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HCPCS Procedure & Supply Codes

Private Payer Codes

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Drugs Administered

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Injections

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S0017   Injection, aminocaproic acid, 5 grams
S0021   Injection, cefoperazone sodium, 1 gram
S0023   Injection, cimetidine hydrochloride, 300 mg
S0028   Injection, famotidine, 20 mg
S0032   Injection, nafcillin sodium, 2 grams
S0034   Injection, ofloxacin, 400 mg
S0039   Injection, sulfamethoxazole and trimethoprim, 10 ml
S0040   Injection, ticarcillin disodium and clavulanate potassium, 3.1 grams
S0074   Injection, cefotetan disodium, 500 mg
S0078   Injection, fosphenytoin sodium, 750 mg
S0080   Injection, pentamidine isethionate, 300 mg
S0081   Injection, piperacillin sodium, 500 mg
S0092   Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)
S0093   Injection, morphine sulfate, 500 mg (loading dose for infusion pump)
S0122   Injection, menotropins, 75 iu
S0126   Injection, follitropin alfa, 75 iu
S0128   Injection, follitropin beta, 75 iu
S0132   Injection, ganirelix acetate, 250 mcg
S0145   Injection, pegylated interferon alfa-2a, 180 mcg per ml
S0148   Injection, pegylated interferon alfa-2b, 10 mcg
S0164   Injection, pantoprazole sodium, 40 mg
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