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2025B Ambulatory Payment Classification: 5192
Title: Level 2 Endovascular Procedures
| 2025B Relative Weight: | 63.9406 |
| 2025B Payment Rate: | $5701.52 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $1140.31 |
Addendum D1 Information
Status Indicator: J1
Item / Code / Service:
Hospital Part B services paid through a comprehensive APC
OPPS Payment Status:
Paid under OPPS; all covered Part B services on the claim are packaged with the primary "J1" service for the claim, except services with OPPS SI=F,G, H, L and U; ambulance services; diagnostic and screening mammography; all preventive services; and certain Part B inpatient services.
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| 2021 Top 10 OPPS Facility Claims for APC 5192* |
| NPI | Organization | APC 5192 Submitted |
| 1699286922 |
HUMBLE VASCULAR SURGICAL CENTER LLC-HUMBLE-TX
|
XXX
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| 1770004772 |
NORTHWEST ATLANTA VASCULAR CARE LLC-NAPLES-FL
|
XXX
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| 1528501939 |
AMERICAN ACCESS CARE OF FLORIDA ASC LLC-BOSTON-MA
|
XXX
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| 1154417368 |
ST JOHN MEDICAL CENTER INC-TULSA-OK
|
XXX
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| 1598835308 |
SSM HEALTH CARE ST. LOUIS-BRIDGETON-MO
|
XXX
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| 1578094462 |
AMERICAN ACCESS CARE OF JACKSONVILLE ASC LLC-MALVERN-PA
|
XXX
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| 1306123344 |
MCLEOD LORIS SEACOAST HOSPITAL-LORIS-SC
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XXX
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| 1558339424 |
PREMIER SURGERY CENTER-CONCORD-CA
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XXX
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| 1457309247 |
THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES-ORANGEBURG-SC
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XXX
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| 1992789721 |
PHOEBE PUTNEY MEMORIAL HOSPITAL INC-ALBANY-GA
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XXX
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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:
0338T Trnscth renal symp denrv unl
0339T Trnscth renal symp denrv bil
0644T Tcat rmvl/dblk icar mas perq
0913T Prq tcat ther rx ntrac balo1
36902 Intro cath dialysis circuit
36904 Thrmbc/nfs dialysis circuit
37183 Revision tips
37220 Iliac revasc
37224 Fem/popl revas w/tla
37246 Trluml balo angiop 1st art
37248 Trluml balo angiop 1st vein
92920 Prq cardiac angioplast 1 art
92986 Revision of aortic valve
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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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