rule (85 FR 48832), CMS proposed to establish a new HCPCS code, C9770 (Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent) to describe this process. They stated that they believed that this new HCPCS code accurately described the unique service associated with intraocular administration of HCPCS code J3398. However, they also recognized that it is not prudent for the code that describes the administration of this unique gene therapy, C9770, to be assigned to the same C-APC to which HCPCS code 67036 is assigned, as this would package the primary therapy, HCPCS code J3398, into the code that represents the process to administer the gene therapy.
Bronchoscopy with Transbronchial Ablation of Lesion(s) by Microwave Energy (HCPCS code C9751) CMS is finalizing their proposal to continue to assign HCPCS code C9751 to APC 1562 (New Technology— Level 25 ($3501–$4000)), with a payment rate of $3,750.50 for CY 2022.
HCPCS
Long Descriptor
Finalized
Finalized
Finalized
CY 2022
CY 2022
OPPS
OPPS SI
OPPS APC
Payment
CY 2022
Rate Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic C9751
guidance, when performed, with computed tomography acquisition(s) and 3-D
T
1562
$3,750.50
rendering, computer-assisted, image-guided navigation, and endobronchial ultrasound (EBUS) guided transtracheal and/or
Fractional Flow Reserve Derived From Computed Tomography (FFRCT) (HeartFlow) (CPT code 0503T) After reviewing all of the public comments, CMS is finalizing their proposal, without modification, to continue to use equitable adjustment authority under section 1833(t)(2)(E) of the Act to assign CPT code 0503T to the same New Technology APC in CY 2022 as in CY 2020 and CY 2021: New Technology APC 1511 (New Technology—Level 11 ($901–$1000)), with a payment rate of $950.50 for CY 2022.
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Summary of the CY2022 OPPS Final Rule
Software. Consulting. Education. Results.
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