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2025B Ambulatory Payment Classification: 5593
Title: Level 3 Nuclear Medicine and Related Services
| 2025B Relative Weight: | 14.6405 |
| 2025B Payment Rate: | $1305.48 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $261.10 |
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 5593* |
| NPI | Organization | APC 5593 Submitted |
| 1083617005 |
OKLAHOMA HEART HOSPITAL, LLC-OKLAHOMA CITY-OK
|
X,XXX
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| 1053384776 |
AHS HOSPITAL CORP.-MORRISTOWN-NJ
|
X,XXX
|
| 1679525919 |
THE CLEVELAND CLINIC FOUNDATION-CLEVELAND-OH
|
X,XXX
|
| 1578527172 |
BAPTIST MEMORIAL HOSPITAL-MEMPHIS-TN
|
X,XXX
|
| 1124074273 |
METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P.-SAN ANTONIO-TX
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X,XXX
|
| 1013981554 |
EISENHOWER MEDICAL CENTER-RANCHO MIRAGE-CA
|
X,XXX
|
| 1083612881 |
ENGLEWOOD HOSPITAL AND MEDICAL CENTER-ENGLEWOOD-NJ
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X,XXX
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| 1720033947 |
ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP-AUSTIN-TX
|
X,XXX
|
| 1184709057 |
ORLANDO HEALTH, INC.-ORLANDO-FL
|
X,XXX
|
| 1659387975 |
COMMUNITY HOSPITAL GROUP INC-EDISON-NJ
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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:
0331T Heart symp image plnr
0332T Heart symp image plnr spect
78075 Adrenal cortex & medulla img
78110 Plasma volume single
78111 Plasma volume multiple
78451 Ht muscle image spect sing
78452 Ht muscle image spect mult
78453 Ht muscle image planar sing
78454 Ht musc image planar mult
78456 Acute venous thrombus image
78459 Myocrd img pet single study
78650 Csf leakage imaging
78802 Rp loclzj tum whbdy 1 d img
78803 Rp loclzj tum spect 1 area
78804 Rp loclzj tum whbdy 2+d img
78811 Pet image ltd area
78830 Rp loclzj tum spect w/ct 1
78831 Rp loclzj tum spect 2 areas
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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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