"Procedural APCs with the final CY 2017 portions of the APC payment amounts uniquely associated with the cost of devices and two types of non-pass-through drugs: ""threshold packaged"" drugs that are packaged under the packaging threshold and ""policy-packaged"" drugs that are always packaged. These portions will be used as the APC offset amounts to evaluate whether the cost of a device or type of drug in an application for pass-through payment is not insignificant in relation to the APC payment amount for the service related to the device or type of drug."			"Final CY 2017 Portion of APC Payment Associated with Devices, Including Implantable Biologicals"		"Final CY 2017 Portion of APC Payment Associated with ""Threshold Packaged"" Drugs (Drugs that May Be Packaged under the Packaging Threshold)"		"Final CY 2017 Portion of APC Payment Associated with ""Policy Packaged"" Drugs (Drugs that Are Always Packaged, i.e., Diagnostic Radiopharmaceuticals, Contrast Agents, Skin Substitutes, and Stress Agents)"	
APC	APC Title	Final CY 2017 APC Payment Rate	Percent	Dollar Amount	Percent	Dollar Amount	Percent	Dollar Amount
1906	"New Technology - Level 51 ($140,001-$160,000)"	"$150,000.50"	94.25%	"$141,375.47"	0.51%	$765.00	0.00%	$0.00
5012	Clinic Visits and Related Services	$106.61	0.01%	$0.01	0.89%	$0.95	0.02%	$0.02
5021	Level 1 Type A ED Visits	$61.37	0.00%	$0.00	1.14%	$0.70	0.02%	$0.01
5022	Level 2 Type A ED Visits	$111.47	0.02%	$0.02	1.34%	$1.49	0.03%	$0.03
5023	Level 3 Type A ED Visits	$201.25	0.01%	$0.02	1.05%	$2.11	0.03%	$0.06
5024	Level 4 Type A ED Visits	$332.41	0.01%	$0.03	0.95%	$3.16	0.03%	$0.10
5025	Level 5 Type A ED Visits	$488.74	0.01%	$0.05	1.22%	$5.96	0.03%	$0.15
5031	Level 1 Type B ED Visits	$85.13	0.00%	$0.00	0.37%	$0.31	0.00%	$0.00
5032	Level 2 Type B ED Visits	$75.57	0.01%	$0.01	0.77%	$0.58	0.01%	$0.01
5033	Level 3 Type B ED Visits	$125.00	0.01%	$0.01	0.75%	$0.94	0.01%	$0.01
5034	Level 4 Type B ED Visits	$178.55	0.03%	$0.05	0.82%	$1.46	0.02%	$0.04
5035	Level 5 Type B ED Visits	$367.89	0.00%	$0.00	0.94%	$3.46	0.01%	$0.04
5041	Critical Care	$687.17	0.06%	$0.41	8.37%	$57.52	0.06%	$0.41
5045	Trauma Response with Critical Care	$872.07	0.00%	$0.00	0.00%	$0.00	0.00%	$0.00
5051	Level 1 Skin Procedures	$153.12	0.01%	$0.02	2.85%	$4.36	0.08%	$0.12
5052	Level 2 Skin Procedures	$292.62	0.03%	$0.09	0.68%	$1.99	0.07%	$0.20
5053	Level 3 Skin Procedures	$453.10	0.12%	$0.54	0.82%	$3.72	6.81%	$30.86
5054	Level 4 Skin Procedures	"$1,427.77"	0.32%	$4.57	1.64%	$23.42	50.97%	$727.73
5055	Level 5 Skin Procedures	"$2,504.69"	1.36%	$34.06	5.01%	$125.48	7.33%	$183.59
5061	Hyperbaric Oxygen	$110.24	0.00%	$0.00	0.00%	$0.00	0.00%	$0.00
5071	Level 1 Excision/ Biopsy/ Incision and Drainage	$539.11	0.77%	$4.15	1.73%	$9.33	0.13%	$0.70
5072	Level 2 Excision/ Biopsy/ Incision and Drainage	"$1,236.62"	2.24%	$27.70	2.82%	$34.87	0.34%	$4.20
5073	Level 3 Excision/ Biopsy/ Incision and Drainage	"$2,148.91"	1.12%	$24.07	4.69%	$100.78	0.76%	$16.33
5091	Level 1 Breast/Lymphatic Surgery and Related Procedures	"$2,499.48"	0.73%	$18.25	5.26%	$131.47	0.52%	$13.00
5092	Level 2 Breast/Lymphatic Surgery and Related Procedures	"$4,419.46"	2.89%	$127.72	7.34%	$324.39	1.87%	$82.64
5093	Level 3 Breast/Lymphatic Surgery and Related Procedures	"$6,486.35"	31.56%	"$2,047.09"	4.01%	$260.10	4.73%	$306.80
5094	Level 4 Breast/Lymphatic Surgery and Related Procedures	"$10,037.05"	32.11%	"$3,222.90"	4.69%	$470.74	13.67%	"$1,372.06"
5101	Level 1 Strapping and Cast Application	$125.15	0.01%	$0.01	0.38%	$0.48	0.05%	$0.06
5102	Level 2 Strapping and Cast Application	$220.75	0.01%	$0.02	0.17%	$0.38	0.08%	$0.18
5111	Level 1 Musculoskeletal Procedures	$199.83	0.19%	$0.38	0.68%	$1.36	0.01%	$0.02
5112	Level 2 Musculoskeletal Procedures	"$1,217.42"	0.28%	$3.41	4.68%	$56.98	0.15%	$1.83
5113	Level 3 Musculoskeletal Procedures	"$2,438.34"	4.53%	$110.46	5.31%	$129.48	0.42%	$10.24
5114	Level 4 Musculoskeletal Procedures	"$5,221.57"	22.21%	"$1,159.71"	5.04%	$263.17	0.36%	$18.80
5115	Level 5 Musculoskeletal Procedures	"$9,561.23"	42.35%	"$4,049.18"	3.22%	$307.87	0.35%	$33.46
5116	Level 6 Musculoskeletal Procedures	"$14,704.13"	62.60%	"$9,204.79"	2.76%	$405.83	0.24%	$35.29
5151	Level 1 Airway Endoscopy	$146.20	0.01%	$0.01	0.11%	$0.16	0.00%	$0.00
5152	Level 2 Airway Endoscopy	$361.92	0.10%	$0.36	0.09%	$0.33	0.04%	$0.14
5153	Level 3 Airway Endoscopy	"$1,269.79"	0.34%	$4.32	5.00%	$63.49	0.16%	$2.03
5154	Level 4 Airway Endoscopy	"$2,431.23"	2.35%	$57.13	5.11%	$124.24	0.22%	$5.35
5155	Level 5 Airway Endoscopy	"$4,362.95"	12.62%	$550.60	5.47%	$238.65	0.13%	$5.67
5161	Level 1 ENT Procedures	$177.09	0.23%	$0.41	2.38%	$4.21	0.05%	$0.09
5162	Level 2 ENT Procedures	$442.62	0.21%	$0.93	1.12%	$4.96	0.02%	$0.09
5163	Level 3 ENT Procedures	"$1,038.55"	1.89%	$19.63	7.90%	$82.05	0.55%	$5.71
5164	Level 4 ENT Procedures	"$2,173.69"	0.75%	$16.30	6.67%	$144.99	0.31%	$6.74
5165	Level 5 ENT Procedures	"$4,130.94"	3.42%	$141.28	5.74%	$237.12	0.46%	$19.00
5166	Cochlear Implant Procedure	"$31,836.99"	83.08%	"$26,450.17"	0.90%	$286.53	0.04%	$12.73
5181	Level 1 Vascular Procedures	$684.13	9.15%	$62.60	3.80%	$26.00	0.93%	$6.36
5182	Level 2 Vascular Procedures	"$2,360.60"	21.60%	$509.89	4.38%	$103.39	1.06%	$25.02
5183	Level 3 Vascular Procedures	"$3,924.28"	15.25%	$598.45	4.33%	$169.92	0.85%	$33.36
5191	Level 1 Endovascular Procedures	"$2,833.55"	12.12%	$343.43	3.53%	$100.02	3.13%	$88.69
5192	Level 2 Endovascular Procedures	"$4,825.20"	29.64%	"$1,430.19"	2.74%	$132.21	1.54%	$74.31
5193	Level 3 Endovascular Procedures	"$9,752.43"	43.46%	"$4,238.41"	4.55%	$443.74	1.36%	$132.63
5194	Level 4 Endovascular Procedures	"$14,782.14"	52.95%	"$7,827.14"	3.21%	$474.51	1.01%	$149.30
5200	Implantation Wireless PA Pressure Monitor	"$29,517.57"	92.32%	"$27,250.62"	0.27%	$79.70	0.15%	$44.28
5211	Level 1 Electrophysiologic Procedures	$866.85	0.86%	$7.45	4.35%	$37.71	0.17%	$1.47
5212	Level 2 Electrophysiologic Procedures	"$5,006.40"	33.80%	"$1,692.16"	4.92%	$246.31	0.29%	$14.52
5213	Level 3 Electrophysiologic Procedures	"$16,785.23"	39.65%	"$6,655.34"	2.63%	$441.45	0.18%	$30.21
5221	Level1 Pacemaker and Similar Procedures	"$2,559.59"	23.78%	$608.67	5.78%	$147.94	0.27%	$6.91
5222	Level 2 Pacemaker and Similar Procedures	"$6,976.57"	72.54%	"$5,060.80"	0.99%	$69.07	0.09%	$6.28
5223	Level 3 Pacemaker and Similar Procedures	"$9,413.65"	65.27%	"$6,144.29"	1.40%	$131.79	0.10%	$9.41
5224	Level 4 Pacemaker and Similar Procedures	"$16,766.86"	68.78%	"$11,532.25"	1.01%	$169.35	0.15%	$25.15
5231	Level 1 ICD and Similar Procedures	"$21,999.98"	76.22%	"$16,768.38"	0.51%	$112.20	0.02%	$4.40
5232	Level 2 ICD and Similar Procedures	"$30,527.21"	78.33%	"$23,911.96"	0.54%	$164.85	0.07%	$21.37
5241	Level 1 Blood Product Exchange and Related Services	$354.54	0.05%	$0.18	6.39%	$22.66	0.01%	$0.04
5242	Level 2 Blood Product Exchange and Related Services	"$1,098.68"	0.02%	$0.22	92.59%	"$1,017.27"	0.34%	$3.74
5243	Level 3 Blood Product Exchange and Related Services	"$3,187.83"	0.03%	$0.96	5.03%	$160.35	0.29%	$9.24
5244	Level 4 Blood Product Exchange and Related Services	"$27,764.47"	0.00%	$0.00	0.76%	$211.01	0.00%	$0.00
5301	Level 1 Upper GI Procedures	$699.79	1.99%	$13.93	13.68%	$95.73	0.21%	$1.47
5302	Level 2 Upper GI Procedures	"$1,334.83"	8.60%	$114.80	4.29%	$57.26	0.26%	$3.47
5303	Level 3 Upper GI Procedures	"$2,510.70"	12.14%	$304.80	4.88%	$122.52	0.68%	$17.07
5311	Level 1 Lower GI Procedures	$667.67	0.05%	$0.33	5.19%	$34.65	0.07%	$0.47
5312	Level 2 Lower GI Procedures	$877.60	0.30%	$2.63	4.25%	$37.30	0.05%	$0.44
5313	Level 3 Lower GI Procedures	"$2,167.51"	0.62%	$13.44	6.76%	$146.52	1.68%	$36.41
5331	Complex GI Procedures	"$3,940.61"	29.62%	"$1,167.21"	4.21%	$165.90	0.55%	$21.67
5341	Abdominal/Peritoneal/Biliary and Related Procedures	"$2,862.74"	12.59%	$360.42	5.73%	$164.04	0.78%	$22.33
5361	Level 1 Laparoscopy and Related Services	"$4,199.13"	4.60%	$193.16	6.01%	$252.37	0.44%	$18.48
5362	Level 2 Laparoscopy and Related Services	"$6,969.84"	10.26%	$715.11	5.13%	$357.55	0.32%	$22.30
5371	Level 1 Urology and Related Services	$216.04	1.53%	$3.31	61.22%	$132.26	0.63%	$1.36
5372	Level 2 Urology and Related Services	$549.44	0.40%	$2.20	1.98%	$10.88	0.19%	$1.04
5373	Level 3 Urology and Related Services	"$1,644.66"	5.64%	$92.76	6.60%	$108.55	0.73%	$12.01
5374	Level 4 Urology and Related Services	"$2,542.56"	9.02%	$229.34	6.39%	$162.47	0.57%	$14.49
5375	Level 5 Urology and Related Services	"$3,484.01"	4.37%	$152.25	4.66%	$162.35	0.24%	$8.36
5376	Level 6 Urology and Related Services	"$7,452.66"	38.28%	"$2,852.88"	3.73%	$277.98	0.46%	$34.28
5377	Level 7 Urology and Related Services	"$14,363.61"	65.59%	"$9,421.09"	2.63%	$377.76	0.12%	$17.24
5401	Dialysis	$552.58	0.42%	$2.32	12.80%	$70.73	0.07%	$0.39
5411	Level 1 Gynecologic Procedures	$152.21	0.12%	$0.18	0.50%	$0.76	0.01%	$0.02
5412	Level 2 Gynecologic Procedures	$275.76	0.09%	$0.25	0.68%	$1.88	0.02%	$0.06
5413	Level 3 Gynecologic Procedures	$665.87	0.11%	$0.73	2.15%	$14.32	0.06%	$0.40
5414	Level 4 Gynecologic Procedures	"$2,085.47"	0.93%	$19.39	4.72%	$98.43	0.11%	$2.29
5415	Level 5 Gynecologic Procedures	"$3,810.85"	16.93%	$645.18	5.99%	$228.27	0.19%	$7.24
5416	Level 6 Gynecologic Procedures	"$5,866.07"	24.23%	"$1,421.35"	5.86%	$343.75	0.55%	$32.26
5431	Level 1 Nerve Procedures	"$1,563.42"	0.37%	$5.78	4.53%	$70.82	0.14%	$2.19
5432	Level 2 Nerve Procedures	"$4,151.86"	20.47%	$849.89	5.19%	$215.48	0.42%	$17.44
5441	Level 1 Nerve Injections	$231.00	0.03%	$0.07	49.22%	$113.70	1.22%	$2.82
5442	Level 2 Nerve Injections	$507.19	0.05%	$0.25	54.14%	$274.59	1.59%	$8.06
5443	Level 3 Nerve Injections	$638.93	0.12%	$0.77	6.59%	$42.11	2.40%	$15.33
5461	Level 1 Neurostimulator and Related Procedures	"$2,690.46"	16.68%	$448.77	6.27%	$168.69	0.22%	$5.92
5462	Level 2 Neurostimulator and Related Procedures	"$5,745.11"	56.86%	"$3,266.67"	1.65%	$94.79	0.06%	$3.45
5463	Level 3 Neurostimulator and Related Procedures	"$17,803.38"	84.74%	"$15,086.58"	0.92%	$163.79	0.03%	$5.34
5464	Level 4 Neurostimulator and Related Procedures	"$27,047.11"	83.90%	"$22,692.53"	0.86%	$232.61	0.03%	$8.11
5471	Implantation of Drug Infusion Device	"$15,622.57"	76.14%	"$11,895.02"	2.77%	$432.75	0.06%	$9.37
5481	Laser Eye Procedures	$469.87	0.06%	$0.28	7.18%	$33.74	0.06%	$0.28
5491	Level 1 Intraocular Procedures	"$1,824.35"	14.14%	$257.96	13.50%	$246.29	0.55%	$10.03
5492	Level 2 Intraocular Procedures	"$3,418.76"	11.64%	$397.94	10.22%	$349.40	0.25%	$8.55
5493	Level 3 Intraocular Procedures	"$8,201.63"	46.68%	"$3,828.52"	6.57%	$538.85	0.17%	$13.94
5494	Level 4 Intraocular Procedures	"$12,047.28"	1.47%	$177.10	75.90%	"$9,143.89"	4.20%	$505.99
5495	Level 5 Intraocular Procedures	"$18,991.75"	68.60%	"$13,028.34"	10.56%	"$2,005.53"	0.00%	$0.00
5501	"Level 1 Extraocular, Repair, and Plastic Eye Procedures"	$268.49	0.79%	$2.12	3.15%	$8.46	0.01%	$0.03
5502	"Level 2 Extraocular, Repair, and Plastic Eye Procedures"	$774.57	2.04%	$15.80	3.62%	$28.04	0.57%	$4.42
5503	"Level 3 Extraocular, Repair, and Plastic Eye Procedures"	"$1,701.48"	2.06%	$35.05	7.24%	$123.19	0.29%	$4.93
5504	"Level 4 Extraocular, Repair, and Plastic Eye Procedures"	"$2,774.83"	7.05%	$195.63	7.55%	$209.50	0.32%	$8.88
5521	Level 1 Diagnostic Radiology without Contrast	$59.86	0.02%	$0.01	0.18%	$0.11	0.02%	$0.01
5522	Level 2 Diagnostic Radiology without Contrast	$112.73	0.00%	$0.00	0.16%	$0.18	0.07%	$0.08
5523	Level 3 Diagnostic Radiology without Contrast	$225.91	0.05%	$0.11	0.26%	$0.59	0.26%	$0.59
5524	Level 4 Diagnostic Radiology without Contrast	$449.68	0.06%	$0.27	0.29%	$1.30	0.52%	$2.34
5571	Level 1 Diagnostic Radiology with Contrast	$265.02	0.02%	$0.05	1.78%	$4.72	25.52%	$67.63
5572	Level 2 Diagnostic Radiology with Contrast	$426.52	0.10%	$0.43	1.16%	$4.95	15.16%	$64.66
5573	Level 3 Diagnostic Radiology with Contrast	$656.91	0.01%	$0.07	0.84%	$5.52	12.51%	$82.18
5591	Level 1 Nuclear Medicine and Related Services	$333.08	0.01%	$0.03	0.64%	$2.13	13.96%	$46.50
5592	Level 2 Nuclear Medicine and Related Services	$429.13	0.02%	$0.09	8.31%	$35.66	19.61%	$84.15
5593	Level 3 Nuclear Medicine and Related Services	"$1,138.94"	0.01%	$0.11	0.54%	$6.15	26.65%	$303.53
5594	Level 4 Nuclear Medicine and Related Services	"$1,321.53"	0.01%	$0.13	0.26%	$3.44	17.86%	$236.03
5611	Level 1 Therapeutic Radiation Treatment Preparation	$117.59	0.00%	$0.00	0.02%	$0.02	0.00%	$0.00
5612	Level 2 Therapeutic Radiation Treatment Preparation	$311.57	0.00%	$0.00	0.05%	$0.16	0.11%	$0.34
5613	Level 3 Therapeutic Radiation Treatment Preparation	"$1,066.24"	0.55%	$5.86	0.14%	$1.49	0.00%	$0.00
5621	Level 1 Radiation Therapy	$114.35	0.00%	$0.00	0.14%	$0.16	0.01%	$0.01
5622	Level 2 Radiation Therapy	$204.51	0.00%	$0.00	0.10%	$0.20	0.00%	$0.00
5623	Level 3 Radiation Therapy	$494.63	0.00%	$0.00	0.09%	$0.45	0.00%	$0.00
5624	Level 4 Radiation Therapy	$738.63	0.03%	$0.22	0.01%	$0.07	0.00%	$0.00
5625	Level 5 Radiation Therapy	$994.12	0.00%	$0.00	0.03%	$0.30	0.00%	$0.00
5626	Level 6 Radiation Therapy	"$1,651.29"	0.00%	$0.00	0.49%	$8.09	0.00%	$0.00
5627	Level 7 Radiation Therapy	"$7,455.99"	0.25%	$18.64	1.21%	$90.22	0.54%	$40.26
5661	Therapeutic Nuclear Medicine	$216.68	0.11%	$0.24	96.16%	$208.36	2.71%	$5.87
5671	Level 1 Pathology	$39.70	0.05%	$0.02	0.37%	$0.15	0.02%	$0.01
5672	Level 2 Pathology	$103.88	0.20%	$0.21	6.18%	$6.42	0.08%	$0.08
5673	Level 3 Pathology	$184.01	0.46%	$0.85	1.60%	$2.94	0.07%	$0.13
5674	Level 4 Pathology	$454.16	1.12%	$5.09	2.56%	$11.63	0.20%	$0.91
5691	Level 1 Drug Administration	$34.78	0.00%	$0.00	0.11%	$0.04	0.00%	$0.00
5692	Level 2 Drug Administration	$53.17	0.02%	$0.01	54.20%	$28.82	0.04%	$0.02
5693	Level 3 Drug Administration	$179.77	0.07%	$0.13	83.33%	$149.80	0.25%	$0.45
5694	Level 4 Drug Administration	$279.45	0.04%	$0.11	98.29%	$274.67	0.14%	$0.39
5721	Level1 Diagnostic Tests and Related Services	$127.10	0.03%	$0.04	1.19%	$1.51	0.03%	$0.04
5722	Level 2 Diagnostic Tests and Related Services	$232.31	0.03%	$0.07	0.67%	$1.56	1.44%	$3.35
5723	Level 3 Diagnostic Tests and Related Services	$415.87	0.12%	$0.50	7.47%	$31.07	0.35%	$1.46
5724	Level 4 Diagnostic Tests and Related Services	$864.54	0.00%	$0.00	0.05%	$0.43	0.00%	$0.00
5731	Level 1 Minor Procedures	$12.62	0.08%	$0.01	2.62%	$0.33	0.15%	$0.02
5732	Level 2 Minor Procedures	$28.38	0.03%	$0.01	0.31%	$0.09	0.03%	$0.01
5733	Level 3 Minor Procedures	$54.55	0.07%	$0.04	3.91%	$2.13	0.11%	$0.06
5734	Level 4 Minor Procedures	$100.02	0.10%	$0.10	4.10%	$4.10	0.06%	$0.06
5735	Level 5 Minor Procedures	$263.61	0.82%	$2.16	12.99%	$34.24	7.43%	$19.59
5741	Level 1 Electronic Analysis of Devices	$35.15	0.00%	$0.00	0.03%	$0.01	0.00%	$0.00
5742	Level 2 Electronic Analysis of Devices	$109.22	0.03%	$0.03	0.29%	$0.32	0.01%	$0.01
5743	Level 3 Electronic Analysis of Devices	$252.63	0.02%	$0.05	69.38%	$175.27	2.29%	$5.79
5771	Cardiac Rehabilitation	$110.22	0.00%	$0.00	0.00%	$0.00	0.00%	$0.00
5781	Resuscitation and Cardioversion	$481.34	0.05%	$0.24	6.77%	$32.59	0.13%	$0.63
5791	Pulmonary Treatment	$162.08	0.25%	$0.41	20.25%	$32.82	0.49%	$0.79
5801	Ventilation Initiation and Management	$423.95	0.50%	$2.12	22.05%	$93.48	0.30%	$1.27
5811	Manipulation Therapy	$24.62	0.00%	$0.00	0.04%	$0.01	0.00%	$0.00
5821	Level 1 Health and Behavior Services	$25.23	0.00%	$0.00	0.08%	$0.02	0.00%	$0.00
5822	Level 2 Health and Behavior Services	$70.26	0.00%	$0.00	0.01%	$0.01	0.00%	$0.00
5823	Level 3 Health and Behavior Services	$126.01	0.00%	$0.00	0.05%	$0.06	0.00%	$0.00
5871	Dental Procedures	$513.07	0.01%	$0.05	3.34%	$17.14	0.13%	$0.67
5881	Ancillary Outpatient Services When Patient Dies	"$6,754.35"	19.77%	"$1,335.33"	8.09%	$546.43	1.05%	$70.92
8001	LDR Prostate Brachytherapy Composite	"$3,500.25"	7.41%	$259.37	7.29%	$255.17	0.14%	$4.90
8004	Ultrasound Composite	$288.36	0.01%	$0.03	0.20%	$0.58	0.01%	$0.03
8005	CT and CTA without Contrast Composite	$273.09	0.02%	$0.05	0.90%	$2.46	0.28%	$0.76
8006	CT and CTA with Contrast Composite	$489.37	0.02%	$0.10	1.41%	$6.90	16.38%	$80.16
8007	MRI and MRA without Contrast Composite	$551.75	0.00%	$0.00	0.26%	$1.43	0.03%	$0.17
8008	MRI and MRA with Contrast Composite	$851.69	0.01%	$0.09	0.97%	$8.26	7.54%	$64.22
8011	OBSERVATION C-APC	"$2,222.64"	0.03%	$0.67	4.65%	$103.35	2.06%	$45.79
