Type of Service (TOS) Indicator S: Surgical Dressings or Other Medical Supplies

HCPCS codes

CodeDescription
A4206  Syringe with needle, sterile, 1 cc or less, each  
A4207  Syringe with needle, sterile 2 cc, each  
A4208  Syringe with needle, sterile 3 cc, each  
A4209  Syringe with needle, sterile 5 cc or greater, each  
A4210  Needle-free injection device, each  
A4211  Supplies for self-administered injections  
A4212  Non-coring needle or stylet with or without catheter  
A4213  Syringe, sterile, 20 cc or greater, each  
A4215  Needle, sterile, any size, each  
A4244  Alcohol or peroxide, per pint  
A4245  Alcohol wipes, per box  
A4246  Betadine or phisohex solution, per pint  
A4247  Betadine or iodine swabs/wipes, per box  
A4300  Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access  
A4301  Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)  
A4450  Tape, non-waterproof, per 18 square inches  
A4452  Tape, waterproof, per 18 square inches  
A4461  Surgical dressing holder, non-reusable, each  
A4462  ABDOMINAL DRESSING HOLDER, EACH  
A4463  Surgical dressing holder, reusable, each  
A4648  Tissue marker, implantable, any type, each  
A4650  Implantable radiation dosimeter, each  
A6010  Collagen based wound filler, dry form, sterile, per gram of collagen  
A6011  Collagen based wound filler, gel/paste, per gram of collagen  
A6021  Collagen dressing, sterile, size 16 sq. in. or less, each  
A6022  Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each  
A6023  Collagen dressing, sterile, size more than 48 sq. in., each  
A6024  Collagen dressing wound filler, sterile, per 6 inches  
A6154  Wound pouch, each  
A6196  Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing  
A6197  Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing  
A6198  Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing  
A6199  Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches  
A6200  COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING  
A6201  COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING  
A6202  COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING  
A6203  Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing  
A6204  Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing  
A6205  Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing  
A6206  Contact layer, sterile, 16 sq. in. or less, each dressing  
A6207  Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing  
A6208  Contact layer, sterile, more than 48 sq. in., each dressing  
A6209  Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6210  Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6211  Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6212  Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing  
A6213  Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing  
A6214  Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing  
A6215  Foam dressing, wound filler, sterile, per gram  
A6216  Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6217  Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6218  Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6219  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing  
A6220  Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing  
A6221  Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing  
A6222  Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6223  Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6224  Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6228  Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6229  Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6230  Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6231  Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing  
A6232  Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing  
A6233  Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing  
A6234  Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6235  Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6236  Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6237  Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing  
A6238  Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing  
A6239  Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing  
A6240  Hydrocolloid dressing, wound filler, paste, sterile, per ounce  
A6241  Hydrocolloid dressing, wound filler, dry form, sterile, per gram  
A6242  Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6243  Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6244  Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6245  Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing  
A6246  Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing  
A6247  Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing  
A6248  Hydrogel dressing, wound filler, gel, per fluid ounce  
A6250  Skin sealants, protectants, moisturizers, ointments, any type, any size  
A6251  Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6252  Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6253  Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6254  Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing  
A6255  Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing  
A6256  Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing  
A6257  Transparent film, sterile, 16 sq. in. or less, each dressing  
A6258  Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing  
A6259  Transparent film, sterile, more than 48 sq. in., each dressing  
A6260  Wound cleansers, any type, any size  
A6261  Wound filler, gel/paste, per fluid ounce, not otherwise specified  
A6262  Wound filler, dry form, per gram, not otherwise specified  
A6266  Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard  
A6402  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6403  Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing  
A6404  Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing  
A6407  Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard  
A6410  Eye pad, sterile, each  
A6411  Eye pad, non-sterile, each  
A6412  Eye patch, occlusive, each  
A6441  Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard  
A6442  Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard  
A6443  Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard  
A6444  Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard  
A6445  Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard  
A6446  Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard  
A6447  Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard  
A6448  Light compression bandage, elastic, knitted/woven, width less than three inches, per yard  
A6449  Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard  
A6450  Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard  
A6451  Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard  
A6452  High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard  
A6453  Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard  
A6454  Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard  
A6455  Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard  
A6456  Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard  
A6457  Tubular dressing with or without elastic, any width, per linear yard  
A6460  Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing  
A6461  Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing  
A6501  Compression burn garment, bodysuit (head to foot), custom fabricated  
A6502  Compression burn garment, chin strap, custom fabricated  
A6503  Compression burn garment, facial hood, custom fabricated  
A6504  Compression burn garment, glove to wrist, custom fabricated  
A6505  Compression burn garment, glove to elbow, custom fabricated  
A6506  Compression burn garment, glove to axilla, custom fabricated  
A6507  Compression burn garment, foot to knee length, custom fabricated  
A6508  Compression burn garment, foot to thigh length, custom fabricated  
A6509  Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated  
A6510  Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated  
A6511  Compression burn garment, lower trunk including leg openings (panty), custom fabricated  
A6512  Compression burn garment, not otherwise classified  
A6531  Gradient compression stocking, below knee, 30-40 mmhg, each  
A6532  Gradient compression stocking, below knee, 40-50 mmhg, each  
A6545  Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each  
C1713  Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)  
C1714  Catheter, transluminal atherectomy, directional  
C1715  Brachytherapy needle  
C1716  Brachytherapy source, non-stranded, gold-198, per source  
C1717  Brachytherapy source, non-stranded, high dose rate iridium-192, per source  
C1718  BRACHYTHERAPY SOURCE, IODINE 125, PER SOURCE  
C1719  Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source  
C1720  BRACHYTHERAPY SOURCE, PALLADIUM 103, PER SOURCE  
C1721  Cardioverter-defibrillator, dual chamber (implantable)  
C1722  Cardioverter-defibrillator, single chamber (implantable)  
C1724  Catheter, transluminal atherectomy, rotational  
C1725  Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)  
C1726  Catheter, balloon dilatation, non-vascular  
C1727  Catheter, balloon tissue dissector, non-vascular (insertable)  
C1728  Catheter, brachytherapy seed administration  
C1729  Catheter, drainage  
C1730  Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)  
C1731  Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes)  
C1732  Catheter, electrophysiology, diagnostic/ablation, 3d or vector mapping  
C1733  Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, other than cool-tip  
C1734  Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)  
C1749  Endoscope, retrograde imaging/illumination colonoscope device (implantable)  
C1750  Catheter, hemodialysis/peritoneal, long-term  
C1751  Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)  
C1752  Catheter, hemodialysis/peritoneal, short-term  
C1753  Catheter, intravascular ultrasound  
C1754  Catheter, intradiscal  
C1755  Catheter, intraspinal  
C1756  Catheter, pacing, transesophageal  
C1757  Catheter, thrombectomy/embolectomy  
C1758  Catheter, ureteral  
C1759  Catheter, intracardiac echocardiography  
C1760  Closure device, vascular (implantable/insertable)  
C1762  Connective tissue, human (includes fascia lata)  
C1763  Connective tissue, non-human (includes synthetic)  
C1764  Event recorder, cardiac (implantable)  
C1765  Adhesion barrier  
C1766  Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away  
C1767  Generator, neurostimulator (implantable), non-rechargeable  
C1768  Graft, vascular  
C1769  Guide wire  
C1770  Imaging coil, magnetic resonance (insertable)  
C1771  Repair device, urinary, incontinence, with sling graft  
C1772  Infusion pump, programmable (implantable)  
C1773  Retrieval device, insertable (used to retrieve fractured medical devices)  
C1776  Joint device (implantable)  
C1777  Lead, cardioverter-defibrillator, endocardial single coil (implantable)  
C1778  Lead, neurostimulator (implantable)  
C1779  Lead, pacemaker, transvenous vdd single pass  
C1780  Lens, intraocular (new technology)  
C1781  Mesh (implantable)  
C1782  Morcellator  
C1783  Ocular implant, aqueous drainage assist device  
C1784  Ocular device, intraoperative, detached retina  
C1785  Pacemaker, dual chamber, rate-responsive (implantable)  
C1786  Pacemaker, single chamber, rate-responsive (implantable)  
C1787  Patient programmer, neurostimulator  
C1788  Port, indwelling (implantable)  
C1789  Prosthesis, breast (implantable)  
C1813  Prosthesis, penile, inflatable  
C1814  Retinal tamponade device, silicone oil  
C1815  Prosthesis, urinary sphincter (implantable)  
C1816  Receiver and/or transmitter, neurostimulator (implantable)  
C1817  Septal defect implant system, intracardiac  
C1818  Integrated keratoprosthesis  
C1819  Surgical tissue localization and excision device (implantable)  
C1820  Generator, neurostimulator (implantable), with rechargeable battery and charging system  
C1821  Interspinous process distraction device (implantable)  
C1822  Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system  
C1823  Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads  
C1824  Generator, cardiac contractility modulation (implantable)  
C1830  Powered bone marrow biopsy needle  
C1839  Iris prosthesis  
C1840  Lens, intraocular (telescopic)  
C1841  Retinal prosthesis, includes all internal and external components  
C1842  Retinal prosthesis, includes all internal and external components; add-on to c1841  
C1874  Stent, coated/covered, with delivery system  
C1875  Stent, coated/covered, without delivery system  
C1876  Stent, non-coated/non-covered, with delivery system  
C1877  Stent, non-coated/non-covered, without delivery system  
C1878  Material for vocal cord medialization, synthetic (implantable)  
C1879  Tissue marker (implantable)  
C1880  Vena cava filter  
C1881  Dialysis access system (implantable)  
C1882  Cardioverter-defibrillator, other than single or dual chamber (implantable)  
C1883  Adapter/extension, pacing lead or neurostimulator lead (implantable)  
C1884  Embolization protective system  
C1885  Catheter, transluminal angioplasty, laser  
C1886  Catheter, extravascular tissue ablation, any modality (insertable)  
C1887  Catheter, guiding (may include infusion/perfusion capability)  
C1888  Catheter, ablation, non-cardiac, endovascular (implantable)  
C1889  Implantable/insertable device, not otherwise classified  
C1890  No implantable/insertable device used with device-intensive procedures  
C1891  Infusion pump, non-programmable, permanent (implantable)  
C1892  Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away  
C1893  Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away  
C1894  Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser  
C1895  Lead, cardioverter-defibrillator, endocardial dual coil (implantable)  
C1896  Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)  
C1897  Lead, neurostimulator test kit (implantable)  
C1898  Lead, pacemaker, other than transvenous vdd single pass  
C1899  Lead, pacemaker/cardioverter-defibrillator combination (implantable)  
C1900  Lead, left ventricular coronary venous system  
C1982  Catheter, pressure-generating, one-way valve, intermittently occlusive  
C2596  Probe, image-guided, robotic, waterjet ablation  
C2613  Lung biopsy plug with delivery system  
C2614  Probe, percutaneous lumbar discectomy  
C2615  Sealant, pulmonary, liquid  
C2616  Brachytherapy source, non-stranded, yttrium-90, per source  
C2617  Stent, non-coronary, temporary, without delivery system  
C2618  Probe/needle, cryoablation  
C2619  Pacemaker, dual chamber, non rate-responsive (implantable)  
C2620  Pacemaker, single chamber, non rate-responsive (implantable)  
C2621  Pacemaker, other than single or dual chamber (implantable)  
C2622  Prosthesis, penile, non-inflatable  
C2623  Catheter, transluminal angioplasty, drug-coated, non-laser  
C2624  Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components  
C2625  Stent, non-coronary, temporary, with delivery system  
C2626  Infusion pump, non-programmable, temporary (implantable)  
C2627  Catheter, suprapubic/cystoscopic  
C2628  Catheter, occlusion  
C2629  Introducer/sheath, other than guiding, other than intracardiac electrophysiological, laser  
C2630  Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, cool-tip  
C2631  Repair device, urinary, incontinence, without sling graft  
C2633  BRACHYTHERAPY SOURCE, CESIUM-131, PER SOURCE  
J7350  DERMAL (SUBSTITUTE) TISSUE OF HUMAN ORIGIN, INJECTABLE, WITH OR WITHOUT OTHER BIOENGINEERED OR PROCESSED ELEMENTS, BUT WITHOUT METABOLIZED ACTIVE ELEMENTS, PER 10 MG  
K0620  TUBULAR ELASTIC DRESSING, ANY WIDTH, PER LINEAR YARD  
K0744  Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less  
K0745  Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches  
K0746  Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches  
L8110  GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, EACH  
L8120  GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, EACH  
Q0182  DERMAL AND EPIDERMAL, TISSUE OF NON-HUMAN ORIGIN, WITH OR WITHOUT OTHER BIOENGINEERED OR PROCESSED ELEMENTS, WITHOUT METABOLICALLY ACTIVE ELEMENTS, PER SQUARE CENTIMETER  
Q0183  DERMAL TISSUE, OF HUMAN ORIGIN, WITH AND WITHOUT OTHER BIOENGINEERED OR PROCESSED ELEMENTS, BUT WITHOUT METABOLICALLY ACTIVE ELEMENTS, PER SQUARE CENTIMETER  
Q4001  Casting supplies, body cast adult, with or without head, plaster  
Q4002  Cast supplies, body cast adult, with or without head, fiberglass  
Q4003  Cast supplies, shoulder cast, adult (11 years +), plaster  
Q4004  Cast supplies, shoulder cast, adult (11 years +), fiberglass  
Q4005  Cast supplies, long arm cast, adult (11 years +), plaster  
Q4006  Cast supplies, long arm cast, adult (11 years +), fiberglass  
Q4007  Cast supplies, long arm cast, pediatric (0-10 years), plaster  
Q4008  Cast supplies, long arm cast, pediatric (0-10 years), fiberglass  
Q4009  Cast supplies, short arm cast, adult (11 years +), plaster  
Q4010  Cast supplies, short arm cast, adult (11 years +), fiberglass  
Q4011  Cast supplies, short arm cast, pediatric (0-10 years), plaster  
Q4012  Cast supplies, short arm cast, pediatric (0-10 years), fiberglass  
Q4013  Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster  
Q4014  Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass  
Q4015  Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster  
Q4016  Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass  
Q4017  Cast supplies, long arm splint, adult (11 years +), plaster  
Q4018  Cast supplies, long arm splint, adult (11 years +), fiberglass  
Q4019  Cast supplies, long arm splint, pediatric (0-10 years), plaster  
Q4020  Cast supplies, long arm splint, pediatric (0-10 years), fiberglass  
Q4021  Cast supplies, short arm splint, adult (11 years +), plaster  
Q4022  Cast supplies, short arm splint, adult (11 years +), fiberglass  
Q4023  Cast supplies, short arm splint, pediatric (0-10 years), plaster  
Q4024  Cast supplies, short arm splint, pediatric (0-10 years), fiberglass  
Q4025  Cast supplies, hip spica (one or both legs), adult (11 years +), plaster  
Q4026  Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass  
Q4027  Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster  
Q4028  Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass  
Q4029  Cast supplies, long leg cast, adult (11 years +), plaster  
Q4030  Cast supplies, long leg cast, adult (11 years +), fiberglass  
Q4031  Cast supplies, long leg cast, pediatric (0-10 years), plaster  
Q4032  Cast supplies, long leg cast, pediatric (0-10 years), fiberglass  
Q4033  Cast supplies, long leg cylinder cast, adult (11 years +), plaster  
Q4034  Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass  
Q4035  Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster  
Q4036  Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass  
Q4037  Cast supplies, short leg cast, adult (11 years +), plaster  
Q4038  Cast supplies, short leg cast, adult (11 years +), fiberglass  
Q4039  Cast supplies, short leg cast, pediatric (0-10 years), plaster  
Q4040  Cast supplies, short leg cast, pediatric (0-10 years), fiberglass  
Q4041  Cast supplies, long leg splint, adult (11 years +), plaster  
Q4042  Cast supplies, long leg splint, adult (11 years +), fiberglass  
Q4043  Cast supplies, long leg splint, pediatric (0-10 years), plaster  
Q4044  Cast supplies, long leg splint, pediatric (0-10 years), fiberglass  
Q4045  Cast supplies, short leg splint, adult (11 years +), plaster  
Q4046  Cast supplies, short leg splint, adult (11 years +), fiberglass  
Q4047  Cast supplies, short leg splint, pediatric (0-10 years), plaster  
Q4048  Cast supplies, short leg splint, pediatric (0-10 years), fiberglass  
Q4049  Finger splint, static  
Q4050  Cast supplies, for unlisted types and materials of casts  
Q4051  Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)  
S8490  Insulin syringes (100 syringes, any size)  
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