Medicare Advantage, Part D, Medicaid

Medicare OPPS (hospital outpatient)

medicare_silver.fact_opps_addendum_b·live·silver·Medicare Hospital Outpatient (OPPS) Rates

Rows

1,290,799

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1Outpatient Prospective Payment System rates — the hospital OUTPATIENT FACILITY benchmark (payment_rate).
2NOT PFS (benchmarking a facility charge against PFS is the #1 methodology error).
3EXCLUDE status_indicator G/K (pass-through drugs/biologicals; payment_rate up to ~$3.7M/unit for gene/cell therapies — real drug prices, not facility fees) and packaged status-N $0 rows from a facility-fee distribution.

Grain

Key	Grain
N/A	1One row per (hcpcs_code, calendar_year, effective_period) -- CMS OPPS Addendum B APC payment_rate + status_indicator. 2DEEP CY2004-2026; within-year corrections via effective_period_start + cms_vintage_sequence (no quarter column). 3RBP prices as-of the service quarter. 4The shallow medicare_opps_rates is the deprecated recent-years mirror.

Columns (34)

Column	Type	Meaning
`calendar_year`	int
`hcpcs_code`	string
`modifier`	string
`short_descriptor`	string
`status_indicator`	string
`apc`	string
`relative_weight`	decimal(38,18)
`payment_rate`	decimal(38,18)
`national_copayment`	decimal(38,18)
`minimum_copayment`	decimal(38,18)
`coinsurance_pct`	decimal(38,18)
`adjusted_copayment`	decimal(38,18)
`pass_through_expiration`	string
`note`	string
`change_indicator`	string
`source_era`	string
`source_zip_sha256`	string
`source_member`	string
`source_row_number`	bigint
`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_opps_addendum_b")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.fact_opps_addendum_b 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_opps_addendum_b")`
Raw door	Athena (read-only via query_substrate): medicare_silver.fact_opps_addendum_b -- JOIN vlada_curated.fact_hospital_chargemaster ON billing_code=hcpcs_code (outpatient).
Note	CERTIFIED through the Source Acceptance Gate (product1-cert-opps-v1). The old medicare_silver.dim_medicare_opps name was never built. Historical source manifest: docs/reference/source-audit/source-mastery/manifests/large-wave/medicare_opps_resolved_cms_files.json.

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