| Procedure | Description | Number Submitted | Medicare Payment |
| 62323
|
NJX INTERLAMINAR LMBR/SAC
|
XXX
|
$XXXXX.XX
|
| 20930
|
SP BONE ALGRFT MORSEL ADD-ON
|
XX
|
-
|
| 63047
|
LAM FACETEC & FORAMOT LUMBAR
|
XX
|
$XXXXXX.XX
|
| 20936
|
SP BONE AGRFT LOCAL ADD-ON
|
XX
|
-
|
| 22853
|
INSJ BIOMECHANICAL DEVICE
|
XX
|
-
|
| 22612
|
ARTHRD PST TQ 1NTRSPC LUMBAR
|
XX
|
$XXXXXX.XX
|
| 64483
|
NJX AA&/STRD TFRM EPI L/S 1
|
XX
|
$XXXXX.XX
|
| 63048
|
LAM FACETEC &FORAMOT EA ADDL
|
XX
|
-
|
| 22558
|
ARTHRD ANT NTRBD MIN DSC LUM
|
XX
|
$XXXXXX.XX
|
| 22856
|
TOT DISC ARTHRP 1NTRSPC CRV
|
XX
|
$XXXXXX.XX
|
| 64493
|
INJ PARAVERT F JNT L/S 1 LEV
|
XX
|
$XXXXX.XX
|
| 64484
|
NJX AA&/STRD TFRM EPI L/S EA
|
XX
|
-
|
| 22840
|
INSERT SPINE FIXATION DEVICE
|
XX
|
-
|
| 64494
|
INJ PARAVERT F JNT L/S 2 LEV
|
XX
|
-
|
| 22614
|
ARTHRD PST TQ 1NTRSPC EA ADD
|
XX
|
-
|
| Procedure | Description | Number Submitted | Medicare Payment |
| J2704
|
Inj, propofol, 10 mg
|
XXXX
|
-
|
| J1100
|
Dexamethasone sodium phos
|
XXXX
|
-
|
| J0171
|
Adrenalin epinephrine inject
|
XXXX
|
-
|
| J2405
|
Ondansetron hcl injection
|
XXX
|
-
|
| J0690
|
Cefazolin sodium injection
|
XXX
|
-
|
| J0330
|
Succinycholine chloride inj
|
XXX
|
-
|
| J3301
|
Triamcinolone acet inj nos
|
XXX
|
-
|
| J2250
|
Inj midazolam hydrochloride
|
XXX
|
-
|
| J3010
|
Fentanyl citrate injection
|
XXX
|
-
|
| J2370
|
Phenylephrine hcl injection
|
XXX
|
-
|
| J3475
|
Inj magnesium sulfate
|
XXX
|
-
|
| J1170
|
Hydromorphone injection
|
XXX
|
-
|
| J1885
|
Ketorolac tromethamine inj
|
XXX
|
-
|
| J0131
|
Inj, acetaminophen (nos)
|
XXX
|
-
|
| J0702
|
Betamethasone acet&sod phosp
|
XX
|
-
|
| J1040
|
Methylprednisolone 80 mg inj
|
XX
|
-
|
| J2710
|
Neostigmine methylslfte inj
|
XX
|
-
|
| J1644
|
Inj heparin sodium per 1000u
|
XX
|
-
|
| J7050
|
Normal saline solution infus
|
XX
|
-
|
