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2025B Ambulatory Payment Classification: 5771
Title: Cardiac Rehabilitation
| 2025B Relative Weight: | 1.412 |
| 2025B Payment Rate: | $125.91 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 25.19 |
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 5771* |
| NPI | Organization | APC 5771 Submitted |
| 1083617005 |
OKLAHOMA HEART HOSPITAL, LLC-OKLAHOMA CITY-OK
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XX,XXX
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| 1245294826 |
SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT-SARASOTA-FL
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XX,XXX
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| 1013981554 |
EISENHOWER MEDICAL CENTER-RANCHO MIRAGE-CA
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XX,XXX
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| 1558302570 |
LEE MEMORIAL HEALTH SYSTEM-CAPE CORAL-FL
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X,XXX
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| 1841442274 |
OKLAHOMA HEART HOSPITAL SOUTH LLC-OKLAHOMA CITY-OK
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X,XXX
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| 1790775229 |
ARKANSAS HEART HOSPITAL, LLC-LITTLE ROCK-AR
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X,XXX
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| 1174021695 |
REHABILITATION HOSPITAL, LLC-BRENTWOOD-TN
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X,XXX
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| 1386608859 |
HONORHEALTH-SCOTTSDALE-AZ
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X,XXX
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| 1720085137 |
NAPLES COMMUNITY HOSPITAL INC-NAPLES-FL
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X,XXX
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| 1467484972 |
OHIOHEALTH CORPORATION-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:
93797 Phys/qhp op car rhab wo ecg
93798 Phys/qhp op car rhab w/ecg
G0422 Intens cardiac rehab w/exerc
G0423 Intens cardiac rehab no exer
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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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