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2025B Ambulatory Payment Classification: 5735
Title: Level 5 Minor Procedures
| 2025B Relative Weight: | 4.4751 |
| 2025B Payment Rate: | $399.04 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 79.81 |
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 5735* |
| NPI | Organization | APC 5735 Submitted |
| 1639172372 |
CEDARS-SINAI MEDICAL CENTER-LOS ANGELES-CA
|
XXX
|
| 1679525919 |
THE CLEVELAND CLINIC FOUNDATION-CLEVELAND-OH
|
XXX
|
| 1245207521 |
PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S-PHILADELPHIA-PA
|
XXX
|
| 1639101751 |
MASSACHUSETTS EYE AND EAR INFIRMARY-BOSTON-MA
|
XX
|
| 1609824010 |
OREGON HEALTH & SCIENCE UNIVERSITY-PORTLAND-OR
|
XX
|
| 1679660617 |
UNIVERSITY OF MIAMI HOSPITAL AND CLINICS-MIAMI-FL
|
XX
|
| 1174597892 |
CURATORS OF THE UNIVERSITY OF MISSOURI-COLUMBIA-MO
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XX
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| 1376544320 |
STATE UNIVERSITY OF IOWA-IOWA CITY-IA
|
XX
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| 1649259656 |
UNIVERSITY OF KANSAS HOSPITAL AUTHORITY-WESTWOOD-KS
|
XX
|
| 1750358297 |
CITY OF HOPE NATIONAL MEDICAL CENTER-DUARTE-CA
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
0232T Njx platelet plasma
0481T Njx autol wbc concentrate
0881T Cryotherapy oral cavity
11980 Implant hormone pellet(s)
11982 Remove drug implant device
11983 Remove/insert drug implant
15860 Test for blood flow in graft
20665 Rmvl tongs/halo anthr indiv
36425 Venipuncture cutdown 1 yr/>
36680 Insert needle bone cavity
41250 Repair tongue laceration
42809 Remove pharynx foreign body
43752 Nasal/orogastric w/tube plmt
46601 Diagnostic anoscopy
65210 Remove foreign body from eye
65220 Remove foreign body from eye
65430 Corneal smear
68200 Treat eyelid by injection
68801 Dilate tear duct opening
86975 Rbc serum pretx incubj drugs
92284 Dx dark adaptation exam i&r
92311 Contact lens fitg aphakia 1
93024 Ergonovine provocation test
94014 Patient recorded spirometry
95180 Rapid desensitization
95905 Motor &/ sens nrve cndj test
96138 Psycl/nrpsyc tech 1st
G0516 Insert drug del implant, >=4
G0517 Remove drug implant
G0518 Remove w insert drug implant
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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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