2022 HCPCS	2022 Short Description	2022 Days	2022 Units	2022 Total Cost	2022 Minimum Unit Cost	2022 Maximum Unit Cost	2022 Arithmetic Mean Unit Cost	2022 Geometric Mean Unit Cost	2022 Geometric Mean Day Cost	2022 Median Unit Cost	2022 Median Day Cost	2022 CV (%) of Unit Cost	Proposed CY 2024 XRef HCPCS/CPT Code(s)	Proposed CY 2024 XRef SI	Proposed CY 2024  XRef APC	Proposed CY 2024 Payment Rate
A9527	Iodine i-125 sodium iodide	.	.	.	.	.	.	.	.	.	.	.	A9527	U	2632	$61.13
C1716	"Brachytx, non-str, gold-198"	119	193	194933.98	29.26	15658.66	1010.02	275.23	550.98	216.56	500.41	260.784	C1716	U	2645	$272.13
C1717	"Brachytx, non-str,hdr ir-192"	17814	17814	8408035.08	33.28	3830.75	471.99	353.71	353.71	352.69	352.69	85.611	C1717	U	2646	$349.72
C1719	"Brachytx, ns, non-hdrir-192"	2	2	8795.09	23.32	8771.77	4397.54	452.28	452.28	4397.54	4397.54	140.671	C1719	U	2647	$398.74
C2616	"Brachytx, non-str,yttrium-90"	4463	4463	90310230.05	3263.35	94327.02	20235.32	18122.79	18122.79	18579.6	18579.6	47.09	C2616	U	2616	"$17,918.57"
C2634	"Brachytx, non-str, ha, i-125"	189	3103	600263.66	8.8	448.69	193.45	152.13	2057.56	190.67	2664.46	228.201	C2634	U	2634	$150.41
C2635	"Brachytx, non-str, ha, p-103"	20	172	17143.86	91.18	136.08	99.67	98.73	388.6	91.18	136.08	43.907	C2635	U	2635	$60.17
C2636	"Brachy linear, non-str,p-103"	1	120	10720.8	89.34	89.34	89.34	89.34	10720.29	89.34	10720.29	.	C2636	U	2636	$56.50
C2638	"Brachytx, stranded, i-125"	1660	33881	1774841.81	11.13	4356.04	52.38	41.33	205.57	33.55	85.31	526.417	C2638	U	2638	$40.87
C2639	"Brachytx, non-stranded,i-125"	935	49896	2456684.89	4.24	780.69	49.24	36.86	961.49	36.33	1515.24	574.354	C2639	U	2639	$36.44
C2640	"Brachytx, stranded, p-103"	188	13569	1437689.66	30.68	1013.54	105.95	79.08	5401.38	70.15	5025.47	1242.145	C2640	U	2640	$78.19
C2641	"Brachytx, non-stranded,p-103"	280	21032	1900872.63	21.76	1013.54	90.38	77.41	5060.59	71.25	5852.14	842.099	C2641	U	2641	$76.53
C2642	"Brachytx, stranded, c-131"	76	4334	544552.87	30.21	947.49	125.65	99.92	4803.58	79.9	3963.72	790.255	C2642	U	2642	$99.52
C2643	"Brachytx, non-stranded,c-131"	196	8966	879738.96	9.42	4239.81	98.12	83.6	2779.06	89.73	4319.91	548.401	C2643	U	2643	$82.66
C2645	"Brachytx planar, p-103"	3	3	947.83	22.46	483.8	315.94	168.67	168.67	441.57	441.57	80.723	C2645	U	2648	$4.69
C2698	"Brachytx, stranded, nos"	49	53	39959.43	34.51	1554.78	753.95	291.21	306.7	1176.47	1176.47	92.907	C2698	U	2698	$40.87
C2699	"Brachytx, non-stranded, nos"	18	18	10369.77	22.27	6357.06	576.1	49.79	49.79	22.27	22.27	270.265	C2699	U	2699	$36.44
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
