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	Proposed CY 2023 XRef HCPCS/CPT Code(s)	Proposed CY 2023 XRef SI	Proposed CY 2023  XRef APC	Proposed CY 2023 Payment Rate
A9527	Iodine i-125 sodium iodide	9	12	3838.62	62.96	2632.64	319.88	141.23	190.79	116.06	116.06	267.04	A9527	U	2632	$43.96
C1716	"Brachytx, non-str, gold-198"	119	184	156626.67	1.66	24143.16	851.23	243.86	379.28	289.71	307.64	307.153	C1716	U	2645	$241.70
C1717	"Brachytx, non-str,hdr ir-192"	17550	17550	8168792.14	34.28	3200.5	465.46	343.58	343.58	333.41	333.41	91.395	C1717	U	2646	$340.55
C1719	"Brachytx, ns, non-hdrir-192"	14	14	14877.35	28.78	4010.18	1062.67	144.37	144.37	41.8	41.8	161.776	C1719	U	2647	$374.32
C2616	"Brachytx, non-str,yttrium-90"	4469	4469	90518616.94	3458.29	86127.68	20254.78	18144.39	18144.39	19169.7	19169.7	49.514	C2616	U	2616	"$17,984.51"
C2634	"Brachytx, non-str, ha, i-125"	212	3446	893127.51	7.65	3979.86	259.18	185.9	2585.68	208.14	3236.38	439.801	C2634	U	2634	$184.26
C2635	"Brachytx, non-str, ha, p-103"	24	217	27921.94	89.96	159.46	128.67	125.24	539	109.85	797.3	69.813	C2635	U	2635	$50.64
C2636	"Brachy linear, non-str,p-103"	.	.	.	.	.	.	.	.	.	.	.	C2636	U	2636	$52.91
C2638	"Brachytx, stranded, i-125"	1511	39232	1990552.47	7.62	4018.29	50.74	39.42	284.77	49.3	130.34	534.017	C2638	U	2638	$39.07
C2639	"Brachytx, non-stranded,i-125"	983	55114	2581716.66	1.1	6476.52	46.84	35.26	1109.89	32.27	1735.82	851.002	C2639	U	2639	$34.96
C2640	"Brachytx, stranded, p-103"	173	13430	1657503.55	24.44	998.73	123.42	92.33	6821.68	82.8	6722.83	1160.505	C2640	U	2640	$91.51
C2641	"Brachytx, non-stranded,p-103"	280	22534	2215672.56	27.34	998.73	98.33	82.87	5640.03	68.24	6210.17	655.305	C2641	U	2641	$82.14
C2642	"Brachytx, stranded, c-131"	105	6993	905506.69	42.69	585.65	129.49	93.14	5512.52	85.58	5080.08	887.063	C2642	U	2642	$92.32
C2643	"Brachytx, non-stranded,c-131"	268	13188	1232823.42	30.63	635.47	93.48	82.63	3239.72	84.92	3976.75	354.311	C2643	U	2643	$81.91
C2645	"Brachytx planar, p-103"	.	.	.	.	.	.	.	.	.	.	.	C2645	U	2648	$4.69
C2698	"Brachytx, stranded, nos"	44	47	60391.21	42.1	3877.8	1284.92	777.08	847.54	1370.24	1370.24	76.886	C2698	U	2698	$39.07
C2699	"Brachytx, non-stranded, nos"	13	22	10029.53	2.81	2441.54	455.89	35.2	102.89	25.81	25.81	229.39	C2699	U	2699	$34.96
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
																
