A4627

Short Description

• Spacer bag/reservoir

HCPCS Coverage Code

• M = Non-covered by Medicare

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 1997

HCPCS Code Added Date

• January 01, 1991

HCPCS Pricing Indicator Code

• 00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.)

HCPCS Multiple Pricing Indicator Code

• 9 = Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established(pricing indicator is ’99’)

HCPCS Medicare Carriers Manual Reference Section Number

• 2100

HCPCS Type Of Service Code

• 9 = Other medical items or services

HCPCS Anesthesia Base Unit Quantity

• 0