Kidneys Procured En Bloc

140.14 – Kidneys Procured En Bloc (Rev. 13599, Issued: 01-30-26, Effective: 05-01-26, Implementation: 05-01-26) A3-3178.15 When two kidneys are obtained from a deceased donor, and both kidneys are shipped to the same transplant hospital or OPO, the hospital should adjust its normal charges to reflect any increased perfusion, preservation, and shipping costs due to the additional kidney. On the other hand, when the kidneys are sent to separate organizations or transplant hospitals, the excising hospital should prorate its charges to the receiving organizations so that the total charges do not exceed the amount that would have been billed if one transplant hospital or OPO had received both kidneys. Under 42 CFR § 413.412(c), for Medicare cost allocation purposes, OPOs and THs count (1) En bloc kidneys procured and transplanted en bloc (two kidneys transplanted as one unit) as one total usable kidney. En bloc kidneys transplanted into a Medicare beneficiary count as one Medicare usable kidney. (2) En bloc kidneys procured en bloc but separated and transplanted into two different recipients as two total usable kidneys. For each kidney transplanted into a Medicare beneficiary, count each as one Medicare usable kidney.