Non-Medicare Codes

533 HCPCS codes in Category S

S0012Butorphanol tartrate, nasal S0013Esketamine, nasal spray S0014Tacrine hydrochloride, 10 mg S0017Injection, aminocaproic acid S0020Injection, bupivicaine hydro S0021Injection, cefoperazone sod S0023Injection, cimetidine hydroc S0028Injection, famotidine, 20 mg S0030Injection, metronidazole S0032Injection, nafcillin sodium S0034Injection, ofloxacin, 400 mg S0039Injection, sulfamethoxazole S0040Injection, ticarcillin disod S0073Injection, aztreonam, 500 mg S0074Injection, cefotetan disodiu S0077Injection, clindamycin phosp S0078Injection, fosphenytoin sodi S0080Injection, pentamidine iseth S0081Injection, piperacillin sodi S0088Imatinib 100 mg S0090Sildenafil citrate, 25 mg S0091Granisetron 1mg S0092Hydromorphone 250 mg S0093Morphine 500 mg S0104Zidovudine, oral, 100 mg S0106Bupropion hcl sr 60 tablets S0108Mercaptopurine 50 mg S0109Methadone oral 5mg S0117Tretinoin topical 5 g S0119Ondansetron 4 mg S0122Inj menotropins 75 iu S0126Inj follitropin alfa 75 iu S0128Inj follitropin beta 75 iu S0132Inj ganirelix acetat 250 mcg S0136Clozapine, 25 mg S0137Didanosine, 25 mg S0138Finasteride, 5 mg S0139Minoxidil, 10 mg S0140Saquinavir, 200 mg S0142Colistimethate inh sol mg S0144Inj, propofol, 10 mg S0145Peg interferon alfa-2a/180 S0148Peg interferon alfa-2b/10 S0155Epoprostenol dilutant S0156Exemestane, 25 mg S0157Becaplermin gel 1%, 0.5 gm S0160Dextroamphetamine S0164Injection pantroprazole S0166Inj olanzapine 2.5mg S0169Calcitrol S0170Anastrozole 1 mg S0171Bumetanide 0.5 mg S0172Chlorambucil 2 mg S0174Dolasetron 50 mg S0175Flutamide 125 mg S0176Hydroxyurea 500 mg S0177Levamisole 50 mg S0178Lomustine 10 mg S0179Megestrol 20 mg S0182Procarbazine, oral S0183Prochlorperazine 5 mg S0187Tamoxifen 10 mg S0189Testosterone pellet 75 mg S0190Mifepristone, oral, 200 mg S0191Misoprostol, oral, 200 mcg S0194Vitamin suppl 100 caps S0195Pneumo vaccine 5-9 yrs S0197Prenatal vitamins 30 day S0199Med abortion inc all ex drug S0201Partial hospitalization serv S0207Paramedicintercep nonhospals S0208Paramed intrcept nonvol S0209Wc van mileage per mi S0215Nonemerg transp mileage S0220Medical conference by physic S0221Medical conference, 60 min S0250Comp geriatr assmt team S0255Hospice refer visit nonmd S0257End of life counseling S0260H&p for surgery S0265Genetic counsel 15 mins S0270Home std case rate 30 days S0271Home hospice case 30 days S0272Home episodic case 30 days S0273Md home visit outside cap S0274Nurse practr visit outs cap S0280Medical home, initial plan S0281Medical home, maintenance S0285Cnslt before screen colonosc S0302Completed epsdt S0310Hospitalist visit S0311Comp mgmt care coord adv ill S0315Disease management program S0316Follow-up/reassessment S0317Disease mgmt per diem S0320Rn telephone calls to dmp S0340Lifestyle mod 1st stage S0341Lifestyle mod 2 or 3 stage S0342Lifestyle mod 4th stage S0353Cancer treatmentplan initial S0354Cancer treatment plan change S0390Rout foot care per visit S0395Impression casting ft S0400Global eswl kidney S0500Dispos cont lens S0504Singl prscrp lens S0506Bifoc prscp lens S0508Trifoc prscrp lens S0510Non-prscrp lens S0512Daily cont lens S0514Color cont lens S0515Scleral lens liquid bandage S0516Safety frames S0518Sunglass frames S0580Polycarb lens S0581Nonstnd lens S0590Misc integral lens serv S0592Comp cont lens eval S0595New lenses in pts old frame S0596Phakic iol refractive error S0601Screening proctoscopy S0610Annual gynecological examina S0612Annual gynecological examina S0613Ann breast exam S0618Audiometry for hearing aid S0620Routine ophthalmological exa S0621Routine ophthalmological exa S0622Phys exam for college S0630Removal of sutures S0800Laser in situ keratomileusis S0810Photorefractive keratectomy S0812Phototherap keratect S1001Deluxe item S1002Custom item S1015Iv tubing extension set S1016Non-pvc intravenous administ S1030Gluc monitor purchase S1031Gluc monitor rental S1034Art pancreas system S1035Art pancreas inv disp sensor S1036Art pancreas ext transmitter S1037Art pancreas ext receiver S1040Cranial remolding orthosis S1090Mometasone sinus implant S1091Stent non-coronary propel S2053Transplantation of small int S2054Transplantation of multivisc S2055Harvesting of donor multivis S2060Lobar lung transplantation S2061Donor lobectomy (lung)S2065Simult panc kidn trans S2066Breast gap flap reconst S2067Breast "stacked" diep/gap S2068Breast diep or siea flap S2070Cysto laser tx ureteral calc S2079Lap esophagomyotomy S2080Laup S2083Adjustment gastric band S2095Transcath emboliz microspher S2102Islet cell tissue transplant S2103Adrenal tissue transplant S2107Adoptive immunotherapy S2112Knee arthroscp harv S2115Periacetabular osteotomy S2117Arthroereisis, subtalar S2118Total hip resurfacing S2120Low density lipoprotein(ldl)S2140Cord blood harvesting S2142Cord blood-derived stem-cell S2150Bmt harv/transpl 28d pkg S2152Solid organ transpl pkg S2202Echosclerotherapy S2205Minimally invasive direct co S2206Minimally invasive direct co S2207Minimally invasive direct co S2208Minimally invasive direct co S2209Minimally invasive direct co S2225Myringotomy laser-assist S2230Implant semi-imp hear S2235Implant auditory brain imp S2260Induced abortion 17-24 weeks S2265Induced abortion 25-28 wks S2266Induced abortion 29-31 wks S2267Induced abortion 32 or more S2300Arthroscopy, shoulder, surgi S2325Hip core decompression S2340Chemodenervation of abductor S2341Chemodenerv adduct vocal S2342Nasal endoscop po debrid S2348Decompress disc rf lumbar S2350Diskectomy, anterior, with d S2351Diskectomy, anterior, with d S2360Vertebroplast cerv 1st S2361Vertebroplast cerv addl S2400Fetal surg congen hernia S2401Fetal surg urin trac obstr S2402Fetal surg cong cyst malf S2403Fetal surg pulmon sequest S2404Fetal surg myelomeningo S2405Fetal surg sacrococ teratoma S2409Fetal surg noc S2411Fetoscop laser ther ttts S2900Robotic surgical system S3000Bilat dil retinal exam S3005Eval self-assess depression S3600Stat lab S3601Stat lab home/nf S3620Newborn metabolic screening S3630Eosinophil blood count S3645Hiv-1 antibody testing of or S3650Saliva test, hormone level;S3652Saliva test, hormone level;S3655Antisperm antibodies test S3708Gastrointestinal fat absorpt S3721Pca3 testing S3722Dose optimization auc - 5fu S3800Genetic testing als S3840Dna analysis ret-oncogene S3841Gene test retinoblastoma S3842Gene test hippel-lindau S3844Dna analysis deafness S3845Gene test alpha-thalassemia S3846Gene test beta-thalassemia S3849Gene test niemann-pick S3850Gene test sickle cell S3852Dna analysis apoe alzheimer S3853Gene test myo musclr dyst S3854Gene profile panel breast S3855Gene test presenilin-1 gene S3861Genetic test brugada S3865Comp genet test hyp cardiomy S3866Spec gene test hyp cardiomy S3870Cgh test developmental delay S3890Fecal dna analysis S3900Surface emg S3902Ballistocardiogram S3904Masters two step S4005Interim labor facility globa S4011Ivf package S4013Compl gift case rate S4014Compl zift case rate S4015Complete ivf nos case rate S4016Frozen ivf case rate S4017Ivf canc a stim case rate S4018F emb trns canc case rate S4020Ivf canc b4 aspir case rate S4021Ivf canc aftr aspr case rate S4022Asst oocyte fert case rate S4023Incompl donor egg case rate S4024Air polymer foam per study S4025Donor serv ivf case rate S4026Procure donor sperm S4027Store prev froz embryos S4028Microsurg epi sperm asp S4030Sperm procure init visit S4031Sperm procure subs visit S4035Stimulated iui case rate S4037Cryo embryo transf case rate S4040Monit store cryo embryo 30 d S4042Ovulation mgmt per cycle S4981Insert levonorgestrel ius S4988Penile contractur devic manu S4989Contracept iud S4990Nicotine patch legend S4991Nicotine patch nonlegend S4993Contraceptive pills for bc S4995Smoking cessation gum S5000Prescription drug, generic S5001Prescription drug,brand name S50105% dextrose and 0.45% saline S50115% dextrose in lactated ring S50125% dextrose with potassium S50135%dextrose/0.45%saline1000ml S5014D5w/0.45ns w kcl and mgs04 S5035Hit routine device maint S5036Hit device repair S5100Adult daycare services 15min S5101Adult day care per half day S5102Adult day care per diem S5105Centerbased day care perdiem S5108Homecare train pt 15 min S5109Homecare train pt session S5110Family homecare training 15m S5111Family homecare train/sessio S5115Nonfamily homecare train/15m S5116Nonfamily hc train/session S5120Chore services per 15 min S5121Chore services per diem S5125Attendant care service /15m S5126Attendant care service /diem S5130Homaker service nos per 15m S5131Homemaker service nos /diem S5135Adult companioncare per 15m S5136Adult companioncare per diem S5140Adult foster care per diem S5141Adult foster care per month S5145Child fostercare th per diem S5146Ther fostercare child /month S5150Unskilled respite care /15m S5151Unskilled respitecare /diem S5160Emer response sys instal&tst S5161Emer rspns sys serv permonth S5162Emer rspns system purchase S5165Home modifications per serv S5170Homedelivered prepared meal S5175Laundry serv,ext,prof,/order S5180Hh respiratory thrpy in eval S5181Hh respiratory thrpy nos/day S5185Med reminder serv per month S5190Wellness assessment by nonph S5199Personal care item nos each S5497Hit cath care noc S5498Hit simple cath care S5501Hit complex cath care S5502Hit interim cath care S5517Hit declotting kit S5518Hit cath repair kit S5520Hit picc insert kit S5521Hit midline cath insert kit S5522Hit picc insert no supp S5523Hip midline cath insert kit S5550Insulin rapid 5 u S5551Insulin most rapid 5 u S5552Insulin intermed 5 u S5553Insulin long acting 5 u S5560Insulin reuse pen 1.5 ml S5561Insulin reuse pen 3 ml S5565Insulin cartridge 150 u S5566Insulin cartridge 300 u S5570Insulin dispos pen 1.5 ml S5571Insulin dispos pen 3 ml S8030Tantalum ring application S8032Low dose ct lung screening S8035Magnetic source imaging S8037Mrcp S8040Topographic brain mapping S8042Mri low field S8055Us guidance fetal reduct S8080Scintimammography S8085Fluorine-18 fluorodeoxygluco S8092Electron beam computed tomog S8096Portable peak flow meter S8097Asthma kit S8100Spacer without mask S8101Spacer with mask S8110Peak expiratory flow rate (p S8120O2 contents gas cubic ft S8121O2 contents liquid lb S8130Interferential stim 2 chan S8131Interferential stim 4 chan S8185Flutter device S8186Swivel adaptor S8189Trach supply noc S8210Mucus trap S8262Mandib ortho repos device S8265Haberman feeder S8270Enuresis alarm S8301Infect control supplies nos S8415Supplies for home delivery S8420Custom gradient sleev/glov S8421Ready gradient sleev/glov S8422Custom grad sleeve med S8423Custom grad sleeve heavy S8424Ready gradient sleeve S8425Custom grad glove med S8426Custom grad glove heavy S8427Ready gradient glove S8428Ready gradient gauntlet S8429Gradient pressure wrap S8430Padding for comprssn bdg S8431Compression bandage S8450Splint digit S8451Splint wrist or ankle S8452Splint elbow S8460Camisole post-mast S8490100 insulin syringes S8930Auricular electrostimulation S8940Hippotherapy per session S8948Low-level laser trmt 15 min S8950Complex lymphedema therapy,S8990Pt or manip for maint S8999Resuscitation bag S9001Home uterine monitor with or S9002Intra-vag motion sens biofk S9007Ultrafiltration monitor S9015Automated eeg monitoring S9024Paranasal sinus ultrasound S9025Omnicardiogram/cardiointegra S9034Eswl for gallstones S9055Procuren or other growth fac S9056Coma stimulation per diem S9061Medical supplies and equipme S9083Urgent care center global S9088Services provided in urgent S9090Vertebral axial decompressio S9097Home visit wound care S9098Home phototherapy visit S9110Telemonitoring/home per mnth S9117Back school visit S9122Home health aide or certifie S9123Nursing care in home rn S9124Nursing care, in the home; b S9125Respite care, in the home, p S9126Hospice care, in the home, p S9127Social work visit, in the ho S9128Speech therapy, in the home,S9129Occupational therapy, in the S9131Pt in the home per diem S9140Diabetic management program,S9141Diabetic management program,S9145Insulin pump initiation S9150Evaluation by ocularist S9152Speech therapy, re-eval S9208Home mgmt preterm labor S9209Home mgmt pprom S9211Home mgmt gest hypertension S9212Hm postpar hyper per diem S9213Hm preeclamp per diem S9214Hm gest dm per diem S9325Hit pain mgmt per diem S9326Hit cont pain per diem S9327Hit int pain per diem S9328Hit pain imp pump diem S9329Hit chemo per diem S9330Hit cont chem diem S9331Hit intermit chemo diem S9335Ht hemodialysis diem S9336Hit cont anticoag diem S9338Hit immunotherapy diem S9339Hit periton dialysis diem S9340Hit enteral per diem S9341Hit enteral grav diem S9342Hit enteral pump diem S9343Hit enteral bolus nurs S9345Hit anti-hemophil diem S9346Hit alpha-1-proteinas diem S9347Hit longterm infusion diem S9348Hit sympathomim diem S9349Hit tocolysis diem S9351Hit cont antiemetic diem S9353Hit cont insulin diem S9355Hit chelation diem S9357Hit enzyme replace diem S9359Hit anti-tnf per diem S9361Hit diuretic infus diem S9363Hit anti-spasmotic diem S9364Hit tpn total diem S9365Hit tpn 1 liter diem S9366Hit tpn 2 liter diem S9367Hit tpn 3 liter diem S9368Hit tpn over 3l diem S9370Ht inj antiemetic diem S9372Ht inj anticoag diem S9373Hit hydra total diem S9374Hit hydra 1 liter diem S9375Hit hydra 2 liter diem S9376Hit hydra 3 liter diem S9377Hit hydra over 3l diem S9379Hit noc per diem S9381Hit high risk/escort S9401Anticoag clinic per session S9430Pharmacy comp/disp serv S9432Med food non inborn err meta S9433Medical food oral 100% nutr S9434Mod solid food suppl S9435Medical foods for inborn err S9436Lamaze class S9437Childbirth refresher class S9438Cesarean birth class S9439Vbac class S9441Asthma education S9442Birthing class S9443Lactation class S9444Parenting class S9445Pt education noc individ S9446Pt education noc group S9447Infant safety class S9449Weight mgmt class S9451Exercise class S9452Nutrition class S9453Smoking cessation class S9454Stress mgmt class S9455Diabetic management program,S9460Diabetic management program,S9465Diabetic management program,S9470Nutritional counseling, diet S9472Cardiac rehabilitation progr S9473Pulmonary rehabilitation pro S9474Enterostomal therapy by a re S9475Ambulatory setting substance S9476Vestibular rehab per diem S9480Intensive outpatient psychia S9482Family stabilization 15 min S9484Crisis intervention per hour S9485Crisis intervention mental h S9490Hit corticosteroid/diem S9494Hit antibiotic total diem S9497Hit antibiotic q3h diem S9500Hit antibiotic q24h diem S9501Hit antibiotic q12h diem

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