| Code | Description | Version |
| ... | See NUBC codes | added v2.5.1, removed after v2.6 |
| 01 | Most common semi-private rate | added v2.3.1, removed after v2.4 |
| 02 | Hospital has no semi-private rooms | added v2.3.1, removed after v2.4 |
| 04 | Inpatient professional component charges which are combined billed | added v2.3.1, removed after v2.4 |
| 05 | Professional component included in charges and also billed separate to carrier | added v2.3.1, removed after v2.4 |
| 06 | Medicare blood deductible | added v2.3.1, removed after v2.4 |
| 08 | Medicare life time reserve amount in the first calendar year | added v2.3.1, removed after v2.4 |
| 09 | Medicare co-insurance amount in the first calendar year | added v2.3.1, removed after v2.4 |
| 10 | Lifetime reserve amount in the second calendar year | added v2.3.1, removed after v2.4 |
| 11 | Co-insurance amount in the second calendar year | added v2.3.1, removed after v2.4 |
| 12 | Working aged beneficiary/spouse with employer group health plan | added v2.3.1, removed after v2.4 |
| 13 | ESRD beneficiary in a Medicare coordination period with an employer group health plan | added v2.3.1, removed after v2.4 |
| 14 | No Fault including auto/other | added v2.3.1, removed after v2.4 |
| 15 | Worker's Compensation | added v2.3.1, removed after v2.4 |
| 16 | PHS, or other federal agency | added v2.3.1, removed after v2.4 |
| 17 | Payer code | added v2.3.1, removed after v2.4 |
| 21 | Catastrophic | added v2.3.1, removed after v2.4 |
| 22 | Surplus | added v2.3.1, removed after v2.4 |
| 23 | Recurring monthly incode | added v2.3.1, removed after v2.4 |
| 24 | Medicaid rate code | added v2.3.1, removed after v2.4 |
| 30 | Pre-admission testing | added v2.3.1, removed after v2.4 |
| 31 | Patient liability amount | added v2.3.1, removed after v2.4 |
| 37 | Pints of blood furnished | added v2.3.1, removed after v2.4 |
| 38 | Blood deductible pints | added v2.3.1, removed after v2.4 |
| 39 | Pints of blood replaced | added v2.3.1, removed after v2.4 |
| 40 | New coverage not implemented by HMO (for inpatient service only) | added v2.3.1, removed after v2.4 |
| 41 | Black lung | added v2.3.1, removed after v2.4 |
| 42 | VA | added v2.3.1, removed after v2.4 |
| 43 | Disabled beneficiary under age 64 with LGHP | added v2.3.1, removed after v2.4 |
| 44 | Amount provider agreed to accept from primary payer when this amount is less than charges but higher than payment received,, then a Medicare secondary payment is due | added v2.3.1, removed after v2.4 |
| 45 | Accident hour | added v2.3.1, removed after v2.4 |
| 46 | Number of grace days | added v2.3.1, removed after v2.4 |
| 47 | Any liability insurance | added v2.3.1, removed after v2.4 |
| 48 | Hemoglobin reading | added v2.3.1, removed after v2.4 |
| 49 | Hematocrit reading | added v2.3.1, removed after v2.4 |
| 50 | Physical therapy visits | added v2.3.1, removed after v2.4 |
| 51 | Occupational therapy visits | added v2.3.1, removed after v2.4 |
| 52 | Speech therapy visits | added v2.3.1, removed after v2.4 |
| 53 | Cardiac rehab visits | added v2.3.1, removed after v2.4 |
| 56 | Skilled nurse - home visit hours | added v2.3.1, removed after v2.4 |
| 57 | Home health aide - home visit hours | added v2.3.1, removed after v2.4 |
| 58 | Arterial blood gas | added v2.3.1, removed after v2.4 |
| 59 | Oxygen saturation | added v2.3.1, removed after v2.4 |
| 60 | HHA branch MSA | added v2.3.1, removed after v2.4 |
| 67 | Peritoneal dialysis | added v2.3.1, removed after v2.4 |
| 68 | EPO-drug | added v2.3.1, removed after v2.4 |
| 70 ... 72 | Payer codes | added v2.3.1, removed after v2.4 |
| 75 ... 79 | Payer codes | added v2.3.1, removed after v2.4 |
| 80 | Psychiatric visits | added v2.3.1, removed after v2.4 |
| 81 | Visits subject to co-payment | added v2.3.1, removed after v2.4 |
| A1 | Deductible payer A | added v2.3.1, removed after v2.4 |
| A2 | Coinsurance payer A | added v2.3.1, removed after v2.4 |
| A3 | Estimated responsibility payer A | added v2.3.1, removed after v2.4 |
| X0 | Service excluded on primary policy | added v2.3.1, removed after v2.4 |
| X4 | Supplemental coverage | added v2.3.1, removed after v2.4 |
| … | See NUBC codes | added v2.7 |
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