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2025B Ambulatory Payment Classification: 9174
Title: Inj, durolane 1 mg
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 6.93 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 1.39 |
Addendum D1 Information
Status Indicator: K
Item / Code / Service:
(1) Non-Pass-Through Drugs and Biologicals
(2) Therapeutic Radiopharmaceuticals
(3) Brachytherapy Sources
(4) Blood and Blood Products
OPPS Payment Status:
(1) Paid under OPPS; Separate APC payment.
(2) Paid under OPPS; Separate APC payment.
(3) Paid under OPPS; Separate APC payment.
(4) Paid under OPPS; Separate APC payment.
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| 2021 Top 10 OPPS Facility Claims for APC 9174* |
| NPI | Organization | APC 9174 Submitted |
| 1073606901 |
MEMORIAL HOSPITAL AT GULFPORT-GULFPORT-MS
|
XXX
|
| 1679525919 |
THE CLEVELAND CLINIC FOUNDATION-CLEVELAND-OH
|
XXX
|
| 1992761985 |
ST JOSEPH MERCY CHELSEA INC-CHELSEA-MI
|
XXX
|
| 1144210253 |
ASCENSION PROVIDENCE HOSPITAL-SOUTHFIELD-MI
|
XXX
|
| 1992703540 |
DUKE UNIVERSITY HEALTH SYSTEM, INC.-DURHAM-NC
|
XXX
|
| 1831116441 |
BRONSON METHODIST HOSPITAL-KALAMAZOO-MI
|
XXX
|
| 1720031701 |
STRAUB CLINIC & HOSPITAL-HONOLULU-HI
|
XXX
|
| 1710918545 |
REGENTS OF THE UNIVERSITY OF CALIFORNIA-RANCHO CORDOVA-CA
|
XX
|
| 1205197894 |
GEISINGER WYOMING VALLEY MEDICAL CENTER-DANVILLE-PA
|
XX
|
| 1780673376 |
SONORA COMMUNITY HOSPITAL-LOS ANGELES-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:
J7318 Inj, durolane 1 mg
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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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