HCPCS S0028

Injection, famotidine, 20 mg

Retired code12 hospitals with prices

Description from CMS's HCPCS Level II code file.

This code is retired. Some hospitals still list it.

What Washington hospitals publish for this code

Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.

Prices for HCPCS S0028 by hospital
Hospital	Other government program rates (lowest – highest)	Cash price	List price (before discounts)
Cascade Medical CenterLeavenworth	$13.38 – $1062 plans	$12.00	$15.00
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	—	$1.00

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.