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2025B Ambulatory Payment Classification: 5692
Title: Level 2 Drug Administration
| 2025B Relative Weight: | 0.7982 |
| 2025B Payment Rate: | $ 71.17 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 14.24 |
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 5692 * |
| NPI | Organization | APC 5692 Submitted |
| 1700887411 |
MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES-NEW YORK-NY
|
XX,XXX
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| 1174582050 |
UNIVERSITY OF TEXAS M. D. ANDERSON CANCER CENTER-HOUSTON-TX
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XX,XXX
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| 1851333686 |
DANA-FARBER CANCER INSTITUTE, INC.-BOSTON-MA
|
XX,XXX
|
| 1679525919 |
THE CLEVELAND CLINIC FOUNDATION-CLEVELAND-OH
|
XX,XXX
|
| 1013981554 |
EISENHOWER MEDICAL CENTER-RANCHO MIRAGE-CA
|
XX,XXX
|
| 1780653618 |
H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.-TAMPA-FL
|
XX,XXX
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| 1457396079 |
NORTHSIDE HOSPITAL, INC.-ATLANTA-GA
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XX,XXX
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| 1649259656 |
UNIVERSITY OF KANSAS HOSPITAL AUTHORITY-WESTWOOD-KS
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XX,XXX
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| 1871543215 |
STANFORD HEALTH CARE-STANFORD-CA
|
XX,XXX
|
| 1952311508 |
UPMC MAGEE-WOMENS HOSPITAL-PITTSBURGH-PA
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XX,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:
90471 Immunization admin
90473 Immune admin oral/nasal
95147 Antigen therapy services
95148 Antigen therapy services
95149 Antigen therapy services
96367 Tx/proph/dg addl seq iv inf
96371 Sc ther infusion reset pump
96372 Ther/proph/diag inj sc/im
96401 Chemo anti-neopl sq/im
96402 Chemo hormon antineopl sq/im
96405 Chemo intralesional up to 7
96411 Chemo iv push addl drug
96415 Chemo iv infusion addl hr
96417 Chemo iv infus each addl seq
G0012 Injection of hiv prep drug
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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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