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CMS Transmittals





0784 Quick jump to APC Code (numbers only eg. 0172):
0786

2025A Ambulatory Payment Classification: 0785

Title: Inj, cyclophosphamd, sandoz

2025A Relative Weight: 0
2025A Payment Rate: $ 4.35
2025A National Unadjusted Copay: $ 0.00
2025A Minimum Unadjusted Copay: $ 0.88
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.




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


Procedure Codes in this APC:
J9074 Inj, cyclophosphamd, sandoz


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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