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2025B Ambulatory Payment Classification: 5151
Title: Level 1 Airway Endoscopy
| 2025B Relative Weight: | 2.1772 |
| 2025B Payment Rate: | $194.14 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 38.83 |
Addendum D1 Information
Status Indicator: T
Item / Code / Service:
Procedure or Service, Multiple Procedure Reduction Applies
OPPS Payment Status:
Paid under OPPS; Separate APC payment.
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| 2021 Top 10 OPPS Facility Claims for APC 5151* |
| NPI | Organization | APC 5151 Submitted |
| 1639101751 |
MASSACHUSETTS EYE AND EAR INFIRMARY-BOSTON-MA
|
X,XXX
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| 1851370910 |
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA-PHILADELPHIA-PA
|
X,XXX
|
| 1679525919 |
THE CLEVELAND CLINIC FOUNDATION-CLEVELAND-OH
|
X,XXX
|
| 1871543215 |
STANFORD HEALTH CARE-STANFORD-CA
|
X,XXX
|
| 1215916002 |
THOMAS JEFFERSON UNIVERSITY HOSPITALS INC-PHILADELPHIA-PA
|
X,XXX
|
| 1679660617 |
UNIVERSITY OF MIAMI HOSPITAL AND CLINICS-MIAMI-FL
|
X,XXX
|
| 1932213600 |
RUSH UNIVERSITY MEDICAL CENTER-CHICAGO-IL
|
X,XXX
|
| 1376544320 |
STATE UNIVERSITY OF IOWA-IOWA CITY-IA
|
X,XXX
|
| 1700887411 |
MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES-NEW YORK-NY
|
X,XXX
|
| 1396882205 |
VANDERBILT UNIVERSITY MEDICAL CENTER-NASHVILLE-TN
|
X,XXX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
31231 Nasal endoscopy dx
31505 Diagnostic laryngoscopy
31511 Remove foreign body larynx
31575 Diagnostic laryngoscopy
31899 Unlisted px trachea bronchi
92511 Nasopharyngoscopy
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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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