References: 1. Isselbacher EM, Preventza O, Hamilton Black J 3rd, Augoustides JG, Beck AW, Bolen MA, Braverman AC, Bray BE, Brown-Zimmerman MM, Chen EP, Collins TJ, DeAnda A Jr, Fanola CL, Girardi LN, Hicks CW, Hui DS, Schuyler Jones W, Kalahasti V, Kim KM, Milewicz DM, Oderich GS, Ogbechie L, Promes SB, Gyang Ross E, Schermerhorn ML, Singleton Times S, Tseng EE, Wang GJ, Woo YJ. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022 Dec 13;146(24):e334-e482. doi: 10.1161/ CIR.0000000000001106. Epub 2022 Nov 2. PMID: 36322642; PMCID: PMC9876736. 2. C D-10-CM and ICD-10-PCS codes referenced in this guide are effective for discharges on or after October 1, 2025, in accordance with the FY 2026 IPPS Final Rule (Centers for Medicare & Medicaid Services, available at https://www.cms.gov/medicare/coding/icd10). 3. D RG values were calculated using a base rate of $6,752.61 and a Capital Standard Payment of $524.15. The base payment rate assumes the hospital submitted quality data and is a meaningful user of EHR. The weighted rate used the 10% Cap Applied. The hospital’s base payment rate will change if the hospital does not meet either or both of these measures. Calculations were based on data provided in the FY 2026 IPPS Final Rule (Tables 1A, 1D, and 5). 4. C PT® 2025 Professional Edition. Copyright © 2024 American Medical Association. All Rights Reserved. CPT® is a registered trademark of the American Medical Association. 5. C Y 2025 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; (CMS-1807-F); Addendum B. All MPFS Fee Schedules calculated using CF of $32.3465 effective January 1, 2025.
Reimbursement Guide - Effective 10/01/2025 | 7
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