| Short Descr | Intraosseous destruct add'l | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 53 – Statute | MPI | A – Not applicable, as HCPCS priced under one methodology | Statute | 1833(t) | Cross-Reference(s) | 64629 | BETOS | P5B – Ambulatory procedures - musculoskeletal | TOS Code(s) | 2 – Surgery | Added Date | 1/1/2019 | Termination Date | 12/31/2021 | APC Status Indicator | Items and Services Packaged into APC Rates | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No |
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| 2021-12-31 | Deleted | Code deleted, see 64629 |
| 2019-01-01 | Added | Added |
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