Hospital Outpatient Prospective Payment System (OPPS)

NOTICE:  Please note that as of April 2009, the OPPS Identifiable Data Set (IDS) is now considered a Limited Data Set (LDS).  The former identifiable version of the file is now the only version available.  The record layout below lists the data elements included on the new LDS, which include the elements from prior year versions of the IDS. This 2018 file has every element that was contained in the 2007 LDS and the 2007 IDS. Requestors should follow the link for Instructions on How to Request LDS Data Files below to obtain this file.

This file contains select claim level data and is derived from 2018 hospital outpatient PPS claims, updated through June 2019, that is, claims for services furnished on or after January 1, 2018 through December 31, 2018 that were received, processed, paid, and passed to the National Claims History file by June 30, 2019. This file includes data elements such as diagnosis codes, bill type, outlier payments, and service revenue payments. This file includes more than 120 million claims for services paid under the OPPS, including multiple and single claims.  The record length is 13,603, blocksize is 32,760.

The OPPS LDS file will be available twice a year, once for the NPRM in early summer, and again for the final rule within a month of publication of the OPPS final rule in the Federal Register. 

Media: DVD
Cost: $3,000  

Data Format:  CSV format with SAS® read-in program
Available: Final Rule 2020

To browse the record layout, see the Downloads section below.

Please follow the instructions on the DUA - Limited Data Sets page.

Page Last Modified:
10/30/2019 10:49 AM