APC 01747
Monovisc inj per dose
Historical IOCE Data
v27.2.0 (2026-07-01 to 2036-06-30)
$655.34
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $655.34
-
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)
$564.77
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $564.77
-
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)
$636.59
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $636.59
-
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)
$528.58
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $528.58
-
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)
$663.64
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $663.64
-
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)
$564.65
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $564.65
-
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)
$683.17
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $683.17
-
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)
$651.85
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $651.85
-
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)
$711.54
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $711.54
-
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)
$714.37
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $714.37
-
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)
$728.29
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $728.29
-
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)
$692.75
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $692.75
-
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
v24.2.12 (2023-07-01 to 2023-09-30)
$719.33
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $719.33
-
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
v24.1.13 (2023-04-01 to 2023-06-30)
$712.18
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $712.18
-
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
v24.0.14 (2023-01-01 to 2023-03-31)
$756.93
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $756.93
-
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)
$754.90
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $754.90
-
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
v23.2.16 (2022-07-01 to 2022-09-30)
$769.61
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $769.61
-
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)
$790.78
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $790.78
-
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)
$762.80
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $762.80
-
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
v22.3.19 (2021-10-01 to 2021-12-31)
$790.58
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $790.58
-
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)
$709.05
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $709.05
-
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)
$785.19
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $785.19
-
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)
$694.58
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $694.58
-
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)
$766.34
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $766.34
-
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)
$739.86
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $739.86
-
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)
$781.27
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $781.27
-
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)
$769.51
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $769.51
-
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
v20.3.27 (2019-10-01 to 2019-12-31)
$1511.15
Description
"Monovisc inj per dose"
Core Attributes
- Payment Amount
- $1511.15
-
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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