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2025B Ambulatory Payment Classification: 1613
Title: Trastuzumab injection
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 75.69 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 15.14 |
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.
|
| 2021 Top 10 OPPS Facility Claims for APC 1613* |
| NPI | Organization | APC 1613 Submitted |
| 1437230034 |
NYU LANGONE HOSPITALS-NEW YORK-NY
|
X,XXX
|
| 1467420448 |
COBB HOSPITAL, INC-MARIETTA-GA
|
XXX
|
| 1871543215 |
STANFORD HEALTH CARE-STANFORD-CA
|
XXX
|
| 1679660617 |
UNIVERSITY OF MIAMI HOSPITAL AND CLINICS-MIAMI-FL
|
XXX
|
| 1457396079 |
NORTHSIDE HOSPITAL, INC.-ATLANTA-GA
|
XXX
|
| 1164493847 |
FRED HUTCHINSON CANCER CENTER-SEATTLE-WA
|
XXX
|
| 1851333686 |
DANA-FARBER CANCER INSTITUTE, INC.-BOSTON-MA
|
XXX
|
| 1124127683 |
ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE-COLUMBUS-OH
|
XXX
|
| 1770690695 |
HONORHEALTH-PHOENIX-AZ
|
XXX
|
| 1528042884 |
BAPTIST HOSPITAL OF MIAMI INC-SOUTH MIAMI-FL
|
XXX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J9355 Inj trastuzumab excl biosimi
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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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