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City New York / Washington / Arlington / / Company Medicare Carrier Part B Wisconsin Physician Service Insurance Corporation / / Country Puerto Rico / / Facility Facility C9257 / / MedicalCondition Histoplasma capsulatum retinitis / Macular retinal edema / Glaucoma / macular edema / vascular disorders / macular degeneration / vitreous hemorrhage / F. Proliferative diabetic retinopathy / choroidal neovascularization / Histoplasma duboisii retinitis / H. Retinal neovascularization / E. Histoplasmosis retinitis / Angioid streaks / cystoid macular edema / diabetic retinopathy / C. Central retinal vein occlusion / neovascular glaucoma / Retinal neovascularization NOS / Histoplasmosis retinitis / I. Cystoid macular degeneration / senile macular degeneration / G. Severe nonproliferative diabetic retinopathy / macular degeneration B. Diabetic / diabetic macular edema / retinal vein occlusion / Infection / Retinal edema / K. Glaucoma / / MusicGroup Oregon / Dakota / / NaturalFeature Venous tributary / / Organization Medicare / / Position RT / Report modifier RT / / Product C9257 Injection / Avastin / MG L30555 FACILITY / Tennessee HCPCS Code OFFICE J9035 Injection / / ProvinceOrState Texas / New Jersey / Virginia / Alabama / Alaska / Maine / Fairfax / Maryland / North Dakota / Nevada / Louisiana / Oregon / Hawaii / New York / Connecticut / Washington / South Dakota / New Mexico / Utah / District of Columbia / Pennsylvania / Arlington / Rhode Island / Montana / Oklahoma / Mississippi / Delaware / Florida / California / Georgia / Arizona / Massachusetts / Idaho / Arkansas / New Hampshire / / URL www.wps.medicare.com / www.aao.org/coding / www.novitas-solutions.com / http / SocialTag 
Bevacizumab (Avastin®) – Medicare Part B Coding for Off-Label Ophthalmic Use Updated April 2014 Carriers Subject to Change – www.aao.org/coding Medicare Carrier Part B Cahaba GBA