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2025B Ambulatory Payment Classification: 9466
Title: Inj., benralizumab, 1 mg
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $163.30 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 32.67 |
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 9466* |
| NPI | Organization | APC 9466 Submitted |
| 1184721722 |
MERCY HOSPITAL OKLAHOMA CITY, INC-OKLAHOMA CITY-OK
|
XXX
|
| 1457396079 |
NORTHSIDE HOSPITAL, INC.-ATLANTA-GA
|
XXX
|
| 1326015777 |
NATIONAL JEWISH HEALTH-DENVER-CO
|
XXX
|
| 1437119310 |
SENTARA HOSPITALS-NORFOLK-VA
|
XXX
|
| 1750399192 |
MARYVIEW HOSPITAL LLC-CINCINNATI-OH
|
XXX
|
| 1295789907 |
CAROLINAS MEDICAL CENTER-CHARLOTTE-NC
|
XXX
|
| 1548202641 |
BETH ISRAEL DEACONESS MEDICAL CENTER, INC.-BOSTON-MA
|
XXX
|
| 1518912609 |
HARRISON MEDICAL CENTER-SILVERDALE-WA
|
XXX
|
| 1558392563 |
LAHEY CLINIC HOSPITAL, INC.-BURLINGTON-MA
|
XXX
|
| 1013010917 |
COMMUNITY MEDICAL CENTER INC-TOMS RIVER-NJ
|
XXX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J0517 Inj., benralizumab, 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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