Skip to Main Content

Print | Bookmark | Font Size: + |

Revised April 2022 2nd Quarter ASC Drug File

Effective 04.01.2022 Revised 04.01.2023

HCPCS Code Status Indicator Amount
A9590 A 320.12
A9591 A 677.08
A9592 A 918.36
A9593 A 732.86
A9594 A 717.55
A9595 A 558.03
C9046 A 1.25
C9047 A 691.34
C9067 A 8.64
C9088 A 0.70
C9089 A 0.83
C9090 A 31.80
C9091 A 101.58
C9092 A 42.49
C9093 A 82.40
C9250 A 193.87
C9257 A 1.74
C9290 A 1.34
C9399 C 0.00
C9460 A 16.30
C9482 A 17.58
C9488 A 43.90
J0121 A 3.30
J0129 A 43.90
J0135 A 1,698.61
J0172 A 5.64
J0178 A 914.20
J0179 A 312.28
J0180 A 198.74
J0185 A 1.73
J0202 A 2,149.00
J0207 A 1,135.69
J0219 A 72.71
J0220 A 117.07
J0221 A 181.57
J0222 A 97.85
J0223 A 106.66
J0224 A 302.28
J0256 A 4.54
J0257 A 4.97
J0287 A 9.70
J0289 A 27.38
J0291 A 3.14
J0300 A 125.22
J0390 A 165.22
J0401 A 5.99
J0475 A 179.65
J0480 A 4,062.84
J0485 A 3.78
J0490 A 48.25
J0491 A 16.21
J0517 A 165.57
J0558 A 11.78
J0561 A 15.12
J0565 A 39.87
J0570 A 1,311.75
J0584 A 380.10
J0585 A 6.19
J0586 A 8.40
J0587 A 12.17
J0588 A 5.06
J0594 A 1.91
J0596 A 30.11
J0597 A 57.33
J0598 A 58.96
J0600 A 5,708.59
J0630 A 2,644.43
J0638 A 116.94
J0642 A 1.32
J0691 A 0.72
J0695 A 6.40
J0699 A 2.01
J0712 A 3.57
J0714 A 91.79
J0716 A 4,377.00
J0717 A 5.64
J0740 A 546.20
J0741 A 20.54
J0742 A 2.31
J0745 A 135.64
J0775 A 58.79
J0791 A 124.18
J0795 A 9.67
J0840 A 2,622.69
J0841 A 918.85
J0850 A 1,526.58
J0875 A 14.47
J0881 A 3.28
J0882 A 3.28
J0883 A 1.28
J0884 A 1.28
J0885 A 8.11
J0888 A 1.56
J0894 A 2.71
J0896 A 37.40
J0897 A 21.26
J1095 A 0.92
J1096 A 133.13
J1097 A 99.20
J1162 A 4,296.54
J1190 A 181.22
J1201 A 15.11
J1212 A 636.55
J1290 A 501.36
J1300 A 228.52
J1301 A 20.99
J1303 A 224.77
J1305 A 165.63
J1322 A 250.30
J1327 A 2.69
J1410 A 341.49
J1426 A 166.25
J1427 A 58.94
J1429 A 166.19
J1430 A 457.18
J1437 A 24.22
J1438 A 790.78
J1439 A 1.14
J1442 A 0.99
J1447 A 0.44
J1448 A 4.95
J1451 A 5.64
J1454 A 464.38
J1455 A 72.67
J1458 A 411.92
J1459 A 45.05
J1460 A 46.43
J1554 A 481.77
J1555 A 14.74
J1556 A 70.49
J1557 A 50.73
J1558 A 13.66
J1559 A 11.79
J1560 A 464.27
J1561 A 43.04
J1566 A 69.93
J1568 A 41.82
J1569 A 43.88
J1571 A 76.11
J1572 A 38.72
J1573 A 76.11
J1575 A 15.25
J1595 A 140.40
J1602 A 15.01
J1610 A 169.74
J1627 A 6.57
J1628 A 81.24
J1632 A 71.00
J1640 A 26.63
J1670 A 523.73
J1726 A 16.47
J1729 A 21.54
J1738 A 2.98
J1742 A 316.20
J1744 A 211.17
J1745 A 36.51
J1746 A 66.49
J1750 A 15.77
J1786 A 43.88
J1823 A 462.87
J1826 A 2,293.85
J1830 A 354.32
J1833 A 0.84
J1930 A 65.01
J1931 A 34.78
J1943 A 2.99
J1944 A 2.93
J1950 A 1,421.56
J1951 A 126.43
J2182 A 28.75
J2186 A 1.84
J2265 A 2.14
J2278 A 9.00
J2315 A 3.54
J2323 A 23.06
J2326 A 1,122.43
J2350 A 58.49
J2353 A 207.43
J2357 A 37.27
J2358 A 2.92
J2406 A 42.38
J2407 A 24.51
J2425 A 23.93
J2426 A 12.64
J2502 A 364.14
J2506 A 167.68
J2507 A 2,985.85
J2547 A 1.68
J2560 A 41.73
J2562 A 382.65
J2597 A 8.27
J2724 A 15.12
J2760 A 377.73
J2770 A 428.33
J2778 A 281.88
J2783 A 321.80
J2786 A 10.23
J2792 A 30.62
J2794 A 11.05
J2796 A 83.90
J2798 A 10.67
J2820 A 54.04
J2840 A 539.54
J2850 A 34.78
J2860 A 128.53
J2993 A 2,151.79
J2997 A 88.28
J3031 A 2.29
J3032 A 16.01
J3060 A 40.35
J3090 A 1.66
J3095 A 6.33
J3101 A 134.76
J3111 A 9.32
J3145 A 1.66
J3240 A 1,858.66
J3241 A 315.88
J3245 A 137.27
J3246 A 3.51
J3262 A 5.82
J3285 A 56.81
J3304 A 17.50
J3315 A 347.65
J3316 A 3,060.21
J3357 A 166.35
J3358 A 11.65
J3380 A 21.72
J3385 A 359.92
J3396 A 11.24
J3398 A 2,951.10
J7168 A 2.09
J7169 A 287.37
J7170 A 48.68
J7175 A 8.20
J7178 A 1.34
J7179 A 1.81
J7180 A 9.38
J7181 A 15.68
J7182 A 1.29
J7183 A 1.13
J7185 A 1.26
J7186 A 1.15
J7187 A 1.29
J7188 A 3.20
J7189 A 2.30
J7190 A 1.07
J7192 A 1.43
J7193 A 1.18
J7194 A 1.53
J7195 A 1.58
J7197 A 3.36
J7198 A 2.21
J7200 A 1.46
J7201 A 3.25
J7202 A 4.70
J7203 A 4.07
J7204 A 2.07
J7205 A 2.13
J7207 A 1.93
J7208 A 2.09
J7209 A 1.24
J7210 A 1.38
J7211 A 1.22
J7212 A 2.01
J7308 A 392.02
J7311 A 334.36
J7312 A 200.12
J7313 A 490.95
J7314 A 518.33
J7316 A 1,046.93
J7318 A 17.74
J7320 A 16.92
J7322 A 31.67
J7323 A 131.21
J7324 A 154.75
J7325 A 10.44
J7326 A 1,219.00
J7327 A 769.61
J7328 A 2.24
J7329 A 19.12
J7331 A 18.02
J7336 A 3.24
J7340 A 211.40
J7342 A 29.98
J7345 A 1.59
J7351 A 206.04
J7352 A 2,873.33
J7402 A 10.56
J7501 A 237.87
J7504 A 2,355.95
J7511 A 842.94
J7525 A 219.71
J8560 A 75.52
J8655 A 355.57
J8670 A 1.71
J9015 A 3,795.26
J9017 A 14.21
J9019 A 427.27
J9021 A 46.53
J9022 A 79.27
J9023 A 87.48
J9025 A 0.72
J9027 A 49.37
J9032 A 44.03
J9033 A 19.37
J9034 A 18.55
J9035 A 69.49
J9036 A 21.62
J9037 A 43.16
J9039 A 124.39
J9041 A 44.70
J9042 A 196.65
J9043 A 190.95
J9044 A 15.66
J9047 A 41.34
J9050 A 801.10
J9055 A 67.64
J9057 A 80.83
J9061 A 17.90
J9065 A 17.70
J9070 A 23.88
J9071 A 3.76
J9119 A 27.62
J9120 A 809.06
J9144 A 44.88
J9145 A 56.68
J9150 A 39.58
J9153 A 212.83
J9155 A 4.05
J9173 A 77.11
J9176 A 6.86
J9177 A 31.34
J9179 A 129.35
J9198 A 25.59
J9202 A 549.64
J9203 A 211.11
J9204 A 213.20
J9205 A 57.51
J9207 A 114.38
J9210 A 364.99
J9214 A 31.86
J9217 A 168.84
J9223 A 180.49
J9225 A 5,166.29
J9226 A 42,802.12
J9227 A 68.88
J9228 A 160.83
J9229 A 2,407.20
J9230 A 11.74
J9245 A 186.85
J9246 A 19.05
J9247 A 497.24
J9261 A 136.94
J9262 A 3.30
J9264 A 14.19
J9266 A 21,561.05
J9268 A 2,065.32
J9269 A 295.90
J9270 A 115.40
J9271 A 53.70
J9272 A 215.19
J9273 A 155.95
J9280 A 48.87
J9281 A 281.22
J9285 A 52.07
J9293 A 33.92
J9295 A 5.74
J9299 A 29.24
J9301 A 63.82
J9302 A 63.96
J9303 A 130.79
J9304 A 79.25
J9305 A 76.38
J9306 A 13.56
J9307 A 321.09
J9308 A 63.69
J9309 A 113.57
J9311 A 37.96
J9312 A 85.44
J9313 A 23.39
J9316 A 70.86
J9317 A 31.26
J9318 A 33.91
J9319 A 33.23
J9320 A 348.84
J9325 A 57.17
J9328 A 10.41
J9330 A 35.35
J9340 A 306.84
J9348 A 547.14
J9349 A 12.78
J9352 A 325.03
J9353 A 43.68
J9354 A 34.14
J9355 A 88.60
J9356 A 70.96
J9357 A 1,412.23
J9358 A 24.62
J9359 A 186.83
J9371 A 3,420.78
J9395 A 11.61
J9400 A 8.22
J9600 A 21,856.35
P9041 A 10.49
P9045 A 52.45
P9046 A 20.98
P9047 A 52.45
Q0138 A 0.93
Q0139 A 0.93
Q2017 A 2,645.71
Q2026 A 257.37
Q2028 A 2.49
Q2043 A 52,916.50
Q2049 A 311.04
Q2050 A 178.82
Q3027 A 54.46
Q5101 A 0.31
Q5103 A 38.68
Q5104 A 61.10
Q5106 A 8.26
Q5107 A 36.13
Q5108 A 179.85
Q5110 A 0.36
Q5111 A 183.41
Q5112 A 76.89
Q5113 A 52.59
Q5114 A 50.11
Q5115 A 53.69
Q5116 A 51.02
Q5117 A 42.88
Q5118 A 45.86
Q5119 A 49.82
Q5120 A 179.24
Q5121 A 43.29
Q5122 A 243.05
Q5123 A 56.59
Q9968 A 7.35
Q9991 A 1,781.31
Q9992 A 1,781.31
90371 A 138.92
90375 A 321.80
90376 A 332.82
90377 A 223.61
90378 A 1,185.67
90396 A 1,959.60
90675 A 293.59
90676 A 189.63
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 2023 by the American Medical Association.

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved