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Anesthetic drugs such as marcaine and lidocaine when administered in an injection are not separately payable from the injection code itself, they are considered part of the injection code already. You can bill for the therapeutic drugs injected, such as dexamethasone, etc, but not the anesthetic drugs. Marcaine/bupvacaine is generally a very inexpensive drug, with a 50 ML bottle costing about $4.00. Not sure why you say it is a big dollar medication?