Medicare Advantage, Part D, Medicaid

Medicare ASC (Ambulatory Surgery Center) rates

medicare_silver.fact_asc_addendum·live·silver·Medicare Ambulatory Surgery Center (ASC) Rates

Rows

462,343

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1Medicare Ambulatory Surgery Center payment schedule (payment_rate) — the benchmark for ASC-setting surgery, a SEPARATE sibling system from OPPS.
2Don't substitute ASC for hospital-outpatient OPPS or vice-versa.

Grain

Key	Grain
N/A	1One row per (hcpcs_code, calendar_year, effective_period) -- Medicare ASC Addendum payment_rate + payment_indicator. 2DEEP 2001-2026. 3The shallow medicare_asc_rates is the deprecated recent-years mirror.

Columns (48)

Column	Type	Meaning
`calendar_year`	int
`hcpcs_code`	string
`addendum_member`	string
`short_descriptor`	string
`payment_indicator`	string
`payment_weight`	decimal(38,18)
`payment_rate`	decimal(38,18)
`pricer_group`	string
`multiple_procedure_discounting`	string
`pass_through_expiration`	string
`source_era`	string
`era_flag`	string
`source_zip_sha256`	string
`source_member`	string
`source_row_number`	bigint
`ira_adjusted_copayment`	decimal(38,18)
`payment_amount`	decimal(38,18)
`asc_payment_group`	string
`reference_opps_payment_rate`	decimal(38,18)
`reference_asc_payment_rate`	decimal(38,18)
`dra_cap`	decimal(38,18)
`asc_copayment_amount`	decimal(38,18)
`former_asc_group`	string
`change_indicator`	string
`fully_implemented_payment_weight`	decimal(38,18)
`fully_implemented_payment`	decimal(38,18)
`first_transition_year_payment`	decimal(38,18)
`second_transition_year_payment_weight`	decimal(38,18)
`second_transition_year_payment`	decimal(38,18)
`third_transition_year_payment_weight`	decimal(38,18)
`third_transition_year_payment`	decimal(38,18)
`notes`	string
`dra_cap_flag`	string
`observed_period`	date
`asserted_at`	date
`effective_period_start`	date
`effective_period_end`	date
`cms_vintage_sequence`	int
`parse_revision`	int
`parser_artifact_hash`	string
`source_url`	string
`sha256_content_hash`	string
`source_id`	string
`is_current`	boolean
`bronze_object_key`	string
`s3_version_id`	string
`vintage_tag`	string
`drug_source_version_id`	string

Query it

describe_data_source(source_fqn="medicare_silver.fact_asc_addendum")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.fact_asc_addendum WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	medicare_allowed
Identity key	`hcpcs_code`
Join	`how_to_join(source_fqn="medicare_silver.fact_asc_addendum")`
Raw door	Athena (read-only via query_substrate): medicare_silver.fact_asc_addendum
Note	CERTIFIED (product1-cert-asc-v1). Historical source manifest: docs/reference/source-audit/source-mastery/manifests/large-wave/medicare_asc_resolved_cms_files.json.

This page as markdown: /docs-md/data/medicare_silver_fact_asc_addendum.md · every page in one file: /llms-full.txt