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2025B Ambulatory Payment Classification: 5241
Title: Level 1 Blood Product Exchange and Related Services
| 2025B Relative Weight: | 4.9028 |
| 2025B Payment Rate: | $437.18 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 87.44 |
Addendum D1 Information
Status Indicator: S
Item / Code / Service:
Procedure or Service, Not Discounted When Multiple
OPPS Payment Status:
Paid under OPPS; Separate APC payment.
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| 2021 Top 10 OPPS Facility Claims for APC 5241* |
| NPI | Organization | APC 5241 Submitted |
| 1174582050 |
UNIVERSITY OF TEXAS M. D. ANDERSON CANCER CENTER-HOUSTON-TX
|
X,XXX
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| 1700887411 |
MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES-NEW YORK-NY
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X,XXX
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| 1851333686 |
DANA-FARBER CANCER INSTITUTE, INC.-BOSTON-MA
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X,XXX
|
| 1780653618 |
H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.-TAMPA-FL
|
X,XXX
|
| 1750358297 |
CITY OF HOPE NATIONAL MEDICAL CENTER-DUARTE-CA
|
X,XXX
|
| 1164493847 |
FRED HUTCHINSON CANCER CENTER-SEATTLE-WA
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X,XXX
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| 1871543215 |
STANFORD HEALTH CARE-STANFORD-CA
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X,XXX
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| 1851370910 |
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA-PHILADELPHIA-PA
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X,XXX
|
| 1457456279 |
HMH HOSPITALS CORPORATION-HACKENSACK-NJ
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X,XXX
|
| 1124127683 |
ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE-COLUMBUS-OH
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X,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:
36430 Transfusion bld/bld compnt
36440 Bld push tfuj 2 yr/<
36450 Bld exchange truj newborn
36455 Bld exchange truj oth thn nb
36456 Prtl exchange transfuse nb
36460 Intrauterine transfusion ftl
36513 Apheresis platelets
38207 Cryopreserve stem cells
38208 Thaw preserved stem cells
38209 Wash harvest stem cells
38210 T-cell depletion of harvest
38211 Tumor cell deplete of harvst
38212 Rbc depletion of harvest
38213 Platelet deplete of harvest
38214 Volume deplete of harvest
38215 Harvest stem cell concentrte
38999 Unlistd px hemic/lymphtc sys
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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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