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HCPCS Range Miscellaneous Drugs, Biologicals, and Supplies

• 1 Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ( C8957 )

• 2 Injection, clevidipine butyrate, 1 mg ( C9248 )

• 3 Human plasma fibrin sealant, vapor-heated, solvent-detergent (Artiss), 2ml ( C9250 )

• 4 Injection, lacosamide, 1 mg ( C9254 )

• 5 Injection, bevacizumab, 0.25 mg ( C9257 )

• 6 Lidocaine 70 mg/tetracaine 70 mg, per patch ( C9285 )

• 7 Injection, bupivacaine liposome, 1 mg ( C9290 )

• 8 Injection, glucarpidase, 10 units ( C9293 )

• 9 Microporous collagen implantable tube (NeuraGen Nerve Guide), per centimeter length ( C9352 )

• 10 Microporous collagen implantable slit tube (NeuraWrap Nerve Protector), per centimeter length ( C9353 )

• 11 Acellular pericardial tissue matrix of non-human origin (Veritas), per square centimeter ( C9354 )

• 12 Collagen nerve cuff (NeuroMatrix), per 0.5 centimeter length ( C9355 )

• 13 Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (TenoGlide Tendon Protector Sheet), per square centimeter ( C9356 )

• 14 Dermal substitute, native, non-denatured collagen, fetal bovine origin (SurgiMend Collagen Matrix), per 0.5 square centimeters ( C9358 )

• 15 Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Putty, Integra Os Osteoconductive Scaffold Putty), per 0.5 cc ( C9359 )

• 16 Dermal substitute, native, non-denatured collagen, neonatal bovine origin (SurgiMend Collagen Matrix), per 0.5 square centimeters ( C9360 )

• 17 Collagen matrix nerve wrap (NeuroMend Collagen Nerve Wrap), per 0.5 centimeter length ( C9361 )

• 18 Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Strip), per 0.5 cc ( C9362 )

• 19 Skin substitute, Integra Meshed Bilayer Wound Matrix, per square centimeter ( C9363 )

• 20 Porcine implant, Permacol, per square centimeter ( C9364 )

• 21 Unclassified drugs or biologicals ( C9399 )

• 22 Injection, cangrelor, 1 mg ( C9460 )

• 23 Injection, sotalol hydrochloride, 1 mg ( C9482 )

• 24 Injection, conivaptan hydrochloride, 1 mg ( C9488 )

• 25 Injection, delafloxacin, 1 mg ( C9462 )

• 26 Cocaine hydrochloride nasal solution for topical administration, 1 mg ( C9046 )

• 27 Injection, caplacizumab-yhdp, 1 mg ( C9047 )

• 28 Gallium ga-68, dotatoc, diagnostic, 0.01 mci ( C9067 )

• 29 Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg ( C9088 )

• 30 Bupivacaine, collagen-matrix implant, 1 mg ( C9089 )

• 31 Injection, oliceridine, 0.1 mg ( C9101 )

• 32 Cocaine hydrochloride nasal solution (numbrino), 1 mg ( C9143 )

• 33 Injection, bupivacaine (posimir), 1 mg ( C9144 )

• 34 Injection, aprepitant, (aponvie), 1 mg ( C9145 )

• 35 Xenon xe-129 hyperpolarized gas, diagnostic, per study dose ( C9150 )