Miscellaneous Provider Services and Supplies HCPCS Code range S0630-S3722

Donor lobectomy (lung) for transplantation, living donor

Simultaneous pancreas kidney transplantation

Breast reconstruction with gluteal artery perforator (GAP) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral

Breast reconstruction of a single breast with "stacked" deep inferior epigastric perforator (DIEP) flap(s) and/or gluteal artery perforator (GAP) flap(s), including harvesting of the flap(s), microvascular transfer, closure of donor site(s) and shaping the flap into a breast, unilateral

Breast reconstruction with deep inferior epigastric perforator (DIEP) flap or superficial inferior epigastric artery (SIEA) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization)

Laparoscopic esophagomyotomy (Heller type)

Laser-assisted uvulopalatoplasty (LAUP)

Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline

Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres