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APC 01458

Phentolaine mesylate inj

Historical IOCE Data

v27.2.0 (2026-07-01 to 2036-06-30) $257.45

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$257.45
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v27.1.1 (2026-04-01 to 2026-06-30) $420.56

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$420.56
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v27.0.2 (2026-01-01 to 2026-03-31) $432.02

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$432.02
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.3.3 (2025-10-01 to 2025-12-31) $436.51

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$436.51
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.2.4 (2025-07-01 to 2025-09-30) $449.30

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$449.30
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.1.5 (2025-04-01 to 2025-06-30) $394.63

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$394.63
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.0.6 (2025-01-01 to 2025-03-31) $367.12

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$367.12
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.3.7 (2024-10-01 to 2024-12-31) $399.33

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$399.33
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.2.8 (2024-07-01 to 2024-09-30) $444.32

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$444.32
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.1.9 (2024-04-01 to 2024-06-30) $446.80

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$446.80
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.0.10 (2024-01-01 to 2024-03-31) $453.66

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$453.66
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.3.11 (2023-10-01 to 2023-12-31) $458.18

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$458.18
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.2.12 (2023-07-01 to 2023-09-30) $452.42

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$452.42
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.1.13 (2023-04-01 to 2023-06-30) $450.36

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$450.36
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.0.14 (2023-01-01 to 2023-03-31) $413.47

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$413.47
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.3.15 (2022-10-01 to 2022-12-31) $392.68

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$392.68
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.2.16 (2022-07-01 to 2022-09-30) $377.73

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$377.73
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.1.17 (2022-04-01 to 2022-06-30) $414.12

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$414.12
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.0.18 (2022-01-01 to 2022-03-31) $416.00

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$416.00
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.3.19 (2021-10-01 to 2021-12-31) $409.55

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$409.55
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.2.20 (2021-07-01 to 2021-09-30) $413.36

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$413.36
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.1.21 (2021-04-01 to 2021-06-30) $356.88

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$356.88
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.0.22 (2021-01-01 to 2021-03-31) $359.14

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$359.14
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.3.23 (2020-10-01 to 2020-12-31) $374.74

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$374.74
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.2.24 (2020-07-01 to 2020-09-30) $378.75

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$378.75
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.1.25 (2020-04-01 to 2020-06-30) $381.90

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$381.90
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.0.26 (2020-01-01 to 2020-03-31) $377.57

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$377.57
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v20.3.27 (2019-10-01 to 2019-12-31) $392.15

Description

"Phentolaine mesylate inj"

Core Attributes

Payment Amount
$392.15
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0

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