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	Proposed CY 2025 XRef HCPCS/CPT Code(s)	Proposed CY 2025 XRef SI	Proposed CY 2025  XRef APC	Proposed CY 2025 Payment Rate
A9527	Iodine i-125 sodium iodide	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	A9527	U	2632	$196.73
C1716	"Brachytx, non-str, gold-198"	 86 	 134 	" 100,867 "	 55 	" 7,381 "	 753 	 297 	 590 	 458 	 823 	 160 	C1716	U	2645	$867.00
C1717	"Brachytx, non-str,hdr ir-192"	" 17,813 "	" 17,813 "	" 8,435,494 "	 36 	" 3,562 "	 474 	 357 	 357 	 362 	 362 	 88 	C1717	U	2646	$345.68
C1719	"Brachytx, ns, non-hdrir-192"	 2 	 4 	" 1,065 "	 5 	 353 	 266 	 120 	 71 	 353 	 532 	 113 	C1719	U	2647	$552.59
C2616	"Brachytx, non-str,yttrium-90"	" 4,309 "	" 4,309 "	" 85,803,634 "	" 3,912 "	" 84,348 "	" 19,913 "	" 18,003 "	" 18,003 "	" 18,707 "	" 18,707 "	 45 	C2616	U	2616	"$17,412.53"
C2634	"Brachytx, non-str, ha, i-125"	 181 	" 3,195 "	" 611,860 "	 6 	 790 	 192 	 167 	" 2,552 "	 169 	" 2,965 "	 227 	C2634	U	2634	$161.22
C2635	"Brachytx, non-str, ha, p-103"	 13 	 175 	" 17,689 "	 95 	 109 	 101 	 101 	 629 	 95 	" 1,417 "	 26 	C2635	U	2635	$67.73
C2636	"Brachy linear, non-str,p-103"	 1 	 1 	" 3,694 "	" 3,694 "	" 3,694 "	" 3,694 "	" 3,694 "	" 3,694 "	" 3,694 "	" 3,694 "	 . 	C2636	U	2636	$51.81
C2638	"Brachytx, stranded, i-125"	" 1,593 "	" 27,770 "	" 1,447,957 "	 11 	" 2,903 "	 52 	 42 	 213 	 39 	 134 	 375 	C2638	U	2638	$40.49
C2639	"Brachytx, non-stranded,i-125"	 813 	" 40,863 "	" 1,962,917 "	 4 	" 4,340 "	 48 	 36 	 874 	 35 	" 1,595 "	 635 	C2639	U	2639	$34.41
C2640	"Brachytx, stranded, p-103"	 213 	" 14,690 "	" 1,295,716 "	 36 	 993 	 88 	 71 	" 4,495 "	 59 	" 4,155 "	" 1,104 "	C2640	U	2640	$69.00
C2641	"Brachytx, non-stranded,p-103"	 272 	" 17,719 "	" 1,621,202 "	 23 	" 4,199 "	 92 	 79 	" 3,985 "	 88 	" 5,361 "	 840 	C2641	U	2641	$76.38
C2642	"Brachytx, stranded, c-131"	 84 	" 5,259 "	" 597,692 "	 20 	 184 	 114 	 109 	" 6,352 "	 115 	" 7,064 "	 204 	C2642	U	2642	$105.40
C2643	"Brachytx, non-stranded,c-131"	 93 	" 3,489 "	" 407,354 "	 12 	" 4,703 "	 117 	 100 	" 2,596 "	 112 	" 2,675 "	 823 	C2643	U	2643	$96.57
C2645	"Brachytx planar, p-103"	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	 . 	C2645	U	2648	$4.69
C2698	"Brachytx, stranded, nos"	 50 	 50 	" 39,411 "	 32 	" 2,964 "	 788 	 213 	 213 	 69 	 69 	 120 	C2698	U	2698	$40.49
C2699	"Brachytx, non-stranded, nos"	 7 	 7 	" 4,004 "	 24 	" 1,943 "	 572 	 83 	 83 	 24 	 24 	 164 	C2699	U	2699	$34.41
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
