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CMS Transmittals



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9375 Quick jump to APC Code (numbers only eg. 0172):
9377

2025B Ambulatory Payment Classification: 9376

Title: Sacituzumab govitecan-hziy

2025B Relative Weight: 0
2025B Payment Rate: $ 35.80
2025B National Unadjusted Copay: $ 0.00
2025B Minimum Unadjusted Copay: $ 7.16
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.


2021 Top 10 OPPS Facility Claims for APC 9376*
NPIOrganization APC 9376 Submitted
1700887411 MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES-NEW YORK-NY XXX
1851333686 DANA-FARBER CANCER INSTITUTE, INC.-BOSTON-MA XXX
1457396079 NORTHSIDE HOSPITAL, INC.-ATLANTA-GA XXX
1578778726 YALE NEW HAVEN HOSPITAL-NEW HAVEN-CT XXX
1306925540 BAPTIST HEALTHCARE SYSTEM, INC.-LOUISVILLE-KY XXX
1689608150 UNIVERSITY OF CALIFORNIA IRVINE-ANAHEIM-CA XXX
1396882205 VANDERBILT UNIVERSITY MEDICAL CENTER-NASHVILLE-TN XXX
1689772592 UNIVERSITY OF CALIFORNIA, SAN FRANCISCO-SAN FRANCISCO-CA XXX
1871543215 STANFORD HEALTH CARE-STANFORD-CA XXX
1093705428 JACKSON MADISON COUNTY GENERAL HOSPITAL-JACKSON-TN XXX


* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.


Procedure Codes in this APC:
J9317 Sacituzumab govitecan-hziy


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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