2013 HCPCS	2013 Short Description	2013 Days	2013 Units	2013 Minimum Unit Cost	2013 Maximum Unit Cost	2013 Mean Unit Cost	2013 Geometric Mean Unit Cost	2013 Median Unit Cost	2013 CV of Unit Cost	Fial CY 2015 XRef HCPCS/CPT Code(s)	Final CY 2015 XRef SI	Final CY 2015 XRef APC	Final CY 2015 Payment Rate
A9527	Iodine i-125 sodium iodide	31	720	$0.60	$409.22	$19.05	$13.75	$10.38	$728.10	A9527	U	2632	$13.25
C1716	"Brachytx, non-str, gold-198"	158	375	$4.64	"$1,148.88"	$109.71	$38.70	$37.65	$305.73	C1716	U	1716	$37.29
C1717	"Brachytx, non-str,hdr ir-192"	"23,184"	"31,314"	$16.57	"$3,751.49"	$433.78	$282.56	$286.06	$121.53	C1717	U	1717	$272.27
C1719	"Brachytx, ns, non-hdrir-192"	70	468	$0.31	$954.68	$79.53	$55.74	$37.12	$283.11	C1719	U	1719	$53.71
C2616	"Brachytx, non-str,yttrium-90"	"2,464"	"2,464"	"$1,522.80"	"$61,594.50"	"$18,131.21"	"$16,164.79"	"$17,011.17"	$46.85	C2616	U	2616	"$15,576.59"
C2634	"Brachytx, non-str, ha, i-125"	137	"2,460"	$10.78	"$8,194.18"	$150.64	$89.02	$111.42	$835.29	C2634	U	2634	$85.78
C2635	"Brachytx, non-str, ha, p-103"	61	"2,548"	$21.87	"$7,180.13"	$32.06	$26.78	$21.87	"$2,899.52"	C2635	U	2635	$25.80
C2636	"Brachy linear, non-str,p-103"	5	176	$19.38	"$1,473.21"	$29.20	$20.17	$19.38	"$2,523.60"	C2636	U	2636	$19.43
C2638	"Brachytx, stranded, i-125"	"1,599"	"89,485"	$0.35	"$8,188.34"	$57.04	$44.00	$42.67	$995.00	C2638	U	2638	$42.40
C2639	"Brachytx, non-stranded,i-125"	"1,817"	"106,269"	$2.53	"$9,826.20"	$51.69	$38.43	$40.48	"$1,599.42"	C2639	U	2639	$37.03
C2640	"Brachytx, stranded, p-103"	501	"45,954"	$6.47	$247.43	$77.35	$67.95	$66.79	$496.67	C2640	U	2640	$65.48
C2641	"Brachytx, non-stranded,p-103"	846	"64,143"	$0.05	$275.48	$83.30	$70.46	$70.51	$495.77	C2641	U	2641	$67.90
C2642	"Brachytx, stranded, c-131"	49	"3,828"	$49.48	$169.46	$118.69	$109.33	$135.74	$327.10	C2642	U	2642	$105.35
C2643	"Brachytx, non-stranded,c-131"	146	"8,454"	$19.57	$166.21	$66.09	$56.75	$53.86	$396.62	C2643	U	2643	$54.69
C2644	Brachytx cesium-131 chloride									C2644	U	2644	$13.25
C2698	"Brachytx, stranded, nos"	12	319	$48.91	$657.24	$106.05	$99.59	$116.63	$215.60	C2698	U	2698	$42.40
C2699	"Brachytx, non-stranded, nos"	8	203	$0.73	"$4,022.99"	$131.37	$105.88	$116.63	"$1,125.85"	C2699	U	2699	$19.43
													
"NOS codes C2698 and C2699 payment rates are set to the lowest stranded or non-stranded source costs, respectively. "													
C2644 is a new code with no claims data; the payment rate was set to that of A9527.													
													
													
													
