2021 HCPCS	2021 Short Description	2021 Days	2021 Units	2021 Total Cost	2021 Minimum Unit Cost	2021 Maximum Unit Cost	2021 Arithmetic Mean Unit Cost	2021 Geometric Mean Unit Cost	2021 Geometric Mean Day Cost	2021 Median Unit Cost	2021 Median Day Cost	2021 CV (%) of Unit Cost	Final CY 2023 XRef HCPCS/CPT Code(s)	Final CY 2023 XRef SI	Final CY 2023  XRef APC	Final CY 2023 Payment Rate
P9010	Whole blood for transfusion	128	183	48223.75	40.96	915.48	263.52	234.06	297.3	235.33	235.33	58.358	P9010	R	9510	$234.06
P9011	Blood split unit	754	893	163733.87	15.39	1024.55	183.35	143	162.29	132.15	170.5	88.99	P9011	R	9520	$143.00
P9012	Cryoprecipitate each unit	467	2606	245319.75	11.93	831.2	94.14	76.5	330.33	74.2	324.17	181.832	P9012	R	9511	$76.50
P9016	Rbc leukocytes reduced	243722	362330	82364666.56	22.9	1642.82	227.32	194.58	273.07	204.84	274.73	69.896	P9016	R	9512	$194.58
P9017	Plasma 1 donor frz w/in 8 hr	2630	8574	925167.56	3.94	845.65	107.9	87.89	193.2	79.33	203.76	136.148	P9017	R	9508	$87.89
P9019	"Platelets, each unit"	344	1314	115498.6	29.43	939.29	87.9	79.42	276.82	106.03	424.12	121.105	P9019	R	9515	$79.42
P9020	Plaelet rich plasma unit	27	27	12388.96	450.48	625.23	458.85	457.9	457.9	452.53	452.53	7.247	P9020	R	9516	$457.90
P9021	Red blood cells unit	5344	8235	1489029.03	12.28	1900.51	180.82	139.37	193.2	123.75	171.7	98.275	P9021	R	9517	$139.37
P9022	Washed red blood cells unit	727	1577	787226.65	21.91	1364.06	499.19	407	673.77	386.92	625.71	93.093	P9022	R	9518	$407.00
P9023	"Frozen plasma, pooled, sd"	125	350	34363.04	29.4	299.31	98.18	95.66	247.65	105.28	315.83	37.078	P9023	R	9509	$95.66
P9031	Platelets leukocytes reduced	447	1457	252638.17	22.38	1271.19	173.4	134.6	383.93	131.93	413.78	162.725	P9031	R	9526	$134.60
P9032	"Platelets, irradiated"	487	2033	300672.94	132.62	171.87	147.9	147.88	612.64	149.46	585.02	2.786	P9032	R	9500	$147.88
P9033	Platelets leukoreduced irrad	2150	5171	1764469.08	45.18	1201.97	341.22	275.97	622.85	368.64	612.72	105.188	P9033	R	9521	$275.97
P9034	"Platelets, pheresis"	2009	2411	1222766.45	15.09	4253.17	507.16	343.44	400.89	501.35	536.14	85.898	P9034	R	9507	$343.44
P9035	Platelet pheres leukoreduced	24582	29371	17019607.99	72.28	3014.35	579.47	499.43	575.64	509.57	581.11	60.962	P9035	R	9501	$499.43
P9036	Platelet pheresis irradiated	873	952	639931.37	233.55	1539.83	672.2	634.17	680.64	608.68	779.37	33.535	P9036	R	9502	$634.17
P9037	Plate pheres leukoredu irrad	37688	42497	32093626.92	105.11	4157.37	755.2	656.29	723.46	687.8	750.72	55.962	P9037	R	9530	$656.29
P9038	Rbc irradiated	1233	1731	427833.61	62.09	797.48	247.16	201.76	276.82	201.17	242.64	75.118	P9038	R	9505	$201.76
P9039	Rbc deglycerolized	22	30	19967.09	94.4	1719.12	665.57	424.95	645.73	391.81	660.82	100.155	P9039	R	9504	$424.95
P9040	Rbc leukoreduced irradiated	113932	152244	45587543.77	44.85	1556.23	299.44	266.47	336.96	268.31	338.03	56.572	P9040	R	9522	$266.47
P9044	Cryoprecipitatereducedplasma	170	363	29362.52	23.16	455.85	80.89	70.85	135.33	51.8	103.59	95.07	P9044	R	9523	$70.85
P9048	"Plasmaprotein fract,5%,250ml"	15	133	21979.3	37.54	169.44	165.26	162.85	973.7	169.44	2033.28	37.539	P9048	R	9519	$162.85
P9051	"Blood, l/r, cmv-neg"	475	728	165274.75	13	715.92	227.03	202	282.7	184.81	268.42	59.572	P9051	R	9524	$202.00
P9052	"Platelets, hla-m, l/r, unit"	1097	1307	1285150.33	199.08	3161.95	983.28	852.05	1000.76	896.46	939.05	59.473	P9052	R	9525	$852.05
P9053	"Plt, pher, l/r cmv-neg, irr"	626	759	475233.81	145.91	2828.37	626.13	547.55	640.51	621.03	623.45	70.567	P9053	R	9531	$547.55
P9054	"Blood, l/r, froz/degly/wash"	97	136	67799.19	41.42	2328.36	498.52	305.29	399.51	203.73	407.45	154.752	P9054	R	9527	$305.29
P9055	"Plt, aph/pher, l/r, cmv-neg"	162	197	82332.75	75.66	1109.1	417.93	343.08	404.22	235.32	330.34	77.694	P9055	R	9528	$343.08
P9056	"Blood, l/r, irradiated"	482	721	92623.07	40.37	544.32	128.46	111.8	159.68	116.17	161.08	68.628	P9056	R	9529	$111.80
P9057	"Rbc, frz/deg/wsh, l/r, irrad"	161	272	116298.39	171.21	999.36	427.57	405	649.19	354.58	709.15	47.688	P9057	R	9532	$405.00
P9058	"Rbc, l/r, cmv-neg, irrad"	1593	2155	644976.51	58.52	1035.13	299.29	258.1	342.66	267.1	347.98	68.779	P9058	R	9533	$258.10
P9059	"Plasma, frz between 8-24hour"	2299	6734	628696.8	5	797.48	93.36	78.35	155.17	88.53	138.11	98.918	P9059	R	9513	$78.35
P9060	Fr frz plasma donor retested	14	14	865.55	40.95	200.39	61.82	56.29	56.29	51.21	51.21	64.716	P9060	R	9503	$56.29
P9070	Pathogen reduced plasma pool	4	8	1844.61	40.27	1499.47	230.58	75.08	191.78	52.92	146.11	339.682	P9070	R	9534	$75.08
P9071	Pathogen reduced plasma sing	8	13	2119.48	31.96	1008.46	163.04	91.43	133.21	99.32	99.32	208.592	P9071	R	9535	$91.43
P9073	Platelets pheresis path redu	32606	36388	25111961.64	87.45	2924.56	690.12	594.27	648.08	613.79	681.82	56.03	P9073	R	9536	$594.27
P9099	Blood component/product noc	176	176	74228.4	159.96	796.95	421.75	411.88	411.88	416.24	416.24	23.387	P9099	R	9537	$56.29
