CPT/HCPCS Section

HCPCS Q: Temporary Codes

193 procedure codes with Medicare Physician Fee Schedule payment data. Click a code for Facility vs Non-Facility rates, allowed amounts and utilization.

Q0091Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory$30Q0092Set-up portable x-ray equipment$20Q0111Wet mounts, including preparations of vaginal, cervical or skin specimens$16Q0112All potassium hydroxide (koh) preparations$6Q0138Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)$0Q0139Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)$0Q0224Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medica$199Q0477Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only$720Q0479Power module for use with electric or electric/pneumatic ventricular assist device, replacement only$10879Q0481Microprocessor control unit for use with electric ventricular assist device, replacement only$12576Q0495Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only$3821Q0496Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only$1362Q0497Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only$425Q0498Holster for use with electric or electric/pneumatic ventricular assist device, replacement only$481Q0499Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only$153Q0501Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only$468Q0506Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only$781Q0508Miscellaneous supply or accessory for use with an implanted ventricular assist device$1043Q0509Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a$1210Q0516Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 30-days$10Q2028Injection, sculptra, 0.5 mg$1Q2035Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)$16Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)$17Q2038Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)$17Q2043Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion$42521Q2050Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg$90Q3001Radioelements for brachytherapy, any type, each$420Q3014Telehealth originating site facility fee$18Q4005Cast supplies, long arm cast, adult (11 years +), plaster$12Q4006Cast supplies, long arm cast, adult (11 years +), fiberglass$27Q4009Cast supplies, short arm cast, adult (11 years +), plaster$8Q4010Cast supplies, short arm cast, adult (11 years +), fiberglass$18Q4012Cast supplies, short arm cast, pediatric (0-10 years), fiberglass$9Q4013Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster$15Q4014Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass$24Q4017Cast supplies, long arm splint, adult (11 years +), plaster$8Q4018Cast supplies, long arm splint, adult (11 years +), fiberglass$13Q4021Cast supplies, short arm splint, adult (11 years +), plaster$6Q4022Cast supplies, short arm splint, adult (11 years +), fiberglass$11Q4024Cast supplies, short arm splint, pediatric (0-10 years), fiberglass$6Q4029Cast supplies, long leg cast, adult (11 years +), plaster$26Q4030Cast supplies, long leg cast, adult (11 years +), fiberglass$67Q4034Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass$59Q4037Cast supplies, short leg cast, adult (11 years +), plaster$15Q4038Cast supplies, short leg cast, adult (11 years +), fiberglass$38Q4041Cast supplies, long leg splint, adult (11 years +), plaster$18Q4042Cast supplies, long leg splint, adult (11 years +), fiberglass$31Q4045Cast supplies, short leg splint, adult (11 years +), plaster$10Q4046Cast supplies, short leg splint, adult (11 years +), fiberglass$17Q4048Cast supplies, short leg splint, pediatric (0-10 years), fiberglass$8Q4049Finger splint, static$2Q4050Cast supplies, for unlisted types and materials of casts$33Q4051Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)$7Q4101Apligraf, per square centimeter$24Q4102Oasis wound matrix, per square centimeter$10Q4104Integra bilayer matrix wound dressing (bmwd), per square centimeter$39Q4106Dermagraft, per square centimeter$35Q4111Gammagraft, per square centimeter$6Q4118Matristem micromatrix, 1 mg$2Q4121Theraskin, per square centimeter$36Q4124Oasis ultra tri-layer wound matrix, per square centimeter$7Q4132Grafix core and grafixpl core, per square centimeter$118Q4133Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter$106Q4137Amnioexcel, amnioexcel plus or biodexcel, per square centimeter$81Q4151Amnioband or guardian, per square centimeter$106Q4154Biovance, per square centimeter$117Q4158Kerecis omega3, per square centimeter$184Q4159Affinity, per square centimeter$249Q4160Nushield, per square centimeter$74Q4161Bio-connekt wound matrix, per square centimeter$1330Q4164Helicoll, per square centimeter$1206Q4166Cytal, per square centimeter$14Q4169Artacent wound, per square centimeter$142Q4170Cygnus, per square centimeter$45Q4173Palingen or palingen xplus, per square centimeter$303Q4180Revita, per square centimeter$398Q4186Epifix, per square centimeter$121Q4187Epicord, per square centimeter$191Q4188Amnioarmor, per square centimeter$649Q4190Artacent ac, per square centimeter$277Q4191Restorigin, per square centimeter$1187Q4193Coll-e-derm, per square centimeter$1617Q4194Novachor, per square centimeter$774Q4195Puraply, per square centimeter$118Q4196Puraply am, per square centimeter$81Q4197Puraply xt, per square centimeter$86Q4199Cygnus matrix, per square centimeter$247Q4201Matrion, per square centimeter$82Q4204Xwrap, per square centimeter$2181Q4205Membrane graft or membrane wrap, per square centimeter$1039Q4210Axolotl graft or axolotl dualgraft, per square centimeter$664Q4217Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter$531Q4221Amniowrap2, per square centimeter$1362Q4222Progenamatrix, per square centimeter$80Q4225Amniobind or dermabind tl, per square centimeter$1177Q4227Amniocore, per square centimeter$319Q4229Cogenex amniotic membrane, per square centimeter$689Q4232Corplex, per square centimeter$135Q4234Xcellerate, per square centimeter$494Q4236Carepatch, per square centimeter$640Q4238Derm-maxx, per square centimeter$915Q4239Amnio-maxx or amnio-maxx lite, per square centimeter$1906Q4244Procenta, per 200 mg$7946Q4248Dermacyte amniotic membrane allograft, per square centimeter$848Q4249Amniply, for topical use only, per square centimeter$586Q4250Amnioamp-mp, per square centimeter$1835Q4252Vendaje, per square centimeter$159Q4253Zenith amniotic membrane, per square centimeter$206Q4256Mlg-complete, per square centimeter$997Q4257Relese, per square centimeter$731Q4259Celera dual layer or celera dual membrane, per square centimeter$969Q4262Dual layer impax membrane, per square centimeter$893Q4263Surgraft tl, per square centimeter$779Q4264Cocoon membrane, per square centimeter$1500Q4265Neostim tl, per square centimeter$1647Q4266Neostim membrane, per square centimeter$1207Q4267Neostim dl, per square centimeter$649Q4268Surgraft ft, per square centimeter$904Q4271Complete ft, per square centimeter$1321Q4274Esano ac, per square centimeter$1190Q4275Esano aca, per square centimeter$2069Q4276Orion, per square centimeter$1058Q4277Woundplus membrane or e-graft, per square centimeter$1383Q4278Epieffect, per square centimeter$314Q4279Vendaje ac, per square centimeter$1697Q4280Xcell amnio matrix, per square centimeter$1555Q4281Barrera sl or barrera dl, per square centimeter$1065Q4282Cygnus dual, per square centimeter$576Q4283Biovance tri-layer or biovance 3l, per square centimeter$990Q4289Revoshield + amniotic barrier, per square centimeter$1666Q4290Membrane wrap-hydro, per square centimeter$1514Q4294Amnio quad-core, per square centimeter$1759Q4295Amnio tri-core amniotic, per square centimeter$1544Q4296Rebound matrix, per square centimeter$1785Q4297Emerge matrix, per square centimeter$1756Q4298Amnicore pro, per square centimeter$1689Q4299Amnicore pro+, per square centimeter$1886Q4301Activate matrix, per square centimeter$1915Q4303Complete aa, per square centimeter$2599Q4304Grafix plus, per square centimeter$932Q4309Via matrix, per square centimeter$1178Q4310Procenta, per 100 mg$2038Q4313Dermabind fm, per square centimeter$2513Q4316Amchoplast, per square centimeter$3315Q4326Woundplus, per square centimeter$1508Q4331Axolotl graft, per square centimeter$1310Q4332Axolotl dualgraft, per square centimeter$1343Q5101Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram$0Q5103Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg$9Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg$23Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units$1Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units$6Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg$20Q5108Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg$111Q5110Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram$0Q5111Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg$110Q5112Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg$28Q5114Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg$43Q5115Injection, rituximab-abbs, biosimilar, (truxima), 10 mg$25Q5116Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg$12Q5117Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg$13Q5118Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg$16Q5119Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg$16Q5120Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg$231Q5121Injection, infliximab-axxq, biosimilar, (avsola), 10 mg$17Q5122Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg$55Q5123Injection, rituximab-arrx, biosimilar, (riabni), 10 mg$31Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg$134Q5125Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram$0Q5126Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg$46Q5127Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg$257Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg$181Q5129Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg$50Q5130Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg$153Q5135Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg$4Q9950Injection, sulfur hexafluoride lipid microspheres, per ml$14Q9954Oral magnetic resonance contrast agent, per 100 ml$1Q9956Injection, octafluoropropane microspheres, per ml$32Q9957Injection, perflutren lipid microspheres, per ml$31Q9958High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml$0Q9960High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml$0Q9961High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml$0Q9962High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml$0Q9963High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml$0Q9965Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml$1Q9966Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml$0Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml$0Q9968Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg$4Q9969Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose$11Q9982Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries$2792Q9983Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries$2454Q9991Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg$904Q9992Injection, buprenorphine extended-release (sublocade), greater than 100 mg$716