IV Anesthesia & Sedation — Billing & Coding Reference

About this reference

IV anesthetics, sedatives, opioids, and reversal agents are among the highest-utilization drugs in U.S. hospitals — and among the most consistently miscoded for separate billing. The financial question on this page is rarely “how much does propofol pay?” The CMS ASP for propofol is roughly nine cents per 10 mg. The real question is whether the drug generates a separately payable Part B line at all — and for most encounters the honest answer is no.

Anesthesia and sedation drugs are packaged into three big payment containers. First, the CPT 00xxx anesthesia time codes (00100–01999): when an anesthesia provider (anesthesiologist or CRNA) personally delivers anesthesia for a surgical case, every drug used during the anesthesia time — induction agents, opioids, benzos, neuromuscular blockers, reversal agents — is part of the anesthesia time payment. Reporting J2704 or J2786 alongside an 00xxx claim is bundled and is not separately payable. Second, the OPPS / ASC packaging for hospital outpatient and ambulatory-surgery procedural sedation: propofol, midazolam, and fentanyl used during a colonoscopy, endoscopy, cataract, or other outpatient procedure are packaged into the procedure APC or ASC facility payment. The proceduralist captures sedation work via the moderate sedation CPT family (99151 / 99152 / 99153); the drug J-codes are informational only. Third, the MS-DRG and ICU per-diem bundling: continuous propofol, midazolam, fentanyl, and dexmedetomidine sedation for an inpatient ICU encounter is absorbed into the DRG-weighted payment. The drug usage appears on the chargemaster but produces no separately payable Part B line.

The minority case — where these drugs are separately billable — is what this page focuses on. Emergency department naloxone administration for opioid overdose (POS 23), ED flumazenil for benzodiazepine reversal, ED lorazepam IV for status epilepticus, ED opioid bolus (hydromorphone, morphine, fentanyl) for documented acute pain, and standalone outpatient IV ketamine for treatment-resistant depression (controversial, largely cash-pay) are the recognized separately payable encounters. Several of the drugs in this class do not have permanent J-codes as of 2026 — ketamine, dexmedetomidine, etomidate, flumazenil, and sugammadex all bill under J3490 (NOC) with NDC and invoice when separately payable. The persistent coder trap is that J2786 is reslizumab (Cinqair, an asthma biologic), not sugammadex. Sugammadex / Bridion has no permanent J-code.

Sedative class families — induction / benzos / opioids / reversal Clinical taxonomy May 2026

Twelve drugs grouped into four pharmacologic families. The family explains the clinical context; the context drives the billing rule.

Per-drug dosing & typical regimens FDA labels + ASA / ACEP standards, verified May 2026

Adult dosing per FDA-approved labels and standard hospital practice. Pediatric / weight-based dosing follows the label and is not summarized here.

Induction agents

Benzodiazepines

Opioid analgesics

Alpha-2 agonist sedation

Reversal agents

NDC reference — common manufacturers FDA NDC Directory verified May 2026

Most of these are mature generic injectables produced by multiple manufacturers. NDCs change frequently with shortage substitutions. Always use the 11-digit carton NDC of the vial actually administered, with N4 qualifier.

Propofol — J2704

Midazolam — J2250 / J2251

Fentanyl citrate — J3010

Hydromorphone & morphine

Lorazepam — J2060

Naloxone — J2310 / J2311 / J2312

NOC drugs (J3490) — ketamine, dexmedetomidine, etomidate, flumazenil, sugammadex

Administration codes — 00xxx vs 99151 vs 96374 CPT 2026 + ASA verified May 2026

The administration code family depends on who is sedating, why, and in what setting. There are four common patterns.

CPT 00xxx — anesthesia time codes (surgical anesthesia)

CPT 99151–99157 — moderate (conscious) sedation

CPT 96374 — IV push of therapeutic / diagnostic substance (standalone, not anesthesia)

CPT 96365 / 96366 — therapeutic IV infusion (rarely applies to sedation)

CPT 96365 (initial) and 96366 (each additional hour) are for therapeutic / prophylactic / diagnostic IV drug infusions. They almost never apply to the sedation drug class. The rare exception is a continuous infusion of a sedation drug delivered for a separately payable therapeutic indication outside the anesthesia / procedural / ICU bundles — for example, a standalone outpatient infusion-center ketamine drip for treatment-resistant depression (in the rare commercial-payer-covered case) or a standalone outpatient dexmedetomidine drip (essentially never separately payable). In nearly all real billing, sedation continuous infusions fall under anesthesia time, procedural packaging, or ICU per-diem — not 96365/96366.

The boundary line, worked

Modifiers CMS + ASA verified May 2026

The high-stakes modifier set for sedation is the anesthesia modifier family (AA / AD / QK / QY / QX + P1–P6 physical status), not JW / JZ vial waste.

JW / JZ — rarely apply

The CMS July 2023 single-dose container waste-reporting policy requires JW (waste) or JZ (no waste) on every separately payable J-code claim from a single-dose vial. Most sedation drugs are multi-dose vials or single-patient vials hung as a drip — waste reporting generally does not apply. Additionally, the great majority of sedation drug usage is bundled (not separately payable), so the modifier never triggers. For the rare separately payable single-dose vial scenarios (ED naloxone single-dose vial, ED flumazenil), follow the current CMS Drug Waste Reporting list before adding JW / JZ.

Anesthesia modifiers — the dominant family

Site-of-care modifiers (POS)

POS is the dominant practical modifier for sedation drug billing because POS controls whether the drug is packaged, bundled, or separately payable. POS 11 office (rare for these drugs), POS 22 on-campus HOPD, POS 24 ASC, POS 23 ED, POS 21 inpatient hospital, POS 49 freestanding ambulatory infusion (rare; ketamine clinics).

Modifier 25 — same-day E/M

Use modifier 25 on the same-day ED E/M code (e.g., 99284 / 99285) when a significant, separately identifiable E/M service was performed alongside the IV push / drug administration. Required to support payment of the ED E/M alongside the J2310 naloxone line or J2060 lorazepam line.

ICD-10-CM by indication FY2026 verified May 2026

Most billing for these drugs happens under the procedural ICD-10 (the ICD-10 for the procedure being sedated for, not for the sedation drug itself). For the standalone separately payable scenarios, indication-specific codes apply.

Site of care — bundling controls payment CMS OPPS Q2 2026 + IPPS FY2026 + ASA

Almost every site-of-care for these drugs is bundled. The exceptions are the ED and the rare standalone outpatient ketamine clinic.

How OPPS packaging works for procedural sedation drugs

Under the Outpatient Prospective Payment System, sedation drugs reported alongside a separately payable procedure APC are packaged into the parent APC. The drug acquisition cost is captured in the APC payment; a separate J2704 / J2250 / J3010 line on the same claim is processed but produces no incremental payment. The relevant CMS rule is the OPPS packaging logic, refreshed each calendar quarter in OPPS Addendum B. Procedural sedation drugs are prototypical packaged items.

How MS-DRG / ICU per-diem bundling works for inpatient sedation

Inpatient continuous sedation drug use is captured in the MS-DRG assigned to the admission. ICU per-diem cost is reflected in the DRG payment. The J-code is reported only on outpatient claims; on inpatient claims, sedation drug usage is captured via revenue code for chargemaster purposes and does not produce a separately payable Part B line. The day of intubation, the ICU length-of-stay, and the discharge disposition drive DRG assignment — not the cumulative milligrams of propofol delivered.

How CPT 00xxx anesthesia time works for surgical drugs

When an anesthesia provider delivers anesthesia for a surgical case, the anesthesia claim is built as: base units (assigned to the 00xxx code) + time units (15-minute increments from anesthesia start to end) + physical-status / qualifying-circumstance modifiers. Every drug administered during the anesthesia time — induction, opioids, benzos, paralytics, paralytic reversal (sugammadex), antiemetics — is part of the anesthesia time payment. The facility separately captures drug acquisition cost through the OPPS / ASC / DRG payment for the procedure itself. There is no separately payable J-code claim for any anesthesia drug used during the case.

Claim form field mapping CMS verified May 2026

CMS-1500 / 837P for ED physician / anesthesia professional / standalone outpatient. UB-04 / 837I for hospital outpatient, ASC, ED facility, inpatient.

CMS-1500 / 837P (ED professional, anesthesia professional, office)

UB-04 / 837I (HOPD facility, ASC, ED facility, inpatient)

Anesthesia claim specifics (00xxx)

Anesthesia claims are built around base units + time units + modifiers. The anesthesia provider reports CPT 00xxx with anesthesia-time minutes in 24G; the payer converts to time units (15-min increments) and applies the locality conversion factor. Sedation drugs administered during the anesthesia time are part of the payment and are NOT reported as separate J-lines on the anesthesia professional claim. The facility captures drug acquisition cost through the OPPS / ASC / DRG payment for the parent procedure.

Payer policy snapshot Reviewed May 2026

Commercial payers broadly follow Medicare on sedation drug coverage: bundled in anesthesia / procedural / ICU contexts; separately payable in ED reversal / analgesia / status epilepticus; rarely covered for standalone outpatient ketamine TRD.

Ketamine for treatment-resistant depression — the coverage reality

IV racemic ketamine for treatment-resistant depression is off-label, considered experimental / investigational by most commercial payers and Medicare, and is not covered in the standalone outpatient ketamine clinic context. Patients seeking IV ketamine for depression typically pay cash (~$400–$1,000 per session, 6–8 sessions per induction course). The FDA-approved alternative is intranasal esketamine (Spravato; HCPCS G2082 / G2083 / J3490 per plan), which is covered with PA + REMS-program documentation by most payers. Do not bill IV racemic ketamine to commercial or Medicare as a covered TRD service without confirmed PA — the encounter will be denied.

Dexmedetomidine prolonged ICU use — medical-necessity expectations

Dexmedetomidine (Precedex) is FDA-labeled for ICU sedation up to 24 hours. Real-world ICU practice routinely extends beyond 24 hours for spontaneous-breathing trials, awake ventilator weaning, and post-extubation delirium management. Most payers do not impose PA on inpatient dexmedetomidine (the cost is in the DRG), but a small subset of plans require medical-necessity documentation for prolonged outpatient or HOPD short-stay dexmedetomidine drips. Standard documentation is the indication, the RASS goal, the alternative sedatives tried, and the rationale for continued dexmedetomidine.

Step therapy

No meaningful step therapy applies to acute sedation / reversal / analgesia drugs in the ED or procedural context — clinical choice is driven by drug pharmacology, not payer step therapy. For standalone outpatient ketamine TRD, step therapy is effectively a coverage barrier — failure of multiple antidepressant trials is typically required before esketamine PA approval; IV racemic ketamine is generally not in the step-therapy pathway at all.

Medicare reimbursement CMS Q2 2026 (live)

ASP from the CMS Part B Drug ASP Pricing File. Refreshes automatically each quarter. Most sedation drug ASPs are very small per unit (generic injectables) — financial leverage on this page is bundling, not per-unit rate. Five drugs in this class have no permanent J-code (J3490 NOC) — manual MAC pricing by invoice when separately payable.

Full Q2 2026 ASP table

Sequestration

Where these J-codes are separately payable, standard ~2% sequestration applies, bringing effective payment to roughly ASP + 4.3%. In bundled or DRG-bundled contexts, sequestration is applied at the procedural payment level (APC or MS-DRG), not at the drug line.

Code history and stability

• J2704, J2250, J2251, J3010, J1171, J2270, J2272, J2274, J2060, J2312 — permanent CMS HCPCS Level II codes; descriptors stable
• J2310, J2311 — naloxone product-specific codes; verify current MAC convention quarterly as new naloxone formulations (intranasal Kloxxado, take-home Narcan) have updated coding
• J3490 — permanent NOC for unclassified drugs; required for ketamine, dexmedetomidine, etomidate, flumazenil, sugammadex; pricing is by MAC determination from invoice
• J2786 — reslizumab (Cinqair); not sugammadex; do not use for sugammadex
• Next ASP update: July 1, 2026 for Q3 2026

Patient assistance Reviewed May 2026

Generally not applicable to inpatient / procedural use of these drugs — the drug cost is absorbed by the facility / anesthesia time payment. For standalone outpatient ketamine TRD, programs exist but vary.

• No manufacturer PAP for generic IV sedatives, benzos, or opioids. Propofol, midazolam, lorazepam, fentanyl, hydromorphone, morphine, ketamine, etomidate, and naloxone (injectable) are commodity generic injectables produced at low cost by ICU Medical / Hospira, Fresenius Kabi, Hikma / West-Ward, B. Braun, Sandoz, and others. There is no copay card, no free-drug program, no PAN / HealthWell foundation fund for these products. Patient OOP for the underlying ED, procedure, or admission encounter is captured through facility / E/M / admin code coinsurance + deductible, not through a drug copay program.
• Sugammadex (Bridion, Merck) — manufacturer access. Merck Patient Assistance Program (mapus.com/patient-assistance) provides free drug to financially qualifying uninsured patients, but the practical relevance is minimal because sugammadex use is bundled into the anesthesia time payment — the patient does not face a separate drug bill in nearly all surgical cases.
• Dexmedetomidine (Precedex, originator Hospira / Pfizer). Generic dexmedetomidine is widely available. No meaningful PAP for the inpatient ICU use case (cost is in the DRG). For the rare HOPD outpatient drip, patient OOP flows through facility coinsurance, not a drug copay.
• Esketamine (Spravato, Janssen) — J&J Pathways and Spravato Savings Card. For the FDA-approved intranasal TRD product (distinct from IV racemic ketamine), Janssen offers a commercial savings card and a PAP for uninsured patients who meet financial criteria. Use is gated by REMS program enrollment — clinic must be REMS-certified.
• Standalone IV racemic ketamine for TRD — mostly cash-pay. Standalone ketamine clinics typically offer in-house payment plans (~$400–$1,000 per session); no manufacturer PAP applies because IV racemic ketamine is generic. Patients seeking financial assistance for this route are generally redirected to the esketamine (Spravato) pathway through their psychiatrist.
• Naloxone take-home (Narcan nasal spray, Emergent BioSolutions). Distinct from injectable naloxone J-codes — this is a pharmacy benefit product increasingly covered as a preventive benefit by Medicaid and many commercial plans, with manufacturer copay assistance and free distribution through state harm-reduction programs.
• Hospital financial assistance / charity care. For uninsured or underinsured patients with an ED reversal / status epilepticus / acute pain encounter, hospital-based financial assistance programs (required by 501(r) for non-profit hospitals) are the appropriate safety net for the underlying encounter costs.

Common denials & how to fix them Reviewed May 2026

Frequently asked questions

Can I bill propofol separately during a colonoscopy?

No. Propofol (J2704) administered as procedural sedation during a hospital outpatient or ASC colonoscopy, endoscopy, or other procedure is packaged into the procedure’s APC payment (HOPD) or the ASC facility payment. The drug is reported informationally on the chargemaster but produces no separately payable Part B line. Attempting to bill J2704 separately on top of the colonoscopy APC is the single most common denial in the entire sedation category. The administration of propofol by the proceduralist (when no separate anesthesia provider is present) is also bundled into the procedure work value.

96365 / 96366 vs moderate sedation 99151–99153 — what’s the difference?

CPT 96365 / 96366 is for therapeutic IV drug infusion (antibiotics, biologics, electrolyte concentrates) and almost never applies to sedation drugs. Moderate (conscious) sedation is reported under CPT 99151 / 99152 / 99153 when performed by the same physician performing the procedure, and 99155 / 99156 / 99157 when performed by an independent provider. Deep sedation or general anesthesia is reported under the CPT 00xxx anesthesia time codes by the anesthesia provider. Using 96365 for a propofol procedural sedation encounter is a coding error.

Is ED naloxone administration separately billable?

Yes, in most ED contexts. Naloxone administered IV / IM / intranasally in the emergency department for documented opioid overdose (F11.x opioid use disorder; T40.x poisoning by opioid) is generally separately payable under Part B on top of the ED facility E/M, when the chart documents the overdose presentation, the naloxone dose administered, and the patient response. Bill the appropriate naloxone HCPCS (J2310 / J2311 / J2312 — verify current convention) + 96374 IV push, with modifier 25 on the same-day E/M. EMS-administered naloxone follows separate state EMS billing rules.

Is ketamine for treatment-resistant depression covered?

Generally no, for IV racemic ketamine. Most commercial payers and Medicare consider IV racemic ketamine for treatment-resistant depression off-label and experimental / investigational and do not cover standalone outpatient infusion clinic visits. The FDA-approved intranasal esketamine (Spravato) is the covered TRD product and has its own coverage path with REMS-program requirements and PA. Cash-pay IV ketamine clinics are the typical access route for racemic ketamine for depression — not insurance billing. For surgical / procedural ketamine use, the drug is bundled into the anesthesia or procedure payment.

Are dexmedetomidine (Precedex) ICU drips separately billable?

Generally no on an inpatient encounter. Continuous dexmedetomidine sedation during an ICU admission is absorbed into the MS-DRG, just like every other inpatient drug. Dexmedetomidine does not have a permanent J-code as of 2026 and is billed under J3490 (NOC) with NDC and invoice on outpatient claims. The rare standalone HOPD short-stay dexmedetomidine use follows OPPS packaging rules — typically packaged into the procedure APC. Some payers require medical-necessity documentation for prolonged use beyond the FDA-labeled 24-hour duration.

Anesthesia time CPT 00xxx codes vs drug codes — how does that work?

The CPT 00xxx series (00100–01999) is the anesthesia time code family. When an anesthesia provider personally administers anesthesia for a surgical procedure, the anesthesia claim is built around (a) the appropriate 00xxx code matching the surgical procedure, (b) base units + time units (15-minute increments), and (c) physical-status / qualifying-circumstance modifier add-ons (P1–P6, QS, AA, AD, QK, QY, QX). The drugs administered by the anesthesia provider during that time — propofol, fentanyl, midazolam, sugammadex, etc. — are part of the anesthesia time payment and are not separately billable as J-code lines. Reporting J2704 alongside an 00xxx claim will be denied as bundled.

Is ED flumazenil administration separately billable?

Yes, similar to naloxone. Flumazenil (no permanent J-code as of 2026; bill under J3490 NOC with NDC + invoice) administered in the ED for documented benzodiazepine overdose (T42.4x poisoning by benzodiazepines; F13.x sedative use disorder) is generally separately payable on top of the ED facility E/M when the chart documents the overdose, dose administered, and response. Use is uncommon — flumazenil reversal can precipitate seizures in chronic benzo users and is reserved for clear iatrogenic over-sedation or pediatric / accidental overdose contexts.

How is lorazepam IV billed for status epilepticus?

Lorazepam (J2060, per 2 mg) administered IV in the ED, ICU, or floor for status epilepticus (G40.401 / G40.901 / G41.x) is billed per 2 mg administered — a typical 4 mg IV push = 2 units of J2060. On inpatient encounters the J-code is informational only and is captured in the MS-DRG. In the ED, J2060 plus 96374 (IV push) is separately payable on top of the facility E/M when status epilepticus is the documented indication. Alcohol withdrawal IV lorazepam in the ED follows the same logic — separately payable when chart supports F10.23x severe withdrawal.

How is sugammadex (Bridion) billed?

Sugammadex does not have a permanent J-code as of 2026 and is billed under J3490 (NOC) with NDC and invoice on outpatient claims. In surgical / anesthesia contexts — where sugammadex is administered by the anesthesia provider to reverse rocuronium or vecuronium at end of surgery — it is part of the anesthesia time payment and is NOT separately billable. The drug is reported on the chargemaster but produces no separately payable line. Note: J2786 is reslizumab (Cinqair), not sugammadex. The persistent J2786-for-sugammadex coder error is a known trap.

What are the surgical anesthesia drug bundling rules?

When anesthesia is provided by a separate anesthesia provider for a surgical procedure, all drugs administered during the anesthesia time — induction agents (propofol, etomidate, ketamine), opioids (fentanyl, hydromorphone, morphine), benzodiazepines (midazolam), neuromuscular blockers and their reversal agents (sugammadex), antiemetics, and adjuncts — are bundled into the CPT 00xxx anesthesia time payment. The facility separately captures drug acquisition cost through the OPPS / ASC / DRG payment for the procedure. There is no separately payable J-code claim for any anesthesia drug used during the case.

Can I bill midazolam separately during moderate sedation for a same-day outpatient procedure?

Generally no on an outpatient procedure. Midazolam (J2250, per 1 mg) used during proceduralist-administered moderate sedation (CPT 99151 / 99152 / 99153) for a same-day HOPD or ASC procedure is packaged into the procedure APC / ASC facility payment. The midazolam line is reported informationally on the chargemaster but produces no separately payable Part B line. The proceduralist’s moderate sedation CPT (99151 / 99152 / 99153) captures the sedation work.

How is hydromorphone or morphine billed in the ED for acute pain?

Hydromorphone (J1171, per 0.1 mg) and morphine sulfate (J2270, per 10 mg) administered IV in the ED for documented acute pain (G89.11 acute pain due to trauma, M54.x back pain, R10.x abdominal pain, R52 unspecified pain, M79.x soft-tissue pain) are generally separately payable on top of the ED facility E/M when chart supports the indication and dose. Per-dose math: 1 mg hydromorphone = 10 units of J1171; 4 mg morphine = 0.4 units of J2270 (verify rounding convention with payer). Inpatient administration is absorbed into the MS-DRG.

Source documents

1. AMA — CPT 2026 Professional Edition (00100–01999 anesthesia time codes; 99151–99157 moderate sedation; 96374–96376 IV push; 96365 / 96366 therapeutic IV infusion descriptors and parenthetical notes)
   Anesthesia time, moderate sedation, IV push code definitions and hierarchy rules; primary source for the 00xxx / 99151 / 96374 distinction at the heart of this page
2. ASA — American Society of Anesthesiologists, Standards for Basic Anesthetic Monitoring; Statement on Granting Privileges for Administration of Moderate Sedation; Crosswalk and Anesthesia Billing Guidance
   Definitions of anesthesia time, levels of sedation (minimal / moderate / deep / general), and billing convention for anesthesia care; the basis for the 00xxx-time-bundles-all-drugs rule
3. CMS — Medicare Part B Drug ASP Pricing File (Q2 2026)
   Quarterly ASP+6% rates for J2704 / J2250 / J2251 / J3010 / J1171 / J2270 / J2272 / J2274 / J2060 / J2312; effective April 1 – June 30, 2026
4. CMS — OPPS Addendum B (current quarter)
   Status Indicator assignments by HCPCS code; packaging logic for procedural sedation drugs during APC encounters
5. CMS — MS-DRG Classifications and Software (FY2026)
   Inpatient bundling framework absorbing ICU continuous sedation drug use into the DRG payment
6. CMS — HCPCS Level II Quarterly Updates
   Source for naloxone J2310 / J2311 / J2312 product-specific code assignments; confirms J3490 NOC status for ketamine, dexmedetomidine, etomidate, flumazenil, sugammadex (no permanent J-code as of 2026)
7. FDA — Drugs@FDA (propofol, midazolam, fentanyl citrate, hydromorphone, morphine, ketamine, dexmedetomidine, etomidate, lorazepam, naloxone, flumazenil, sugammadex / Bridion)
   FDA-approved labels for each agent; manufacturer labels for dosing, route, contraindications
8. DailyMed — current package inserts (Diprivan, Precedex, Bridion, Narcan, generic injectables)
   Current labels, NDCs, package inserts for each drug
9. ACEP — American College of Emergency Physicians, Policy Statement on Procedural Sedation; Use of Ketamine in the Emergency Department
   ED procedural sedation standards; ketamine in ED use cases
10. AAN — American Academy of Neurology, Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults
    IV lorazepam first-line dosing for status epilepticus
11. SCCM — Society of Critical Care Medicine, Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU
    ICU sedation standards (PADIS guidelines); propofol, midazolam, dexmedetomidine, fentanyl drip dosing
12. CMS — JW / JZ modifier policy (CR 12056, eff. July 2023)
    Single-dose container waste-reporting policy; clarifies scope (most sedation drugs in bundled contexts are out of scope)
13. FDA National Drug Code Directory
    Source for 11-digit NDCs by manufacturer

Refresh cadence

Change log

• May 22, 2026 — Initial publication. Wave 8 commodity rollup. ASP data: Q2 2026 for J2704 / J2250 / J2251 / J3010 / J1171 / J2270 / J2272 / J2274 / J2060 / J2312. NOC drugs (ketamine, dexmedetomidine, etomidate, flumazenil, sugammadex) under J3490. Built per drug-library-completion-plan.md Wave 8 spec. HCPCS spec corrections vs original task brief: hydromorphone J1171 not J1170; naloxone J2310/J2311/J2312 family (J2312 = NOS per 0.01 mg in ASP); dexmedetomidine J3490 NOC not J0470; flumazenil J3490 NOC not J0480 (J0480 = basiliximab); sugammadex J3490 NOC not J2786 (J2786 = reslizumab).

Methodology

Every claim on this page is sourced inline. Pricing reflects the current CMS Part B Drug ASP Pricing File. OPPS packaging is read directly from the current OPPS Addendum B. MS-DRG list is read from the IPPS final rule for the current fiscal year. CPT 00xxx anesthesia time, 99151–99157 moderate sedation, and 96374 IV push descriptors and hierarchy are read directly from the AMA CPT Professional Edition. Indication lists and dosing are verified against current FDA labels, ASA, ACEP, AAN, and SCCM practice guidelines. We do not paraphrase from billing-software vendor blogs.