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2025B Ambulatory Payment Classification: 1480
Title: Elosulfase alfa, injection
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $293.94 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 58.79 |
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 1480* |
| NPI | Organization | APC 1480 Submitted |
| 1831115641 |
OZARKS MEDICAL CENTER-WEST PLAINS-MO
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XX
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| 1568465144 |
NORTHERN MAINE MEDICAL CENTER-FORT KENT-ME
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XX
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| 1487655064 |
BAYSTATE MEDICAL CENTER INC-SPRINGFIELD-MA
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XX
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| 1669462420 |
ST JOSEPHS UNIVERSITY MEDICAL CENTER INC.-PATERSON-NJ
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XX
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* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J1322 Elosulfase alfa, injection
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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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