Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap - filled amounts)
Every HCPCS Level II code priced by Part B as "Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap - filled amounts)".
Part B pricingCMS code 4692 codes
By series
These 92 codes span 9 series, split as below. Opening one shows that whole series, not just the codes listed here.
All codes 92
All code series- A4287Disp col sto bag breast milk
- A4288Replacement breastpump valve
- A4335Incontinence supply
- A4421Ostomy supply misc
- A4543Supply trans elec nerve stim
- A4564Pessary, disposable any type
- A4614Hand-held pefr meter
- A4649Surgical supplies
- A6198Alginate dressing > 48 sq in
- A6205Composite drsg > 48 sq in
- A6206Contact layer <= 16 sq in
- A6208Contact layer > 48 sq in
- A6213Foam drg >16<=48 sq in w/bdr
- A6215Foam dressing wound filler
- A6218Non-sterile gauze > 48 sq in
- A6221Gauze > 48 sq in w/border
- A6228Gauze <= 16 sq in water/sal
- A6230Gauze > 48 sq in water/salne
- A6239Hydrocolld drg > 48 in w/bdr
- A6256Absorpt drg > 48 sq in w/bdr
- A6261Wound filler gel/paste /oz
- A6262Wound filler dry form / gram
- A7011Nondispos corrugated tubing
- A9900Supply/accessory/service
- A9901Delivery/set up/dispensing
- A9999Dme supply or accessory, nos
- B4103Ef ped fluid and electrolyte
- B4158Ef ped complete intact nut
- B4159Ef ped complete soy based
- B4160Ef ped caloric dense>/=0.7kc
- B4161Ef ped hydrolyzed/amino acid
- B4162Ef ped specmetabolic inherit
- E0721Trans elec stim auricular
- E0767Intrabuc am rf emf cancer tx
- E0770Functional electric stim nos
- E1399Durable medical equipment mi
- E2599Sgd accessory noc
- G0333Dispense fee initial 30 day
- J0799Hiv prep, fda approved, noc
- K0108W/c component-accessory nos
- K0739Repair/svc dme non-oxygen eq
- K1005Disp col sto bag breast milk
- K1015Foot, adductus position, adj
- L0999Add to spinal orthosis nos
- L1007Scoliosis orth s-c custom
- L1320Pectus carinatum ortho cust
- L1499Spinal orthosis nos
- L2999Lower extremity orthosis nos
- L3161Foot, adductus position, adj
- L3999Upper limb orthosis nos
- L4205Ortho dvc repair per 15 min
- L4210Orth dev repair/repl minor p
- L5999Lowr extremity prosthes nos
- L7499Upper extremity prosthes nos
- L7510Prosthetic device repair rep
- L7520Repair prosthesis per 15 min
- L8039Breast prosthesis nos
- L8048Unspec maxillofacial prosth
- L8049Repair maxillofacial prosth
- L8499Unlisted misc prosthetic ser
- L8505Artificial larynx, accessory
- L8608Arg ii ext com/sup/acc misc
- L8698Misc used with tot art heart
- L8699Prosthetic implant nos
- L8720Ext low ext sens prosthe mec
- L8721Receptor sole l8720 replace
- L9900O&p supply/accessory/service
- Q0507Misc sup/acc ext vad
- Q0508Mis sup/acc imp vad
- Q0509Mis sup/ac imp vad nopay med
- Q0510Dispens fee immunosupressive
- Q0511Sup fee antiem,antica,immuno
- Q0512Px sup fee anti-can sub pres
- Q0513Disp fee inhal drugs/30 days
- Q0514Disp fee inhal drugs/90 days
- Q0516Supply fee hiv prep oral 30
- Q0517Supply fee hiv prep oral 60
- Q0518Supply fee hiv prep oral 90
- Q0519Supply fee hiv prep inj 30
- Q0520Supply fee hiv prep inj 60
- Q0521Supply fee hiv prep fda appr
- V2199Lens single vision not oth c
- V2299Lens bifocal speciality
- V2399Lens trifocal speciality
- V2499Variable asphericity lens
- V2599Contact lens/es other type
- V2600Hand held low vision aids
- V2610Single lens spectacle mount
- V2615Telescop/othr compound lens
- V2629Prosthetic eye other type
- V2785Corneal tissue processing
- V2799Misc vision item or service
About this list
The pricing indicator comes from the CMS HCPCS release and describes the method Part B uses to price the code. It is not a price, and it says nothing about what another payer will allow. The largest group here is the A series (Transportation Services including Ambulance; Medical and Surgical Supplies; Vision and Hearing Systems).