January 2019 1st QTR ASC Drug File
Effective 01/01/2019
| HCPCS Code | Status Indicator | Amount |
|---|---|---|
| A9586 | A | $3,028.84 |
| A9587 | A | $66.74 |
| A9588 | A | $389.55 |
| C9035 | A | $2.85 |
| C9036 | A | $97.85 |
| C9037 | A | $9.79 |
| C9038 | A | $195.19 |
| C9039 | A | $3.24 |
| C9132 | A | $1.94 |
| C9248 | A | $2.78 |
| C9250 | A | $156.84 |
| C9257 | A | $2.03 |
| C9290 | A | $1.22 |
| C9293 | A | $313.20 |
| C9399 | C | $0.00 |
| C9407 | A | $311.06 |
| C9447 | A | $473.24 |
| C9460 | A | $15.46 |
| C9462 | A | $0.45 |
| C9482 | A | $9.99 |
| C9488 | A | $32.07 |
| J0129 | A | $51.61 |
| J0135 | A | $1,291.09 |
| J0178 | A | $963.54 |
| J0180 | A | $178.17 |
| J0185 | A | $2.11 |
| J0202 | A | $1,882.06 |
| J0207 | A | $979.75 |
| J0220 | A | $141.14 |
| J0221 | A | $166.20 |
| J0256 | A | $4.55 |
| J0257 | A | $4.70 |
| J0287 | A | $8.07 |
| J0289 | A | $22.19 |
| J0300 | A | $56.62 |
| J0401 | A | $5.47 |
| J0475 | A | $169.75 |
| J0480 | A | $3,677.61 |
| J0485 | A | $3.79 |
| J0490 | A | $44.16 |
| J0517 | A | $167.04 |
| J0558 | A | $10.96 |
| J0561 | A | $13.85 |
| J0565 | A | $40.09 |
| J0567 | A | $93.62 |
| J0570 | A | $1,269.91 |
| J0584 | A | $353.40 |
| J0585 | A | $6.14 |
| J0586 | A | $8.53 |
| J0587 | A | $12.00 |
| J0588 | A | $5.08 |
| J0594 | A | $10.82 |
| J0596 | A | $27.46 |
| J0597 | A | $48.92 |
| J0598 | A | $54.02 |
| J0599 | A | $9.67 |
| J0600 | A | $5,594.42 |
| J0606 | A | $2.88 |
| J0630 | A | $2,651.10 |
| J0637 | A | $10.02 |
| J0638 | A | $110.99 |
| J0641 | A | $0.12 |
| J0695 | A | $5.43 |
| J0712 | A | $2.91 |
| J0714 | A | $84.23 |
| J0716 | A | $4,592.80 |
| J0717 | A | $7.89 |
| J0725 | A | $22.60 |
| J0740 | A | $522.74 |
| J0775 | A | $45.06 |
| J0795 | A | $8.93 |
| J0840 | A | $3,291.27 |
| J0841 | A | $1,256.60 |
| J0850 | A | $1,129.15 |
| J0875 | A | $13.55 |
| J0878 | A | $0.41 |
| J0881 | A | $3.83 |
| J0882 | A | $3.83 |
| J0883 | A | $1.02 |
| J0884 | A | $1.02 |
| J0885 | A | $11.95 |
| J0894 | A | $12.63 |
| J0897 | A | $18.61 |
| J1095 | A | $1.11 |
| J1162 | A | $3,687.74 |
| J1190 | A | $220.97 |
| J1212 | A | $541.61 |
| J1290 | A | $478.64 |
| J1300 | A | $230.48 |
| J1301 | A | $19.16 |
| J1322 | A | $236.96 |
| J1327 | A | $15.27 |
| J1364 | A | $78.87 |
| J1410 | A | $308.91 |
| J1428 | A | $168.01 |
| J1430 | A | $444.10 |
| J1438 | A | $645.54 |
| J1439 | A | $1.08 |
| J1442 | A | $1.00 |
| J1447 | A | $0.58 |
| J1451 | A | $8.56 |
| J1453 | A | $2.10 |
| J1454 | A | $529.52 |
| J1455 | A | $82.27 |
| J1458 | A | $390.46 |
| J1459 | A | $40.32 |
| J1460 | A | $39.97 |
| J1555 | A | $13.61 |
| J1556 | A | $70.52 |
| J1557 | A | $45.89 |
| J1559 | A | $10.11 |
| J1560 | A | $399.72 |
| J1561 | A | $40.11 |
| J1566 | A | $43.11 |
| J1568 | A | $35.47 |
| J1569 | A | $42.23 |
| J1571 | A | $64.34 |
| J1572 | A | $34.40 |
| J1573 | A | $64.34 |
| J1575 | A | $14.18 |
| J1595 | A | $194.57 |
| J1602 | A | $23.33 |
| J1610 | A | $219.92 |
| J1627 | A | $3.19 |
| J1628 | A | $97.92 |
| J1640 | A | $22.98 |
| J1670 | A | $418.61 |
| J1726 | A | $24.56 |
| J1740 | A | $55.44 |
| J1742 | A | $235.48 |
| J1743 | A | $542.92 |
| J1744 | A | $363.39 |
| J1745 | A | $76.65 |
| J1746 | A | $58.64 |
| J1750 | A | $13.62 |
| J1786 | A | $42.12 |
| J1826 | A | $2,785.97 |
| J1830 | A | $370.82 |
| J1833 | A | $0.75 |
| J1930 | A | $58.77 |
| J1931 | A | $31.22 |
| J1942 | A | $2.57 |
| J1950 | A | $1,188.99 |
| J2062 | A | $14.71 |
| J2182 | A | $29.50 |
| J2186 | A | $1.66 |
| J2265 | A | $1.65 |
| J2278 | A | $7.73 |
| J2315 | A | $3.25 |
| J2320 | A | $21.69 |
| J2323 | A | $19.73 |
| J2325 | A | $74.80 |
| J2326 | A | $1,101.72 |
| J2350 | A | $57.37 |
| J2353 | A | $197.88 |
| J2355 | A | $163.98 |
| J2357 | A | $37.05 |
| J2407 | A | $23.66 |
| J2425 | A | $20.22 |
| J2426 | A | $10.94 |
| J2469 | A | $14.95 |
| J2502 | A | $290.28 |
| J2504 | A | $367.96 |
| J2505 | A | $4,681.81 |
| J2507 | A | $2,361.05 |
| J2515 | A | $48.29 |
| J2547 | A | $1.61 |
| J2562 | A | $330.48 |
| J2597 | A | $12.46 |
| J2724 | A | $15.13 |
| J2760 | A | $379.64 |
| J2770 | A | $417.76 |
| J2778 | A | $363.98 |
| J2783 | A | $279.82 |
| J2786 | A | $9.34 |
| J2792 | A | $27.78 |
| J2794 | A | $9.41 |
| J2796 | A | $71.61 |
| J2797 | A | $0.94 |
| J2820 | A | $38.96 |
| J2840 | A | $541.13 |
| J2850 | A | $34.78 |
| J2860 | A | $95.38 |
| J2993 | A | $504.98 |
| J2997 | A | $87.75 |
| J3060 | A | $40.34 |
| J3090 | A | $1.42 |
| J3095 | A | $5.55 |
| J3101 | A | $121.81 |
| J3145 | A | $1.36 |
| J3240 | A | $1,653.59 |
| J3243 | A | $1.87 |
| J3246 | A | $7.72 |
| J3262 | A | $4.93 |
| J3285 | A | $66.13 |
| J3300 | A | $3.86 |
| J3304 | A | $18.88 |
| J3315 | A | $244.50 |
| J3316 | A | $2,875.19 |
| J3357 | A | $184.05 |
| J3358 | A | $12.19 |
| J3380 | A | $20.04 |
| J3385 | A | $345.62 |
| J3396 | A | $10.98 |
| J3397 | A | $218.77 |
| J3398 | A | $2,941.50 |
| J7170 | A | $48.60 |
| J7175 | A | $7.17 |
| J7177 | A | $1.07 |
| J7178 | A | $1.17 |
| J7179 | A | $1.96 |
| J7180 | A | $8.21 |
| J7181 | A | $14.82 |
| J7182 | A | $1.33 |
| J7183 | A | $1.02 |
| J7185 | A | $1.22 |
| J7186 | A | $1.00 |
| J7187 | A | $1.13 |
| J7188 | A | $3.05 |
| J7189 | A | $2.08 |
| J7190 | A | $1.08 |
| J7192 | A | $1.30 |
| J7193 | A | $1.14 |
| J7194 | A | $1.43 |
| J7195 | A | $1.50 |
| J7197 | A | $3.50 |
| J7198 | A | $2.00 |
| J7200 | A | $1.31 |
| J7201 | A | $3.00 |
| J7202 | A | $4.31 |
| J7203 | A | $3.65 |
| J7205 | A | $2.01 |
| J7207 | A | $1.69 |
| J7209 | A | $1.34 |
| J7210 | A | $1.36 |
| J7211 | A | $1.27 |
| J7308 | A | $404.59 |
| J7311 | A | $20,142.37 |
| J7312 | A | $200.10 |
| J7313 | A | $490.66 |
| J7316 | A | $1,046.93 |
| J7318 | A | $17.23 |
| J7320 | A | $7.20 |
| J7321 | A | $79.91 |
| J7322 | A | $19.26 |
| J7323 | A | $141.03 |
| J7324 | A | $146.91 |
| J7325 | A | $11.86 |
| J7326 | A | $1,057.88 |
| J7327 | A | $791.24 |
| J7328 | A | $2.18 |
| J7329 | A | $6.99 |
| J7336 | A | $3.15 |
| J7342 | A | $29.97 |
| J7345 | A | $1.37 |
| J7501 | A | $238.89 |
| J7504 | A | $2,066.12 |
| J7511 | A | $731.32 |
| J7525 | A | $206.01 |
| J8560 | A | $75.76 |
| J8600 | A | $12.00 |
| J8655 | A | $282.83 |
| J8670 | A | $1.31 |
| J9015 | A | $4,138.14 |
| J9017 | A | $76.91 |
| J9019 | A | $414.82 |
| J9022 | A | $77.76 |
| J9023 | A | $81.81 |
| J9025 | A | $1.31 |
| J9027 | A | $94.93 |
| J9031 | A | $140.26 |
| J9032 | A | $38.24 |
| J9033 | A | $30.27 |
| J9034 | A | $23.83 |
| J9035 | A | $81.18 |
| J9039 | A | $110.15 |
| J9041 | A | $45.61 |
| J9042 | A | $156.72 |
| J9043 | A | $168.31 |
| J9044 | A | $35.67 |
| J9047 | A | $36.30 |
| J9050 | A | $4,052.35 |
| J9055 | A | $60.57 |
| J9057 | A | $77.46 |
| J9065 | A | $21.88 |
| J9070 | A | $37.82 |
| J9098 | A | $628.37 |
| J9120 | A | $1,455.38 |
| J9145 | A | $52.30 |
| J9150 | A | $48.17 |
| J9153 | A | $190.32 |
| J9155 | A | $3.80 |
| J9171 | A | $1.35 |
| J9173 | A | $73.85 |
| J9176 | A | $6.40 |
| J9179 | A | $115.31 |
| J9202 | A | $501.21 |
| J9203 | A | $194.01 |
| J9205 | A | $45.65 |
| J9207 | A | $76.90 |
| J9213 | A | $169.33 |
| J9214 | A | $34.03 |
| J9217 | A | $236.15 |
| J9225 | A | $3,659.73 |
| J9226 | A | $31,864.23 |
| J9228 | A | $150.90 |
| J9229 | A | $2,208.27 |
| J9230 | A | $320.09 |
| J9245 | A | $804.63 |
| J9261 | A | $152.02 |
| J9262 | A | $2.98 |
| J9264 | A | $11.87 |
| J9266 | A | $15,061.17 |
| J9268 | A | $2,017.33 |
| J9270 | A | $6.12 |
| J9271 | A | $48.99 |
| J9280 | A | $125.07 |
| J9285 | A | $51.04 |
| J9293 | A | $27.58 |
| J9295 | A | $5.61 |
| J9299 | A | $27.50 |
| J9301 | A | $64.62 |
| J9302 | A | $58.49 |
| J9303 | A | $114.70 |
| J9305 | A | $68.11 |
| J9306 | A | $12.20 |
| J9307 | A | $276.23 |
| J9308 | A | $57.62 |
| J9311 | A | $46.64 |
| J9312 | A | $95.40 |
| J9315 | A | $316.78 |
| J9320 | A | $346.38 |
| J9325 | A | $50.05 |
| J9328 | A | $10.46 |
| J9330 | A | $65.56 |
| J9340 | A | $761.59 |
| J9352 | A | $300.63 |
| J9354 | A | $31.22 |
| J9355 | A | $107.00 |
| J9357 | A | $1,331.12 |
| J9371 | A | $2,916.62 |
| J9395 | A | $97.49 |
| J9400 | A | $8.08 |
| J9600 | A | $21,219.57 |
| P9041 | A | $10.49 |
| P9045 | A | $52.45 |
| P9046 | A | $20.98 |
| P9047 | A | $52.45 |
| Q0138 | A | $1.01 |
| Q0139 | A | $1.01 |
| Q2017 | A | $2,583.97 |
| Q2041 | A | $95,380.00 |
| Q2042 | A | $39,388.31 |
| Q2043 | A | $42,616.29 |
| Q2049 | A | $470.40 |
| Q2050 | A | $381.33 |
| Q3027 | A | $53.63 |
| Q4195 | A | $120.78 |
| Q4196 | A | $120.78 |
| Q5101 | A | $0.64 |
| Q5103 | A | $57.28 |
| Q5104 | A | $61.90 |
| Q5105 | A | $1.14 |
| Q5106 | A | $11.36 |
| Q5108 | A | $358.35 |
| Q5110 | A | $0.75 |
| Q5111 | A | $358.35 |
| Q9950 | A | $21.25 |
| Q9968 | A | $4.27 |
| Q9991 | A | $1,674.80 |
| Q9992 | A | $1,674.80 |
| 90371 | A | $119.54 |
| 90375 | A | $307.02 |
| 90376 | A | $311.99 |
| 90378 | A | $1,205.05 |
| 90396 | A | $1,541.50 |
| 90675 | A | $289.98 |
| 90676 | A | $130.01 |
| 90740 | C | $0.00 |
| 90743 | C | $0.00 |
| 90744 | C | $0.00 |
| 90746 | C | $0.00 |
| 90747 | C | $0.00 |
All CPT codes begin with a numeric character and all HCPCS codes begin with an alpha character.
All Current Procedural Terminology (CPT) codes and descriptors are copyrighted 2019 by the American Medical Association.

