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Tirzepatide (Mounjaro, Zepbound) is a dual GIP and GLP-1 receptor agonist administered by subcutaneous injection for type 2 diabetes and chronic weight management

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For the CY 2026 OPPS/ASC proposed rule, CPT code 78803 had a geometric mean cost of around $585 and we proposed to reassign the procedure from APC 5593 (Level 3 Nuclear Medicine and Related Services) with a proposed payment rate of around $1,323 to APC 5592 (Level 2 Nuclear Medicine and Related Services) with a proposed payment rate of around $559 and status indicator S (Procedure or service not subject to multiple procedure discounting)