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2025B Ambulatory Payment Classification: 9472
Title: Inj talimogene laherparepvec
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 70.38 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 14.08 |
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 9472* |
| NPI | Organization | APC 9472 Submitted |
| 1174582050 |
UNIVERSITY OF TEXAS M. D. ANDERSON CANCER CENTER-HOUSTON-TX
|
XXX
|
| 1780653618 |
H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.-TAMPA-FL
|
XXX
|
| 1396882205 |
VANDERBILT UNIVERSITY MEDICAL CENTER-NASHVILLE-TN
|
XXX
|
| 1861554438 |
UNIVERSITY MEDICAL CENTER, INC-LOUISVILLE-KY
|
XXX
|
| 1700887411 |
MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES-NEW YORK-NY
|
XXX
|
| 1932208576 |
UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL-MORRISVILLE-NC
|
XXX
|
| 1316904287 |
ALLINA HEALTH SYSTEM-MINNEAPOLIS-MN
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XX
|
| 1851333686 |
DANA-FARBER CANCER INSTITUTE, INC.-BOSTON-MA
|
XX
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| 1124127683 |
ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE-COLUMBUS-OH
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XX
|
| 1376981993 |
MAINEHEALTH-SCARBOROUGH-ME
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XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J9325 Inj talimogene laherparepvec
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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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