT Code
75565  CPT Code
75571  CPT Code
75572  CPT Code
75573  CPT Code
75574  CPT Code
75600  CPT Code
75605  CPT Code
75625  CPT Code
75630  CPT Code
75635  CPT Code
75650  CPT Code
75658  CPT Code
75660  CPT Code
75662  CPT Code
75665  CPT Code
75671  CPT Code
75676  CPT Code
75680  CPT Code
75685  CPT Code
75705  CPT Code
75710  CPT Code
75716  CPT Code
75722  CPT Code
75724  CPT Code
75726  CPT Code
75731  CPT Code
75733  CPT Code
75736  CPT Code
75741  CPT Code
75743  CPT Code
75746  CPT Code
75756  CPT Code
75774  CPT Code
75790  CPT Code
75791  CPT Code
75801  CPT Code
75803  CPT Code
75805  CPT Code
75807  CPT Code
75809  CPT Code
75810  CPT Code
75820  CPT Code
75822  CPT Code
75825  CPT Code
75827  CPT Code
75831  CPT Code
75833  CPT Code
75840  CPT Code
75842  CPT Code
75860  CPT Code
75870  CPT Code
75872  CPT Code
75880  CPT Code
75885  CPT Code
75887  CPT Code
75889  CPT Code
75891  CPT Code
75893  CPT Code
75898  CPT Code
75956  CPT Code
75957  CPT Code
75958  CPT Code
75959  CPT Code
75970  CPT Code
75992  CPT Code
75993  CPT Code
75994  CPT Code
75995  CPT Code
75996  CPT Code
76000  CPT Code
76001  CPT Code
76010  CPT Code
76080  CPT Code
76098  CPT Code
76100  CPT Code
76101  CPT Code
76102  CPT Code
76120  CPT Code
76125  CPT Code
76140  CPT Code
76150  CPT Code
76350  CPT Code
76376  CPT Code
76377  CPT Code
76380  CPT Code
76390  CPT Code
76391  CPT Code
76496  CPT Code
76497  CPT Code
76498  CPT Code
76499  CPT Code
76506  CPT Code
76510  CPT Code
76511  CPT Code
76512  CPT Code
76513  CPT Code
76514  CPT Code
76516  CPT Code
76519  CPT Code
76529  CPT Code
76536  CPT Code
76604  CPT Code
76641  CPT Code
76642  CPT Code
76645  CPT Code
76700  CPT Code
76705  CPT Code
76706  CPT Code
76770  CPT Code
76775  CPT Code
76776  CPT Code
76800  CPT Code
76801  CPT Code
76802  CPT Code
76805  CPT Code
76810  CPT Code
76811  CPT Code
76812  CPT Code
76813  CPT Code
76814  CPT Code
76815  CPT Code
76816  CPT Code
76817  CPT Code
76818  CPT Code
76819  CPT Code
76820  CPT Code
76821  CPT Code
76825  CPT Code
76826  CPT Code
76827  CPT Code
76828  CPT Code
76830  CPT Code
76831  CPT Code
76856  CPT Code
76857  CPT Code
76870  CPT Code
76872  CPT Code
76873  CPT Code
76880  CPT Code
76881  CPT Code
76882  CPT Code
76885  CPT Code
76886  CPT Code
76930  CPT Code
76932  CPT Code
76937  CPT Code
76940  CPT Code
76945  CPT Code
76970  CPT Code
76975  CPT Code
76977  CPT Code
76978  CPT Code
76979  CPT Code
76981  CPT Code
76982  CPT Code
76983  CPT Code
76998  CPT Code
76999  CPT Code
77001  CPT Code
77002  CPT Code
77003  CPT Code
77011  CPT Code
77012  CPT Code
77013  CPT Code
77014  CPT Code
77021  CPT Code
77022  CPT Code
77031  CPT Code
77032  CPT Code
77046  CPT Code
77047  CPT Code
77048  CPT Code
77049  CPT Code
77051  CPT Code
77053  CPT Code
77054  CPT Code
77055  CPT Code
77056  CPT Code
77058  CPT Code
77059  CPT Code
77061  CPT Code
77062  CPT Code
77063  CPT Code
77065  CPT Code
77066  CPT Code
77067  CPT Code
77071  CPT Code
77072  CPT Code
77073  CPT Code
77074  CPT Code
77075  CPT Code
77076  CPT Code
77077  CPT Code
77078  CPT Code
77079  CPT Code
77080  CPT Code
77081  CPT Code
77082  CPT Code
77083  CPT Code
77084  CPT Code
77371  CPT Code
77372  CPT Code
77373  CPT Code
77424  CPT Code
77425  CPT Code
77469  CPT Code
78000  CPT Code
78001  CPT Code
78003  CPT Code
78006  CPT Code
78007  CPT Code
78010  CPT Code
78011  CPT Code
78012  CPT Code
78013  CPT Code
78014  CPT Code
78015  CPT Code
78016  CPT Code
78018  CPT Code
78020  CPT Code
78070  CPT Code
78071  CPT Code
78072  CPT Code
78075  CPT Code
78099  CPT Code
78102  CPT Code
78103  CPT Code
78104  CPT Code
78110  CPT Code
78111  CPT Code
78120  CPT Code
78121  CPT Code
78122  CPT Code
78130  CPT Code
78135  CPT Code
78140  CPT Code
78185  CPT Code
78190  CPT Code
78191  CPT Code
78195  CPT Code
78199  CPT Code
78201  CPT Code
78202  CPT Code
78205  CPT Code
78206  CPT Code
78215  CPT Code
78216  CPT Code
78220  CPT Code
78223  CPT Code
78226  CPT Code
78227  CPT Code
78230  CPT Code
78231  CPT Code
78232  CPT Code
78258  CPT Code
78261  CPT Code
78262  CPT Code
78264  CPT Code
78270  CPT Code
78271  CPT Code
78272  CPT Code
78278  CPT Code
78282  CPT Code
78290  CPT Code
78291  CPT Code
78299  CPT Code
78300  CPT Code
78305  CPT Code
78306  CPT Code
78315  CPT Code
78320  CPT Code
78350  CPT Code
78351  CPT Code
78399  CPT Code
78414  CPT Code
78428  CPT Code
78445  CPT Code
78451  CPT Code
78452  CPT Code
78453  CPT Code
78454  CPT Code
78456  CPT Code
78457  CPT Code
78458  CPT Code
78459  CPT Code
78460  CPT Code
78461  CPT Code
78464  CPT Code
78465  CPT Code
78466  CPT Code
78468  CPT Code
78469  CPT Code
78472  CPT Code
78473  CPT Code
78478  CPT Code
78480  CPT Code
78481  CPT Code
78483  CPT Code
78491  CPT Code
78492  CPT Code
78494  CPT Code
78496  CPT Code
78499  CPT Code
78579  CPT Code
78580  CPT Code
78582  CPT Code
78584  CPT Code
78585  CPT Code
78586  CPT Code
78587  CPT Code
78588  CPT Code
78591  CPT Code
78593  CPT Code
78594  CPT Code
78596  CPT Code
78597  CPT Code
78598  CPT Code
78599  CPT Code
78600  CPT Code
78601  CPT Code
78605  CPT Code
78606  CPT Code
78607  CPT Code
78608  CPT Code
78609  CPT Code
78610  CPT Code
78615  CPT Code
78630  CPT Code
78635  CPT Code
78645  CPT Code
78647  CPT Code
78650  CPT Code
78660  CPT Code
78699  CPT Code
78700  CPT Code
78701  CPT Code
78707  CPT Code
78708  CPT Code
78709  CPT Code
78710  CPT Code
78725  CPT Code
78730  CPT Code
78740  CPT Code
78761  CPT Code
78799  CPT Code
78800  CPT Code
78801  CPT Code
78802  CPT Code
78803  CPT Code
78804  CPT Code
78805  CPT Code
78806  CPT Code
78807  CPT Code
78811  CPT Code
78812  CPT Code
78813  CPT Code
78814  CPT Code
78815  CPT Code
78816  CPT Code
78890  CPT Code
78891  CPT Code
78999  CPT Code
79005  CPT Code
79101  CPT Code
79445  CPT Code
91110  CPT Code
91111  CPT Code
92978  CPT Code
92979  CPT Code
93555  CPT Code
93556  CPT Code
95965  CPT Code
95966  CPT Code
95967  CPT Code
96020  CPT Code

HCPCS codes

CodeDescription
A4641  Radiopharmaceutical, diagnostic, not otherwise classified  
A4642  Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries  
A4643  SUPPLY OF ADDITIONAL HIGH DOSE CONTRAST MATERIAL(S) DURING MAGNETIC RESONANCE IMAGING, E.G., GADOTERIDOL INJECTION  
A4644  SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (100-199 MGS OF IODINE)  
A4645  SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (200-299 MGS OF IODINE)  
A4646  SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (300-399 MGS OF IODINE)  
A4647  SUPPLY OF PARAMAGNETIC CONTRAST MATERIAL, EG., GADOLINIUM  
A9500  Technetium tc-99m sestamibi, diagnostic, per study dose  
A9501  Technetium tc-99m teboroxime, diagnostic, per study dose  
A9502  Technetium tc-99m tetrofosmin, diagnostic, per study dose  
A9503  Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries  
A9504  Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries  
A9505  Thallium tl-201 thallous chloride, diagnostic, per millicurie  
A9507  Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries  
A9508  Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie  
A9509  Iodine i-123 sodium iodide, diagnostic, per millicurie  
A9510  Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries  
A9511  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M, DEPREOTIDE, PER MCI  
A9512  Technetium tc-99m pertechnetate, diagnostic, per millicurie  
A9513  Lutetium lu 177, dotatate, therapeutic, 1 millicurie  
A9514  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M PYROPHOSPHATE, PER MCI  
A9515  Choline c-11, diagnostic, per study dose up to 20 millicuries  
A9516  Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries  
A9519  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, PER MCI  
A9520  Technetium tc-99m, tilmanocept, diagnostic, up to 0.5 millicuries  
A9521  Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries  
A9522  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM-111 IBRITUMOMAB TIUXETAN, PER MCI  
A9524  Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries  
A9525  SUPPLY OF LOW OR ISO-OSMOLAR CONTRAST MATERIAL, 10 MG OF IODINE  
A9526  Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries  
A9527  Iodine i-125, sodium iodide solution, therapeutic, per millicurie  
A9528  Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie  
A9529  Iodine i-131 sodium iodide solution, diagnostic, per millicurie  
A9531  Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)  
A9533  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, I-131 TOSITUMOMAB, PER MILLICURIE  
A9535  INJECTION, METHYLENE BLUE, 1 ML  
A9536  Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries  
A9537  Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries  
A9538  Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries  
A9539  Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries  
A9540  Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries  
A9541  Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries  
A9542  Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries  
A9544  Iodine i-131 tositumomab, diagnostic, per study dose  
A9546  Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie  
A9547  Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie  
A9548  Indium in-111 pentetate, diagnostic, per 0.5 millicurie  
A9549  TECHNETIUM TC-99M ARCITUMOMAB, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES  
A9550  Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie  
A9551  Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries  
A9552  Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries  
A9553  Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries  
A9554  Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries  
A9555  Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries  
A9556  Gallium ga-67 citrate, diagnostic, per millicurie  
A9557  Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries  
A9558  Xenon xe-133 gas, diagnostic, per 10 millicuries  
A9559  Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie  
A9560  Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries  
A9561  Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries  
A9562  Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries  
A9565  INDIUM IN-111 PENTETREOTIDE, DIAGNOSTIC, PER MILLICURIE  
A9566  Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries  
A9567  Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries  
A9568  Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries  
A9569  Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose  
A9570  Indium in-111 labeled autologous white blood cells, diagnostic, per study dose  
A9571  Indium in-111 labeled autologous platelets, diagnostic, per study dose  
A9572  Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries  
A9575  Injection, gadoterate meglumine, 0.1 ml  
A9576  Injection, gadoteridol, (prohance multipack), per ml  
A9577  Injection, gadobenate dimeglumine (multihance), per ml  
A9578  Injection, gadobenate dimeglumine (multihance multipack), per ml  
A9579  Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml  
A9580  Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries  
A9582  Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries  
A9583  Injection, gadofosveset trisodium, 1 ml  
A9584  Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries  
A9585  Injection, gadobutrol, 0.1 ml  
A9586  Florbetapir f18, diagnostic, per study dose, up to 10 millicuries  
A9698  Non-radioactive contrast imaging material, not otherwise classified, per study  
C1079  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CYANOCOBALAMIN CO 57/58, PER 0.5 MICROCURIE  
C1080  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, I-131 TOSITUMOMAB, PER DOSE  
C1082  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM-111 IBRITUMOMAB TIUXETAN, PER DOSE  
C1091  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM 111 OXYQUINOLINE, PER 0.5 MILLICURIE  
C1092  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM 111 PENTETATE, PER 0.5 MILLICURIE  
C1093  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M FANOLESOMAB, PER DOSE (10 - 20 MCI)  
C1122  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M ARCITUMOMAB, PER VIAL  
C1200  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M SODIUM GLUCOHEPTONATE, PER VIAL  
C1201  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M SUCCIMER, PER VIAL  
C1775  SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, FLUORODEOXYGLUCOSE F18 (2-DEOXY-2-[18F]FLUORO-D-GLUCOSE), PER DOSE (4-40 MCI/ML)  
C2637  Brachytherapy source, non-stranded, ytterbium-169, per source  
C2639  Brachytherapy source, non-stranded, iodine-125, per source  
C2640  Brachytherapy source, stranded, palladium-103, per source  
C2641  Brachytherapy source, non-stranded, palladium-103, per source  
C2642  Brachytherapy source, stranded, cesium-131, per source  
C2643  Brachytherapy source, non-stranded, cesium-131, per source  
C2698  Brachytherapy source, stranded, not otherwise specified, per source  
C2699  Brachytherapy source, non-stranded, not otherwise specified, per source  
C5271  Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area  
C5272  Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition  
C5273  Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c  
C5274  Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each  
C5275  Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq  
C5276  Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio  
C5277  Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100  
C5278  Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100  
C8900  Magnetic resonance angiography with contrast, abdomen  
C8901  Magnetic resonance angiography without contrast, abdomen  
C8902  Magnetic resonance angiography without contrast followed by with contrast, abdomen  
C8903  Magnetic resonance imaging with contrast, breast; unilateral  
C8904  Magnetic resonance imaging without contrast, breast; unilateral  
C8905  Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral  
C8906  Magnetic resonance imaging with contrast, breast; bilateral  
C8907  Magnetic resonance imaging without contrast, breast; bilateral  
C8908  Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral  
C8909  Magnetic resonance angiography with contrast, chest (excluding myocardium)  
C8910  Magnetic resonance angiography without contrast, chest (excluding myocardium)  
C8911  Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)  
C8912  Magnetic resonance angiography with contrast, lower extremity  
C8913  Magnetic resonance angiography without contrast, lower extremity  
C8914  Magnetic resonance angiography without contrast followed by with contrast, lower extremity  
C8918  Magnetic resonance angiography with contrast, pelvis  
C8919  Magnetic resonance angiography without contrast, pelvis  
C8920  Magnetic resonance angiography without contrast followed by with contrast, pelvis  
C8921  Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete  
C8922  Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study  
C8923  Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography  
C8924  Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study  
C8925  Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report  
C8926  Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report  
C8927  Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis  
C8928  Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report  
C8929  Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography  
C8930  Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision  
C8931  Magnetic resonance angiography with contrast, spinal canal and contents  
C8932  Magnetic resonance angiography without contrast, spinal canal and contents  
C8933  Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents  
C8934  Magnetic resonance angiography with contrast, upper extremity  
C8935  Magnetic resonance angiography without contrast, upper extremity  
C8936  Magnetic resonance angiography without contrast followed by with contrast, upper extremity  
C9275  Injection, hexaminolevulinate hydrochloride, 100 mg, per study dose  
C9406  Iodine i-123 ioflupane, diagnostic, per study dose, up to 5 millicuries  
C9733  Non-ophthalmic fluorescent vascular angiography  
C9756  Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in addition to code for primary procedure)  
G0030  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING PREVIOUS PET, G0030-G0047); SINGLE  
G0031  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING PREVIOUS PET, G0030-G0047); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0032  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST SPECT, 78464); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0033  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST SPECT, 78464); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0034  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS SPECT, 78465); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0035  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS SPECT, 78465); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0036  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING CORONARY ANGIOGRAPHY, 93510-93529); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0037  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING CORONARY ANGIOGRAPHY, 93510-93529); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0038  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS PLANAR MYOCARDIAL PERFUSION, 78460); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0039  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS PLANAR MYOCARDIAL PERFUSION, 78460); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0040  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECHOCARDIOGRAM, 93350); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0041  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECHOCARDIOGRAM, 93350); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0042  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS NUCLEAR VENTRICULOGRAM, 78481 OR 78483); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0043  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS NUCLEAR VENTRICULOGRAM, 78481 OR 78483); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0044  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST ECG, 93000); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0045  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST ECG, 93000); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0046  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECG, 93015); SINGLE STUDY, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0047  PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECG, 93015); MULTIPLE STUDIES, REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)  
G0106  Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema  
G0120  Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.  
G0122  Colorectal cancer screening; barium enema  
G0125  PET IMAGING REGIONAL OR WHOLE BODY; SINGLE PULMONARY NODULE  
G0130  Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)  
G0204  Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral  
G0206  Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral  
G0210  PET IMAGING WHOLE BODY; DIAGNOSIS; LUNG CANCER, NON-SMALL CELL  
G0211  PET IMAGING WHOLE BODY; INITIAL STAGING; LUNG CANCER; NON-SMALL CELL (REPLACES G0126)  
G0212  PET IMAGING WHOLE BODY; RESTAGING; LUNG CANCER; NON-SMALL  
G0213  PET IMAGING WHOLE BODY; DIAGNOSIS; COLORECTAL  
G0214  PET IMAGING WHOLE BODY; INITIAL STAGING; COLORECTAL  
G0215  PET IMAGING WHOLE BODY; RESTAGING; COLORECTAL CANCER (REPLACES G0163)  
G0216  PET IMAGING WHOLE BODY; DIAGNOSIS; MELANOMA  
G0217  PET IMAGING WHOLE BODY; INITIAL STAGING; MELANOMA  
G0218  PET IMAGING WHOLE BODY; RESTAGING; MELANOMA (REPLACES G0165)  
G0219  Pet imaging whole body; melanoma for non-covered indications  
G0220  PET IMAGING WHOLE BODY; DIAGNOSIS; LYMPHOMA  
G0221  PET IMAGING WHOLE BODY; INITIAL STAGING; LYMPHOMA (REPLACES G0164)  
G0222  PET IMAGING WHOLE BODY; RESTAGING; LYMPHOMA (REPLACES G0164)  
G0223  PET IMAGING WHOLE BODY OR REGIONAL; DIAGNOSIS; HEAD AND NECK CANCER; EXCLUDING THYROID AND CNS CANCERS  
G0224  PET IMAGING WHOLE BODY OR REGIONAL; INITIAL STAGING; HEAD AND NECK CANCER; EXCLUDING THYROID AND CNS CANCERS  
G0225  PET IMAGING WHOLE BODY OR REGIONAL; RESTAGING; HEAD AND NECK CANCER, EXCLUDING THYROID AND CNS CANCERS  
G0226  PET IMAGING WHOLE BODY; DIAGNOSIS; ESOPHAGEAL CANCER  
G0227  PET IMAGING WHOLE BODY; INITIAL STAGING; ESOPHAGEAL CANCER  
G0228  PET IMAGING WHOLE BODY; RESTAGING; ESOPHAGEAL CANCER  
G0229  PET IMAGING; METABOLIC BRAIN IMAGING FOR PRE-SURGICAL EVALUATION OF REFRACTORY SEIZURES  
G0230  PET IMAGING; METABOLIC ASSESSMENT FOR MYOCARDIAL VIABILITY FOLLOWING INCONCLUSIVE SPECT STUDY  
G0231  PET, WHOLE BODY, FOR RECURRENCE OF COLORECTAL OR COLORECTAL METASTATIC CANCER; GAMMA CAMERAS ONLY  
G0232  PET, WHOLE BODY, FOR STAGING AND CHARACTERIZATION OF LYMPHOMA; GAMMA CAMERAS ONLY  
G0233  PET, WHOLE BODY, FOR RECURRENCE OF MELANOMA OR MELANOMA METASTATIC CANCER; GAMMA CAMERAS ONLY  
G0234  PET, REGIONAL OR WHOLE BODY, FOR SOLITARY PULMONARY NODULE FOLLOWING CT OR FOR INITIAL STAGING OF PATHOLOGICALLY DIAGNOSED NONSMALL CELL LUNG CANCER; GAMMA CAMERAS ONLY  
G0251  Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment  
G0252  Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g. initial staging of axillary lymph nodes)  
G0253  PET IMAGING FOR BREAST CANCER, FULL AND PARTIAL-RING PET SCANNERS ONLY, STAGING/RESTAGING OF LOCAL REGIONAL RECURRENCE OR DISTANT METASTASES (I.E., STAGING/RESTAGING AFTER OR PRIOR TO COURSE OF TREATMENT)  
G0254  PET IMAGING FOR BREAST CANCER, FULL AND PARTIAL- RING PET SCANNERS ONLY, EVALUATION OF RESPONSE TO TREATMENT, PERFORMED DURING COURSE OF TREATMENT  
G0255  Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve  
G0288  Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery  
G0296  Counseling visit to discuss need for lung cancer screening (ldct) using low dose ct scan (service is for eligibility determination and shared decision making)  
G0336  PET IMAGING, BRAIN IMAGING FOR THE DIFFERENTIAL DIAGNOSIS OF ALZHEIMER'S DISEASE WITH ABERRANT FEATURES VS FRONTO-TEMPORAL DEMENTIA  
G0389  Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening  
Q0092  Set-up portable x-ray equipment  
Q9945  LOW OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML  
Q9946  LOW OSMOLAR CONTRAST MATERIAL, 150-199 MG/ML IODINE CONCENTRATION, PER ML  
Q9947  LOW OSMOLAR CONTRAST MATERIAL, 200-249 MG/ML IODINE CONCENTRATION, PER ML  
Q9948  LOW OSMOLAR CONTRAST MATERIAL, 250-299 MG/ML IODINE CONCENTRATION, PER ML  
Q9949  LOW OSMOLAR CONTRAST MATERIAL, 300-349 MG/ML IODINE CONCENTRATION, PER ML  
Q9950  Injection, sulfur hexafluoride lipid microspheres, per ml  
Q9951  Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml  
Q9952  INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, PER ML  
Q9953  Injection, iron-based magnetic resonance contrast agent, per ml  
Q9954  Oral magnetic resonance contrast agent, per 100 ml  
Q9955  Injection, perflexane lipid microspheres, per ml  
Q9956  Injection, octafluoropropane microspheres, per ml  
Q9957  Injection, perflutren lipid microspheres, per ml  
Q9958  High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml  
Q9959  High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml  
Q9960  High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml  
Q9961  High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml  
Q9962  High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml  
Q9963  High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml  
Q9964  High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml  
Q9965  Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml  
Q9966  Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml  
Q9967  Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml  
Q9968  Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg  
R0070  Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen  
R0075  Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen  
S8037  Magnetic resonance cholangiopancreatography (mrcp)  
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