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2025B Ambulatory Payment Classification: 0947
Title: Flebogamma injection
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 55.76 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 11.16 |
Addendum D1 Information
Status Indicator: K
Item / Code / Service:
(1) Non-Pass-Through Drugs and Biologicals
(2) Therapeutic Radiopharmaceuticals
(3) Brachytherapy Sources
(4) Blood and Blood Products
OPPS Payment Status:
(1) Paid under OPPS; Separate APC payment.
(2) Paid under OPPS; Separate APC payment.
(3) Paid under OPPS; Separate APC payment.
(4) Paid under OPPS; Separate APC payment.
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| 2021 Top 10 OPPS Facility Claims for APC 0947* |
| NPI | Organization | APC 0947 Submitted |
| 1750395737 |
HOLYOKE MEDICAL CENTER, INC.-HOLYOKE-MA
|
XXX
|
| 1598755324 |
ST. ANTHONY COMMUNITY HOSPITAL-WARWICK-NY
|
XXX
|
| 1396725677 |
MARIN GENERAL HOSPITAL-SAN RAFAEL-CA
|
XXX
|
| 1366404428 |
BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC-CINCINNATI-OH
|
XXX
|
| 1265431829 |
SALEM HEALTH-SALEM-OR
|
XXX
|
| 1417944224 |
IREDELL MEMORIAL HOSPITAL, INCORPORATED-STATESVILLE-NC
|
XX
|
| 1104859131 |
HOLY NAME MEDICAL CENTER INC.-TEANECK-NJ
|
XX
|
| 1366547747 |
RIVERSIDE HOSPITAL INC-NEWPORT NEWS-VA
|
XX
|
| 1033102942 |
CARILION MEDICAL CENTER-ROANOKE-VA
|
XX
|
| 1083888515 |
PEACEHEALTH-VANCOUVER-WA
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J1572 Flebogamma injection
|
Sources: Updates of Addendum A and B are posted quarterly to the OPPS website. These addenda are a "snapshot" of HCPCS codes and their status indicators,
APC groups, and OPPS payment rates, that are in effect at the beginning of each quarter. The quarterly updates of Addendum A and Addendum B reflect
the OPPS Pricer changes that are part of the quarterly OPPS recurring update notification transmittals.
http://www.cms.gov/HospitalOutpatientPPS/AU/list.asp#TopOfPage
For more information on the Composite APC payment,
please see CMS Transmittal R2141CP.
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