2024 HCPCS	2024 Short Description	2024 Days	2024 Units	2024 Total Cost	2024 Minimum Unit Cost	2024 Maximum Unit Cost	2024 Arithmetic Mean Unit Cost	2024 Geometric Mean Unit Cost	2024 Geometric Mean Day Cost	2024 Median Unit Cost	2024 Median Day Cost	2024 CV (%) of Unit Cost	Proposed CY 2026 XRef HCPCS/CPT Code(s)	Proposed CY 2026 XRef SI	Proposed CY 2026 XRef APC	Proposed CY 2026 Payment Rate
C9507	Covid-19 convalescent plasma	5	7	"6,289.58"	462.92	"1,987.49"	898.51	701.95	817.48	462.92	462.92	101.402	C9507	R	9540	$691.19
P9010	Whole blood for transfusion	129	174	"41,882.30"	25.95	"1,027.60"	240.70	184.45	243.28	198.44	248.65	79.776	P9010	R	9510	$181.63
P9011	Blood split unit	480	546	"107,318.58"	20.75	866.03	196.55	151.11	163.56	141.24	161.36	83.272	P9011	R	9520	$148.80
P9012	Cryoprecipitate each unit	471	"2,711"	"245,041.53"	13.49	739.90	90.39	72.55	372.53	66.38	462.61	176.883	P9012	R	9511	$71.43
P9016	Rbc leukocytes reduced	"180,350"	"253,171"	"56,733,120.71"	19.14	"1,759.60"	224.09	190.09	251.19	198.49	257.43	70.560	P9016	R	9512	$187.18
P9017	Plasma 1 donor frz w/in 8 hr	"1,780"	"5,676"	"579,249.54"	4.76	757.23	102.05	86.87	206.22	82.54	211.81	125.434	P9017	R	9508	$85.54
P9019	"Platelets, each unit"	105	412	"32,329.16"	35.77	591.23	78.47	70.60	232.83	63.49	317.46	134.962	P9019	R	9515	$69.52
P9021	Red blood cells unit	"3,320"	"4,826"	"1,019,797.40"	24.58	"2,100.30"	211.31	158.93	211.02	133.23	208.12	97.384	P9021	R	9517	$156.49
P9022	Washed red blood cells unit	423	959	"418,213.58"	33.56	"1,068.72"	436.09	391.48	700.65	428.91	650.81	64.924	P9022	R	9518	$385.48
P9023	"Frozen plasma, pooled, sd"	61	292	"15,980.38"	32.01	138.02	54.73	46.16	187.51	32.01	160.05	144.887	P9023	R	9509	$45.46
P9025	Plasma cryo redu path each	4	4	552.08	138.02	138.02	138.02	138.02	138.02	138.02	138.02	0.000	P9025	R	9538	$135.90
P9026	Cryo fib comp path redu each	13	28	"16,270.23"	388.61	"1,400.15"	581.08	528.43	"1,118.21"	470.10	876.16	80.344	P9026	R	9539	$520.32
P9031	Platelets leukocytes reduced	235	673	"124,048.31"	24.22	945.28	184.32	154.64	397.91	146.06	444.27	131.643	P9031	R	9526	$152.27
P9032	"Platelets, irradiated"	70	70	"27,894.37"	378.55	398.78	398.49	398.48	398.48	398.78	398.78	0.607	P9032	R	9500	$392.37
P9033	Platelets leukoreduced irrad	"2,088"	"8,031"	"1,806,596.42"	37.96	"1,802.46"	224.95	192.53	763.23	172.42	750.17	169.153	P9033	R	9521	$189.59
P9034	"Platelets, pheresis"	885	"1,113"	"536,799.80"	34.65	"3,476.45"	482.30	332.24	431.09	455.63	541.72	79.261	P9034	R	9507	$327.15
P9035	Platelet pheres leukoreduced	"16,284"	"19,461"	"11,802,135.51"	56.62	"3,886.31"	606.45	513.62	589.86	559.48	612.09	63.697	P9035	R	9501	$505.75
P9036	Platelet pheresis irradiated	429	469	"502,437.11"	210.52	"1,633.04"	"1,071.29"	942.10	"1,011.21"	"1,289.38"	"1,289.38"	41.179	P9036	R	9502	$927.65
P9037	Plate pheres leukoredu irrad	"25,417"	"28,599"	"23,280,687.34"	92.62	"3,369.57"	814.04	699.80	768.31	729.54	755.58	56.301	P9037	R	9530	$689.08
P9038	Rbc irradiated	756	"1,015"	"188,545.66"	33.02	622.31	185.76	150.84	208.52	165.96	207.08	68.230	P9038	R	9505	$148.53
P9039	Rbc deglycerolized	5	6	"1,957.98"	181.50	629.40	326.33	295.25	325.11	287.57	210.37	58.027	P9039	R	9504	$290.72
P9040	Rbc leukoreduced irradiated	"102,912"	"128,547"	"39,357,327.53"	35.09	"1,983.33"	306.17	268.43	322.31	271.72	311.27	60.030	P9040	R	9522	$264.31
P9044	Cryoprecipitatereducedplasma	85	183	"21,912.95"	15.99	297.89	119.74	108.48	136.80	115.48	75.70	56.743	P9044	R	9523	$106.81
P9047	"Albumin (human), 25%, 50ml"	30	53	"5,044.83"	68.99	110.99	95.19	94.08	147.15	87.23	110.99	20.165	P9047	K	0965	$53.08
P9048	"Plasmaprotein fract,5%,250ml"	1	1	37.71	37.71	37.71	37.71	37.71	37.71	37.71	37.71	.	P9048	R	9519	$37.14
P9051	"Blood, l/r, cmv-neg"	214	307	"54,085.01"	29.96	482.45	176.17	149.63	193.82	168.67	191.24	62.410	P9051	R	9524	$147.34
P9052	"Platelets, hla-m, l/r, unit"	"1,067"	"1,267"	"1,070,681.96"	118.60	"4,617.47"	845.05	724.32	823.51	726.05	866.15	65.192	P9052	R	9525	$713.21
P9053	"Plt, pher, l/r cmv-neg, irr"	296	428	"219,632.77"	131.32	"1,288.18"	513.16	466.27	632.72	615.11	616.54	42.208	P9053	R	9531	$459.12
P9054	"Blood, l/r, froz/degly/wash"	29	39	"10,734.49"	122.59	522.78	275.24	245.16	313.41	227.96	305.37	58.862	P9054	R	9527	$241.40
P9055	"Plt, aph/pher, l/r, cmv-neg"	80	98	"22,849.08"	120.02	617.05	233.15	225.50	257.94	232.63	232.63	30.950	P9055	R	9528	$222.04
P9056	"Blood, l/r, irradiated"	437	580	"56,467.90"	42.03	372.00	97.36	86.52	112.65	90.49	90.49	63.193	P9056	R	9529	$85.20
P9057	"Rbc, frz/deg/wsh, l/r, irrad"	94	144	"69,617.07"	162.46	"2,061.54"	483.45	441.85	549.81	605.52	605.52	54.270	P9057	R	9532	$435.07
P9058	"Rbc, l/r, cmv-neg, irrad"	"1,137"	"1,530"	"452,512.13"	56.96	791.35	295.76	252.27	325.80	255.48	335.44	69.014	P9058	R	9533	$248.41
P9059	"Plasma, frz between 8-24hour"	"1,393"	"3,532"	"335,657.35"	3.26	678.83	95.03	76.44	139.77	91.07	115.43	105.270	P9059	R	9513	$75.27
P9060	Fr frz plasma donor retested	3	4	237.42	46.15	90.65	59.36	56.95	76.95	50.31	90.65	43.804	P9060	R	9503	$56.08
P9070	Pathogen reduced plasma pool	2	2	123.32	51.65	71.67	61.66	60.84	60.84	61.66	61.66	22.959	P9070	R	9534	$59.91
P9071	Pathogen reduced plasma sing	18	20	"7,500.72"	51.02	549.02	375.04	294.71	361.87	491.01	491.01	54.965	P9071	R	9535	$290.20
P9073	Platelets pheresis path redu	"41,586"	"47,349"	"35,374,288.04"	84.73	"3,572.71"	747.10	627.77	697.49	674.11	734.21	63.442	P9073	R	9536	$618.14
P9099	Blood component/product noc	496	496	"206,599.38"	319.09	533.27	416.53	415.26	415.26	421.07	421.07	8.062	P9099	R	9537	$37.14
