|
|
.
2025B Ambulatory Payment Classification: 5193
Title: Level 3 Endovascular Procedures
| 2025B Relative Weight: | 127.1806 |
| 2025B Payment Rate: | $11340.57 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $2268.12 |
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.
|
| 2021 Top 10 OPPS Facility Claims for APC 5193* |
| NPI | Organization | APC 5193 Submitted |
| 1790775229 |
ARKANSAS HEART HOSPITAL, LLC-LITTLE ROCK-AR
|
XXX
|
| 1083617005 |
OKLAHOMA HEART HOSPITAL, LLC-OKLAHOMA CITY-OK
|
XXX
|
| 1043279565 |
ST. FRANCIS HOSPITAL-ROSLYN-NY
|
XXX
|
| 1639172372 |
CEDARS-SINAI MEDICAL CENTER-LOS ANGELES-CA
|
XXX
|
| 1962504340 |
TEXAS HEART HOSPITAL OF THE SOUTHWEST LLP-DALLAS-TX
|
XXX
|
| 1932103413 |
MOUNT SINAI HOSPITAL-NEW YORK-NY
|
XXX
|
| 1821017880 |
SANFORD MEDICAL CENTER-SIOUX FALLS-SD
|
XXX
|
| 1801992631 |
NYU LANGONE HOSPITALS-NEW YORK-NY
|
XXX
|
| 1841442274 |
OKLAHOMA HEART HOSPITAL SOUTH LLC-OKLAHOMA CITY-OK
|
XXX
|
| 1497797088 |
REX HOSPITAL INC.-RALEIGH-NC
|
XXX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
0234T Trluml perip athrc renal art
0236T Trluml perip athrc abd aorta
0237T Trluml perip athrc brchiocph
0505T Ev fempop artl revsc
33900 Perq p-art revsc 1 nm nt uni
33901 Perq p-art revsc 1 nm nt bi
33903 Perq p-art revsc 1 abnor bi
36903 Intro cath dialysis circuit
36905 Thrmbc/nfs dialysis circuit
37187 Venous mech thrombectomy
37221 Iliac revasc w/stent
37226 Fem/popl revasc w/stent
37228 Tib/per revasc w/tla
37236 Open/perq place stent 1st
37238 Open/perq place stent same
37241 Vasc embolize/occlude venous
37243 Vasc embolize/occlude organ
37244 Vasc embolize/occlude bleed
61623 Endovasc tempory vessel occl
61626 Transcath occlusion non-cns
92924 Prq card angio/athrect 1 art
92928 Prq card stent w/angio 1 vsl
92937 Prq revasc byp graft 1 vsl
92943 Prq card revasc chronic 1vsl
92987 Revision of mitral valve
92990 Revision of pulmonary valve
92997 Pul art balloon repr percut
C8004 Sim ang w/prs cath rad emb
C9600 Perc drug-el cor stent sing
C9604 Perc d-e cor revasc t cabg s
C9764 Revasc intravasc lithotripsy
C9772 Revasc lithotrip tibi/perone
C9783 Blind cor sinus reducer impl
|
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.
|
|
