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Advancing Lives and the Delivery of Health Care TM

1Bard Peripheral Vascular, Inc. | 2018 Medicare Final Rule

Table of ContentsLower Leg Revascularization ............................................. 2Angiography .......................................................................5Catheter Placement ............................................................6Stent Placement ................................................................ 11Declots ............................................................................. 12Biliary Stenting ................................................................. 13Grafts - AV Fistula Creation .............................................. 14Vena Cava Filters .............................................................. 15Non-Tunneled Venous Access .......................................... 16

Tunneled Venous Access .................................................. 17Port Procedures ................................................................ 18Repair/Removal Procedures ............................................ 20Guidance Procedures ....................................................... 21Feeding ........................................................................... 22Tracheobronchial Stenting .............................................. 24Stent Removal ................................................................. 25ABI ................................................................................... 26Balloon Valvuloplasty ...................................................... 29

BARD PERIPHERAL VASCULAR, INC.2018 Medicare Final Rule

Procedural Payment Guide

PhysicianPayment

Inpatient

Outpatient Hospital

Ambulatory Surgery Center



Definitions:CC = Complications and/or ComorbidyMCC = Major Complications and/or ComorbidyDouble Digit or Greater IncreaseDouble Digit or Greater Decrease

LOWER LEG REVASCULARIZATION (Angioplasty, Stent and Atherectomy)2018 Procedural Payment Guide

NOTE: ICD-9 listings are for reference only. ICD-10PCS coding requires clinical interpretation in order to determine the most appropriate code(s) for your specific coding situation.

Physician Payment Outpatient Hospital Ambulatory Surgery Center Inpatient

CPT Code Description In-office

(Free Standing Center)In Hospital

(Professional Fee) APC Payment ASC PaymentICD-9

Procedure Code

MS-DRG Description Nat'l Avg Payment

2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change

37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty

$3,114 $3,112 -0.1% $423 $421 -0.5% $4,823 $5,085 5.4% $2,209 $2,525 14.3%

37221 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed

$4,617 $4,616 0.0% $523 $519 -0.8% $9,748 $10,510 7.8% $6,048 $6,402 5.9%

+37222 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)

$874 $875 0.1% $197 $196 -0.5% pack-aged

pack-aged

pack-aged

pack-aged

+37223 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)

$2,590 $2,587 -0.1% $225 $224 -0.4% pack-aged

pack-aged

pack-aged

pack-aged

Effective October 1, 2015, the ICD-10 CM diagnosis and ICD-10 PCS procedure code sets replaced ICD-9 coding. Access ICD-9 to ICD-10 code cross reference for diagnosis and procedure codes at: http://www.icd10data.com/Convert

See page 32 for important information about the uses and limitations of this document.

See page 32 for additional information regarding

CPT Codes with “+” sign




LOWER LEG REVASCULARIZATION cont. (Angioplasty, Stent and Atherectomy)2018 Procedural Payment Guide






Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


37224 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty

$3,777 $3,779 0.1% $467 $465 -0.4% $4,823 $5,085 5.4% $3,473 $2,525 -27.3%

37225 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed

$11,063 $11,096 0.3% $638 $635 -0.5% $9,748 $10,510 7.8% $7,449 $7,024 -5.7%

37226 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed

$9,065 $9,072 0.1% $551 $547 -0.7% $9,748 $10,510 7.8% $6,569 $6,749 2.7%

37227 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed

$14,987 $15,015 0.2% $769 $763 -0.8% $14,776 $16,019 8.4% $10,869 $10,864 0.0% 00.40 - 00.43, 00.45

- 00.48, 00.55,

Inclusive to main procedure DRG






LOWER LEG REVASCULARIZATION cont. (Angioplasty, Stent and Atherectomy)2018 Procedural Payment Guide






Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


37228 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty

$5,409 $5,408 0.0% $573 $570 -0.5% $9,748 $10,510 7.8% $4,187 $4,481 7.0% 39.50, 39.90

252 Other Vascular Procedures with MCC

$18,032 $18,282 1.4%

37229 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed

$10,906 $10,942 0.3% $746 $740 -0.8% $14,776 $16,019 8.4% $10,065 $10,228 1.6% 17.56 253 Other Vascular Procedures with CC

$14,393 $14,566 1.2%

+37232 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)

$1,207 $1,207 0.0% $213 $211 -0.9% pack-aged

pack-aged

pack-aged

pack-aged

+37233 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)

$1,459 $1,460 0.1% $346 $345 -0.3% pack-aged

pack-aged

pack-aged

pack-aged

0238T Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel

$14,776 $16,019 8.4% $9,911 $10,318 4.1%




CPT Codes with “+” sign and OTPT Status Q2




ANGIOGRAPHY2018 Procedural Payment Guide






Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


75710 Angiography, extremity, unilateral, radiological supervision and interpretation

$164 $175 6.7% $57 $88 54.4% pack-aged

pack-aged

pack-aged

pack-aged


75716 Angiography, extremity, bilateral, radiological supervision and interpretation

$189 $198 4.8% $65 $98 50.8% pack-aged

pack-aged

pack-aged

pack-aged


75736 Angiography, pelvic, selective or supraselective, radiological supervision and interpretation

$162 $162 0.0% $56 $56 0.0% pack-aged

pack-aged

pack-aged

pack-aged

17.71, 88.48







CATHETER PLACEMENT2018 Procedural Payment Guide






Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36140 Introduction of needle or intracatheter; extremity artery

$430 $435 1.2% $94 $94 0.0% N/A N/A N/A N/A Inclusive to main procedure DRG

36901 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report

$581 $609 4.8% $151 $176 16.6% $684 $613 -10.4% $369 $319 -13.6%

36902 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

1235 1268 2.7% $225 $251 11.6% $4,823 $5,085 5.4% $3,119 $2,525 -19.0%






CATHETER PLACEMENT cont.2018 Procedural Payment Guide






Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36903 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transcatheter placement of intravascular stent(s) peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment

5663 6708 18.5% $308 $332 7.8% $9,748 $10,510 7.8% $6,026 $4,481 -25.6%

36904 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s)

1801 1843 2.3% $355 $387 9.0% $4,823 $5,085 5.4% $3,119 $2,525 -19.0%












Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36905 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

2304 2336 1.4% $445 $464 4.3% $9,748 $10,510 7.8% $6,026 $4,481 -25.6%

36906 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transcatheter placement of an intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit

6867 6927 0.9% $519 $537 3.5% $14,776 $16,019 8.4% $9,342 $6,926 -25.9%












Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36907 Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (List separately in addition to code for primary procedure)

739 768 3.9% $130 $154 18.5% N/C N/C N/C N/C

36908 Transcatheter placement of an intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (List separately in addition to code for primary procedure)

2722 2754 1.2% $194 $219 12.9% N/C N/C N/C N/C

36909 Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (List separately in addition to code for primary procedure)

1985 2002 0.9% $184 $217 17.9% N/C N/C N/C N/C












Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36245 Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family

$1,324 $1,333 0.7% $251 $249 -0.8% N/C N/C pack-aged

pack-aged

38.91 Inclusive to main procedure DRG

36246 Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family

$838 $837 -0.1% $268 $266 -0.7% N/C N/C pack-aged

pack-aged


36247 Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family

$1,523 $1,526 0.2% $318 $316 -0.6% N/C N/C pack-aged

pack-aged







STENT PLACEMENT2018 Procedural Payment Guide





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


37236 Transcatheter placement of an intravascular stent(s) (except lower extremity arteries for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery

$4,017 $3,911 -2.6% $464 $467 0.6% $9,748 $10,510 7.8% $4,187 $4,481 7.0% 252 - Other Vascular Procedures with MCC

$18,032 $18,282 1.4%

+37237 Transcatheter placement of an intravascular stent(s) (except lower extremity arteries for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery (List separately in addition to code for primary procedure)

$2,454 $2,461 0.3% $224 $223 -0.4% pack-aged

pack-aged

pack-aged

pack-aged

253 - Other Vascular Procedures with CC

$14,393 $14,566 1.2%

37238 Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein

$4,190 $4,237 1.1% $314 $313 -0.3% $9,748 $10,510 7.8% $6,334 $6,518 2.9% 254 - Other Vascular Procedures without CC/MCC

$9,670 $10,310 6.6%

+37239 Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (List separately in addition to code for primary procedure)

$2,035 $2,051 0.8% $159 $159 0.0% pack-aged

pack-aged

pack-aged

pack-aged









DECLOTS2018 Procedural Payment Guide





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36593 Declotting by thrombolytic agent of implanted vascular access device or catheter

$32 $32 0.0% N/A N/A N/A $279 $298 6.8% $31 $32 3.2% 99.10 061 - Acute Ischemic Stroke with Use of Thrombolytic Agent with MCC

$14,897 $15,898 6.7%

062 - Acute Ischemic Stroke with Use of Thrombolytic Agent with CC

$10,269 $10,928 6.4%

063 - Acute Ischemic Stroke with Use of Thrombolytic Agent without CC/MCC

$8,581 $9,179 7.0%







BILIARY STENTING2018 Procedural Payment Guide





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


47538 Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation, each stent; existing access

$4,392 $4,408 0.4% $248 $247 -0.4% $4,197 $4,488 6.9% $2,037 $3,076 51.0% Inclusive to main procedure DRG

47539 Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter

$4,860 $4,884 0.5% $449 $448 -0.2% $4,197 $4,488 6.9% $2,037 $2,097 2.9% Inclusive to main procedure DRG

47556 Biliary endoscopy, percutaneous via T-tube with dilation of biliary duct structures with stent

N/A N/A $434 $383 -11.8% $4,197 $4,488 6.9% $3,002 $2,097 -30.1% 51.87 Inclusive to main procedure DRG

N/A Inclusive to main procedure DRG







GRAFTS - AV FISTULA CREATION2018 Procedural Payment Guide





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36830 Creation of A-V fistula, nonautogenous graft

N/A N/A $702 $696 -0.9% $3,923 $4,265 8.7% $2,119 $2,222 4.9% 39.27

673 - Other Kidney and Urinary Tract Procedures with MCC

$18,196 $19,833 9.0%

674 - Other Kidney and Urinary Tract Procedures with CC

$12,274 $13,047 6.3%

36833 Revision, A-V fistula, with thrombectomy, autogenous or nonautogenous graft

N/A N/A $854 $849 -0.6% $3,923 $4,265 8.7% $2,119 $2,222 4.9% 39.42 675 - Other Kidney and Urinary Tract Procedures without CC/MCC

$8,425 $9,279 10.1%

35621 Bypass graft, other than vein, axillary-femoral

N/A N/A $1,158 $1,149 -0.8% Inpa-tient only

Inpa-tient only

Inpa-tient only

Inpa-tient only

39.29 252 - Other Vascular Procedures with MCC

$18,032 $18,282 1.4%

35654 Bypass graft, other than vein, axillary-femoral-femoral


Inpa-tient only

Inpa-tient only

Inpa-tient only

39.29 253 - Other Vascular Procedures with CC

$14,393 $14,566 1.2%

35661 Bypass graft, other than vein, femoral-femoral


Inpa-tient only

Inpa-tient only

Inpa-tient only

39.29 254 - Other Vascular Procedures without CC/MCC

$9,670 $10,310 6.6%







VENA CAVA FILTERS2018 Procedural Payment Guide





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36010 Introduction of catheter, vena cava

$492 $491 -0.2% $114 $114 0.0% NA NA NA NA N/A Inclusive to main procedure DRG


37191 Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed

$2,609 $2,610 0.0% $236 $234 -0.8% $3,923 $4,265 8.7% Inpa-tient only

Inpa-tient only

38.70 252 - Other Vascular Procedures with MCC

$18,032 $18,282 1.4%

37192 Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed

$1,628 $1,377 -15.4% $379 $366 -3.4% $2,360 $2,493 5.6% Inpa-tient only

Inpa-tient only

38.70 253 - Other Vascular Procedures with CC

$14,393 $14,566 1.2%

37193 Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed

$1,555 $1,558 0.2% $368 $366 -0.5% $2,360 $2,493 5.6% Inpa-tient only

Inpa-tient only

38.70 254 - Other Vascular Procedures without CC/MCC

$9,670 $10,310 6.6%







NON-TUNNELED VENOUS ACCESS2018 Procedural Payment Guide





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36555 Insert non-tunnel central venous catheter (<5yrs)

$209 $189 -9.6% $110 $89 -19.1% $684 $983 43.7% $369 $512 38.8% 86.07 579 - Other Skin, Subcutaneous Tissue and Breast Procedures with MCC

$14,805 $15,561 5.1%

36556 Insert non-tunnel central venous catheter (>5yrs)

$238 $214 -10.1% $125 $101 -19.2% $684 $983 43.7% $369 $512 38.8% 86.07 580 - Other Skin, Subcutaneous Tissue and Breast Procedures with CC

$8,972 $9,261 3.2%

36580 Replace nontunneled central venous catheter w/o port

$218 $219 0.5% $69 $69 0.0% $684 $983 43.7% $369 $512 38.8% 86.07 581 - Other Skin, Subcutaneous Tissue and Breast Procedures without CC/MCC

$6,895 $7,292 5.8%







TUNNELED VENOUS ACCESS2018 Procedural Payment Guide





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36557 Insert tunneled central venous catheter w/o port (<5yrs)

$937 $956 2.0% $326 $329 0.9% $3,923 $4,265 8.7% $2,119 $2,222 4.9% N/A Inclusive to main procedure DRG

36558 Insert tunneled central venous catheter w/o port (>5yrs)

$730 $729 -0.1% $274 $272 -0.7% $2,360 $2,493 5.6% $1,274 $1,299 2.0% N/A Inclusive to main procedure DRG

36565 Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, Tesio type catheter)

$904 $903 -0.1% $348 $347 -0.3% $2,360 $2,493 5.6% $1,274 $1,299 2.0% Inclusive to main procedure DRG

36581 Replace tunneled centrally inserted central venous access catheter w/o port

$717 $720 0.4% $191 $190 -0.5% $2,360 $2,493 5.6% $1,274 $1,299 2.0% 86.07 579 - Other Skin, Subcutaneous Tissue and Breast Procedures with MCC

$14,805 $15,561 5.1%

580 - Other Skin, Subcutaneous Tissue and Breast Procedures with CC

$8,972 $9,261 3.2%

581 - Other Skin, Subcutaneous Tissue and Breast Procedures without CC/MCC

$6,895 $7,292 5.8%


Effective October 1, 2015, the ICD-10 CM diagnosis and ICD-10 PCS procedure code sets replaced ICD-9 coding. Access ICD-9 to ICD-10 code cross reference for diagnosis and procedure codes at: http://www.icd10data.com/ConvertSee page 32 for important information about the uses and limitations of this document.




PORT PROCEDURES





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36560 Insert tunneled centrally inserted central venous catheter w/port (<5yrs)

$1,025 $1,332 30.0% $355 $396 11.5% $2,360 $2,493 5.6% $1,274 $1,800 41.3% N/A Inclusive to main procedure DRG

36561 Insert tunneled centrally inserted central venous catheter w/port (>5yrs)

$1,110 $1,106 -0.4% $354 $351 -0.8% $2,360 $2,493 5.6% $1,274 $1,299 2.0% N/A Inclusive to main procedure DRG

36582 Replace tunneled centrally inserted central venous catheter w/port

$1,028 $1,023 -0.5% $303 $301 -0.7% $2,360 $2,493 5.6% $1,274 $1,299 2.0% 86.07 579 - Other Skin, Subcutaneous Tissue and Breast Procedures with MCC

$14,805 $15,561 5.1%


$8,972 $9,261 3.2%

581 - Other Skin, Subcutaneous Tissue and Breast Procedures without CC/MCC

$6,895 $7,292 5.8%

2018 Procedural Payment Guide







PORT PROCEDURES cont.





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36570 Insert peripherally inserted central venous access device w/port (<5yrs)


36571 Insert peripherally inserted central venous access device w/port (>5yrs)


36585 Replace peripherally inserted central venous access device w/port

$1,096 $1,081 -1.4% $284 $282 -0.7% $2,360 $2,493 5.6% $1,274 $1,299 2.0% 86.07 579 - Other Skin, Subcutaneous Tissue and Breast Procedures with MCC

$14,805 $15,561 5.1%


$8,972 $9,261 3.2%

49419 Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)

N/A N/A $462 $461 -0.2% $3,923 $4,265 8.7% $2,119 $2,222 4.9% 581 - Other Skin, Subcutaneous Tissue and Breast Procedures without CC/MCC

$6,895 $7,292 5.8%








REPAIR / REMOVAL PROCEDURES





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


36575 Repair of tunneled or non-tunneled central venous access device w/o port

$169 $168 -0.6% $36 $36 0.0% $684 $613 -10.4% $369 $319 -13.6% 86.09

36576 Repair tunneled central venous catheter w/port

$322 $322 0.0% $192 $191 -0.5% $684 $983 43.7% $369 $512 38.8% 86.09 579 - Other Skin, Subcutaneous Tissue and Breast Procedures with MCC

$14,805 $15,561 5.1%

36578 Replace , catheter only, non-tunneled centrally inserted central venous access device w/port

$458 $459 0.2% $211 $211 0.0% $2,360 $2,493 5.6% $1,274 $1,299 2.0% 86.09 580 - Other Skin, Subcutaneous Tissue and Breast Procedures with CC

$8,972 $9,261 3.2%

36589 Removal tunneled central venous catheter w/o port

$168 $168 0.0% $142 $142 0.0% $684 $613 -10.4% $369 $319 -13.6% 86.09 581 - Other Skin, Subcutaneous Tissue and Breast Procedures without CC/MCC

$6,895 $7,292 5.8%

36590 Removal tunneled central venous catheter w/port

$228 $227 -0.4% $198 $198 0.0% $684 $613 -10.4% $369 $319 -13.6% 86.09

36596 Mech remov tunneled central venous catheter

$134 $134 0.0% $46 $46 0.0% $684 $983 43.7% $369 $512 38.8% 86.09

36597 Reposition venous catheter under fluoro

$130 $130 0.0% $64 $63 -1.6% $684 $983 43.7% $369 $512 38.8% N/A Inclusive to main procedure DRG








GUIDANCE PROCEDURES





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


76937 Ultrasound guidance for vascular access with permanent recording

$32 $32 0.0% $15 $15 0.0% pack-aged

pack-aged

pack-aged

pack-aged


77001 Flouroscopic guidance for central venous access device placement or removal

$85 $85 0.0% $19 $19 0.0% pack-aged

pack-aged

pack-aged

pack-aged










FEEDING





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


49440 Percutaneous placement of gastrostomy tube

$988 $986 -0.2% $216 $215 -0.5% $1,334 $1,427 7.0% $608 $628 3.3% 43.11 Inclusive to main procedure DRG

49441 Percutaneous placement of jejunostomy tube

$1,115 $1,116 0.1% $253 $252 -0.4% $1,334 $1,427 7.0% $608 $628 3.3% 43.11 Inclusive to main procedure DRG

43760 Change of gastrostomy tube, J-Tube straightforward

$499 $506 1.4% $49 $49 0.0% $216 $230 6.5% $117 $120 2.6% 97.02 Inclusive to main procedure DRG

43761 Repostioning of gastric feeding tube

$121 $121 0.0% $107 $107 0.0% $216 $230 6.5% $117 $120 2.6% 44.99 326 - Stomach, Esophageal and Duodenal Procedures with MCC

$29,215 $25,511 -12.7%

327 - Stomach, Esophageal and Duodenal Procedures with CC

$14,098 $11,851 -15.9%

328 - Stomach, Esophageal and Duodenal Procedures without CC/MCC

$8,359 $8,410 0.6%









FEEDING cont.





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


49450 Replace gastrostomy tube $678 $680 0.3% $70 $69 -1.4% $699 $743 6.3% $378 $387 2.4% 97.03 Inclusive to main procedure DRG

49451 Replace jejunostomy tube $741 $742 0.1% $94 $94 0.0% $699 $743 6.3% $378 $387 2.4% 97.04 Inclusive to main procedure DRG

74355 Radiologic supervision and interpretation placement of enteroclysis tube (i.e. J-Tube)

N/A N/A $39 $40 2.6% pack-aged

pack-aged

pack-aged

pack-aged









TRACHEOBRANCHIAL STENTING





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


31631 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required)

N/A N/A $238 $237 -0.4% $4,361 $4,864 11.5% $1,708 $1,768 3.5% 31.64, 31.93

166 - Other Respiratory System O.R. Procedures with MCC

$19,258 $19,658 2.1%

31636 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus

N/A N/A $229 $229 0.0% $4,361 $4,864 11.5% $2,561 $2,501 -2.3% 167 - Other Respiratory System O.R. Procedures with CC

$10,642 $10,082 -5.3%

+31637 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (List separately in addition to code for primary procedure)

N/A N/A $77 $77 0.0% pack-aged

pack-aged

pack-aged

pack-aged

31.93, 31.99

168 - Other Respiratory System O.R. Procedures without CC/MCC

$7,272 $7,145 -1.7%

31638 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)

N/A N/A $261 $259 -0.8% $4,361 $4,864 11.5% $1,708 $1,768 3.5%










STENT REMOVAL





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


31635 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body

$286 $287 0.3% $182 $182 0.0% $1,269 $1,324 4.3% $569 $588 3.3% 98.15 Inclusive to main procedure DRG








ABI





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1-2 levels)

$90 $90 0.0% $13 $13 0.0% $100 $105 5.0% N/A N/A 0.23 Inclusive to main procedure DRG








ABI cont.





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (eg, measurements with postural provocative tests, or measurements with reactive hyperemia)









ABI cont.





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


93924 Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a standardized protocol on a motorized treadmill plus recording of time of onset of claudication or other symptoms, maximal walking time, and time to recovery) complete bilateral study









BALLOON VALVULOPLASTY





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


92986 Percutaneous balloon valvuloplasty; aortic valve

N/A $1,377 $1,373 -0.3% $4,823 $5,085 5.4% N/A N/A 246 - Percutaneous Cardiovascular Procedure with Drug-Eluting Stent with MCC or 4+ Vessels/Stents

$17,705 $18,040 1.9%

92987 Percutaneous balloon valvuloplasty; mitral valve

N/A $1,422 $1,419 -0.2% $9,748 $10,510 7.8% N/A N/A 35.96 247 - Percutaneous Cardiovascular Procedure with Drug-Eluting Stent without MCC

$11,554 $11,879 2.8%

92990 Percutaneous balloon valvuloplasty; pulmonary valve

N/A $1,134 $1,134 0.0% $9,748 $10,510 7.8% N/A N/A 248 - Percutaneous Cardiovascular Procedure with Non Drug-Eluting Stent with MCC or 4+ Vessels/Stents

$16,572 $17,126 3.3%

249 - Percutaneous Cardiovascular Procedure with Non Drug-Eluting Stent without MCC

$10,537 $10,989 4.3%

250 - Percutaneous Cardiovascular Procedure without Coronary Artery Stent with MCC

$14,315 $14,106 -1.5%

251 - Percutaneous Cardiovascular Procedure without Coronary Artery Stent without MCC

$9,182 $9,349 1.8%



Effective October 1, 2015, the ICD-10 CM diagnosis and ICD-10 PCS procedure code sets replaced ICD-9 coding. Access ICD-9 to ICD-10 code cross reference for diagnosis and procedure codes at: http://www.icd10data.com/ConvertSee page 32 for important information about the uses and limitations of this document.




BALLOON VALVULOPLASTY cont.





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


33361 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach

N/A $1,421 $1,416 -0.4% Inpa-tient only

Inpa-tient only

Inpa-tient only

Inpa-tient only

33362 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach


Inpa-tient only

Inpa-tient only

Inpa-tient only

33363 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach


Inpa-tient only

Inpa-tient only

Inpa-tient only

33364 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach


Inpa-tient only

Inpa-tient only

Inpa-tient only

33365 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)


Inpa-tient only

Inpa-tient only

Inpa-tient only

266 - Endovascular Cardiac Valve Replacement with MCC

$45,688 $43,345 -5.1%

33366 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transapical exposure (eg, left thoracotomy)


Inpa-tient only

Inpa-tient only

Inpa-tient only

35.05 267 - Endovascular Cardiac Valve Replacement without MCC

$35,229 $34,150 -3.1%








BALLOON VALVULOPLASTY cont.





Procedure Code


2017 2018 % Change 2017 2018 %

Change 2017 2018 % Change 2017 2018 %


+33367 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separately in addition to code for primary procedure)

N/A $653 $655 0.3% Inpa-tient only

Inpa-tient only

Inpa-tient only

Inpa-tient only

+33368 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (List separately in addition to code for primary procedure)

N/A $780 $779 -0.1% Inpa-tient only

Inpa-tient only

Inpa-tient only

Inpa-tient only

+33369 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List separately in addition to code for primary procedure)


Inpa-tient only

Inpa-tient only

Inpa-tient only









DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services, 42 CFR Parts 414, 416, 419, 482, 486, 488, and 495, [CMS-1656-FC and IFC], RIN 0938-AS82; Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Non-excepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates under the Medicare Physician Fee Schedule for Non-excepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services, 42 CFR Parts 405, 410, 411, 414, 417, 422, 423, 424, 425, and 460, [CMS-1654-F], RIN 0938-AS81; Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements Department of Health and Human Services, Centers for Medicare & Medicaid Services, 42 CFR Parts 405, 412, 413, et al., Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals; Final Rule

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American Medical Association’s “Physician’s Current Procedural Terminology CPT 2017”, www.ama-assn.org

World Health Organization. International Classification of Diseases, 9th revision. Geneva: WHO, 2015 All Rights Reserved.

C. R. Bard, Inc. does not guarantee that use of any of the codes provided will ensure coverage or payment at any particular level. Medicare may implement policies differently in various sections of the country. Physicians and hospitals should confirm with a particular payor or coding authority, such as the American Medical Association or medical specialty society, which codes or combinations of codes are appropriate for a particular procedure or combination of procedures. Reimbursement for a product or procedure can be different depending upon the setting in which the product is used. Coverage and payment policies also change over time, so that information provided here may at some point need to be revised.

Status T-Packaged CodesQ2

NOTE +

Paid under OPPS; Addendum B displays APC assignments when services are separately payable. (1) Packaged APC payment if billed on the same date of service as a HCPCS code assigned status indicator “T.” (2) In other circumstances, payment is made through a separate APC payment.

PPlus sign denotes an Add-on/Plus Code: The American Hospital Association defines add-on or plus codes as services that are never the primary procedure but are reported in addition to the primary procedure when performed by the same provider, for the same patient, on the same date. The AMA has flagged these codes with a plus sign (+) icon preceding the code in the CPT manual.

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