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Outpatient Charge Data CY 2011

The data provided here include estimated hospital-specific charges for 30 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2011.  The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.

For these APCs, the estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.

9/4/13 UPDATE: As a result of using the OPPS ratesetting process to develop the summary of outpatient charge and payment data, we inadvertently excluded claims data for visit APCs 0604 (“Level 1 Hospital Clinic Visits”) and 0607 (“Level 4 Hospital Clinic Visits”).  The revised outpatient data reflects changes to correct this, with volume increases in the summarized data for APCs 0604 and 0607.

6/2/14 UPDATE: Original FY2011 National and State Summaries have been updated and are now based on 100% of discharges. Previously, these summaries were based on the publically available data which contained redactions at the provider/APC level.

Data are available in three formats:

  • An online interactive dataset (allows users to sort and filter data directly without downloading).
  • Microsoft Excel download (.xlsx)
  • Comma separated values download (.csv)

Detailed Data:

Interactive Dataset: Outpatient Charge Data, CY2011, Interactive Dataset

Downloadable Excel: Outpatient Charge Data, CY2011, Microsoft Excel version
Downloadable CSV: Outpatient Charge Data, CY2011, CSV version
 

APC Summary Tables:

Interactive Dataset: National Summary of Outpatient Charge Data, CY2011, Interactive Dataset

Interactive Dataset: State Summary of Outpatient Charge Data, CY2011, Interactive Dataset

Downloadable Excel: National and State Summaries of Outpatient Charge Data, CY2011, Microsoft Excel version
Downloadable CSV: National and State Summaries of Outpatient Charge Data, CY2011, CSV version

Inquiries regarding this data can be sent to MedicareProviderData@cms.hhs.gov.

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