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2025B Ambulatory Payment Classification: 9243
Title: Inj, bendamustine hcl, 1mg
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 1.24 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 0.25 |
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 9243* |
| NPI | Organization | APC 9243 Submitted |
| 1821196486 |
BEEBE MEDICAL CENTER, INC.-LEWES-DE
|
XXX
|
| 1255328621 |
SPENCER MUNICIPAL HOSPITAL-SPENCER-IA
|
XXX
|
| 1043279565 |
ST. FRANCIS HOSPITAL-ROSLYN-NY
|
XXX
|
| 1770693939 |
CENTRA HEALTH INC-LYNCHBURG-VA
|
XX
|
| 1023088168 |
ASCENSION ST JOHN HOSPITAL-CHICAGO-IL
|
XX
|
| 1306849708 |
BRATTLEBORO MEMORIAL HOSPITAL-BRATTLEBORO-VT
|
XX
|
| 1093768962 |
MERCY HEALTH SYSTEM CORPORATION-JANESVILLE-WI
|
XX
|
| 1013918960 |
GASTON MEMORIAL HOSPITAL, INCORPORATED-GASTONIA-NC
|
XX
|
| 1689608150 |
UNIVERSITY OF CALIFORNIA IRVINE-ANAHEIM-CA
|
XX
|
| 1619914785 |
LEWIS-GALE MEDICAL CENTER, LLC-SALEM-VA
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J9033 Inj, bendamustine hcl, 1mg
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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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