2023 HCPCS	2023 Short Description	2023 Days	2023 Units	2023 Total Cost	2023 Minimum Unit Cost	2023 Maximum Unit Cost	2023 Arithmetic Mean Unit Cost	2023 Geometric Mean Unit Cost	2023 Geometric Mean Day Cost	2023 Median Unit Cost	2023 Median Day Cost	2023 CV (%) of Unit Cost	Final CY 2025 XRef HCPCS/CPT Code(s)	Final CY 2025 XRef SI	Final CY 2025  XRef APC	Final CY 2025 Payment Rate
C9507	Covid-19 convalescent plasma	6	7	3016.86	425.6	463.26	430.98	430.79	484.52	425.6	425.6	3.618	C9507	R	9540	$430.79
P9010	Whole blood for transfusion	164	239	64950.88	22.69	1240.05	271.76	227.85	297.33	229.18	316.54	72.733	P9010	R	9510	$227.85
P9011	Blood split unit	549	674	141040.36	12.42	1093.34	209.26	143.51	177.27	117.71	183.16	115.179	P9011	R	9520	$143.51
P9012	Cryoprecipitate each unit	482	3427	268812.02	8.29	854.68	78.44	64.34	374.84	53.07	505.77	201.45	P9012	R	9511	$64.34
P9016	Rbc leukocytes reduced	207757	295796	64327063.76	18.4	1597.21	217.47	184.2	247.42	195.82	251.81	70.667	P9016	R	9512	$184.20
P9017	Plasma 1 donor frz w/in 8 hr	1945	5754	586325.44	4.16	739.79	101.9	85.32	184.08	84.73	177.14	125.314	P9017	R	9508	$85.32
P9019	"Platelets, each unit"	179	599	60762.48	30.27	708.28	101.44	76.89	200.6	63.49	273.16	225.944	P9019	R	9515	$76.89
P9021	Red blood cells unit	4737	7044	1353014.76	9.98	1248.31	192.08	146.07	198.83	122.5	208.8	89.981	P9021	R	9517	$146.07
P9022	Washed red blood cells unit	488	1257	586380.19	67.73	3270.73	466.49	401.68	743.27	439.11	650.81	103.472	P9022	R	9518	$401.68
P9023	"Frozen plasma, pooled, sd"	116	738	55086.73	32.46	237.14	74.64	63.06	351.43	45.45	272.69	144.837	P9023	R	9509	$63.06
P9025	Plasma cryo redu path each	5	5	683.95	136.79	136.79	136.79	136.79	136.79	136.79	136.79	0	P9025	R	9538	$136.79
P9026	Cryo fib comp path redu each	7	21	9141.14	130.88	723.98	435.29	317.57	1256.17	592.54	1447.95	125.296	P9026	R	9539	$317.57
P9031	Platelets leukocytes reduced	277	853	126480.52	24.76	900.26	148.28	127.3	318.87	135.69	316	125.593	P9031	R	9526	$127.30
P9032	"Platelets, irradiated"	833	4034	554374.89	136.91	141.63	137.43	137.42	662.74	136.91	684.55	2.25	P9032	R	9500	$137.42
P9033	Platelets leukoreduced irrad	1616	4741	1378518.47	31.38	1878.21	290.77	207.88	683.36	148.71	708.15	188.835	P9033	R	9521	$207.88
P9034	"Platelets, pheresis"	922	1100	606552.5	19.06	2904.74	551.41	401.95	476.12	535.07	639.08	71.329	P9034	R	9507	$401.95
P9035	Platelet pheres leukoreduced	18673	22340	13395325.15	49.01	4620.95	599.61	493.01	566.04	528.74	605.66	74.302	P9035	R	9501	$493.01
P9036	Platelet pheresis irradiated	496	496	350726.45	129.99	1621.37	707.11	594.78	594.78	469.21	469.21	56.729	P9036	R	9502	$594.78
P9037	Plate pheres leukoredu irrad	29635	32950	26189244.87	84.67	3407.38	794.82	683.86	744.4	723.26	733.11	56.004	P9037	R	9530	$683.86
P9038	Rbc irradiated	1110	1482	278633.12	48.08	1422.74	188.01	151.02	202.38	149.51	196.43	72.984	P9038	R	9505	$151.02
P9039	Rbc deglycerolized	7	8	7275.86	139.84	1820.6	909.48	661.67	660.98	965.12	597.15	75.911	P9039	R	9504	$661.67
P9040	Rbc leukoreduced irradiated	110483	139751	40841006.86	38.02	1733.13	292.24	258.91	313.28	258.12	307.32	58.477	P9040	R	9522	$258.91
P9044	Cryoprecipitatereducedplasma	85	319	52126.87	10.06	189.01	163.41	149.08	282.67	189.01	279.28	56.194	P9044	R	9523	$149.08
P9048	"Plasmaprotein fract,5%,250ml"	13	22	2473.69	35.63	606	112.44	74.61	112.21	60.6	121.2	189.162	P9048	R	9519	$74.61
P9051	"Blood, l/r, cmv-neg"	376	523	101779.15	27.21	448.16	194.61	174.29	228.39	175.92	214.6	52.016	P9051	R	9524	$174.29
P9052	"Platelets, hla-m, l/r, unit"	1049	1218	1057401.2	215.27	2893.05	868.15	786.92	888.28	728.8	866.15	49.986	P9052	R	9525	$786.92
P9053	"Plt, pher, l/r cmv-neg, irr"	490	601	310314.46	132.13	1151.88	516.33	464.8	547.34	488.98	581.48	45.615	P9053	R	9531	$464.80
P9054	"Blood, l/r, froz/degly/wash"	61	90	26556.51	117.59	836.99	295.07	245.38	366.87	180.89	361.78	82.25	P9054	R	9527	$245.38
P9055	"Plt, aph/pher, l/r, cmv-neg"	104	144	35134.9	119.97	748.27	243.99	230	304.75	216.19	260.88	49.706	P9055	R	9528	$230.00
P9056	"Blood, l/r, irradiated"	466	708	72279.9	37.93	551.38	102.09	85.18	124.86	84.1	168.19	102.927	P9056	R	9529	$85.18
P9057	"Rbc, frz/deg/wsh, l/r, irrad"	112	188	97481.55	161.05	924.46	518.52	491.27	717.9	550.42	789.7	37.888	P9057	R	9532	$491.27
P9058	"Rbc, l/r, cmv-neg, irrad"	1388	1896	515600.98	56.16	831.28	271.94	225.57	299.87	215.16	299.79	82.03	P9058	R	9533	$225.57
P9059	"Plasma, frz between 8-24hour"	1910	5652	486443.67	2.52	648.64	86.07	71.96	141.06	93.37	121.89	100.335	P9059	R	9513	$71.96
P9060	Fr frz plasma donor retested	3	4	200.38	37.82	54.19	50.1	49.53	60.56	54.19	54.18	20.007	P9060	R	9503	$49.53
P9070	Pathogen reduced plasma pool	2	2	114.95	48.61	66.34	57.48	56.79	56.79	57.48	57.48	21.813	P9070	R	9534	$56.79
P9071	Pathogen reduced plasma sing	11	11	3854.24	66.34	528.78	350.39	296.07	296.07	300.46	300.46	46.999	P9071	R	9535	$296.07
P9073	Platelets pheresis path redu	43207	48974	35116013.25	79.82	4469.01	717.03	594.4	657	637.92	688.71	66.727	P9073	R	9536	$594.40
P9099	Blood component/product noc	394	394	136173.82	282.81	492.69	345.62	343.29	343.29	342.82	342.82	12.482	P9099	R	9537	$49.53
