| Short Description | Restrata minimatrix, 5 mg |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Action Effective Date | April 01, 2024 |
| HCPCS Code Added Date | April 01, 2024 |
| HCPCS Pricing Indicator Code | 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion) |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Issues Manual Reference Section Number | |
| HCPCS Type Of Service Code | 1 - Medical care |
| HCPCS Anesthesia Base Unit Quantity | 0 |
