CY 2027 AKI NPRM Provider Level Impact File					
					
Column	Title	Description			
A	Provider ID	Six character OSCAR Provider Number (CMS Certification Number). 			
B	Number of Dialysis Treatments	Hemo-equivalent treatments			
C	Total Payment for Step 1	This is the baseline result for comparison purposes- use 2025 data with the final CY 2026 wage index			
D	Total Payment for Step 2	This step incorporates the ESRD PPS proposed amount to be added to the base rate for phosphate binders.			
E	Total Payment for Step 3	This step applies the ESRD budget neutrality factor to account for the proposed changes in pediatric case-mix multipliers.			
F	Total Payment for Step 4	This step applies the ESRD budget neutrality factor to account for updating the two-tier LVPA adjusters to the proposed six-tier LVPA adjusters.			
G	Total Payment for Step 5	This step applies the ESRD budget neutrality factor to account for the proposed LVPA adjustment for pediatric treatments.			
H	Total Payment for Step 6	This step increases the training add-on amount from its 2026 value ($95.60) to its proposed 2027 value ($138.22). 			
I	Total Payment for Step 7	This step applies the ESRD budget neutrality factor to account for proposed changes in training add-on amount.			
J	Total Payment for Step 8	"This step updates the labor share from its 2026 value (0.552) to its proposed 2027 value (0.635), and the wage index to its 2027 value."			
K	Total Payment for Step 9	This step applies the ESRD budget neutrality factor to account for the proposed change in the labor share and application of the 2027 wage index. 			
L	Total Payment for Step 10	This step updates the base rate by the proposed market basket update and the productivity adjustment.  			
M	Rural	Identifies urban or rural status based on geographic location			
		Yes=Rural			
		No=Urban			
N	Hospital Based	Yes=Hospital-based			
		No=Freestanding			
O	Census Region	Identifies location of facility by Census Region			
P	State	Identifies the facility's state			
Q	Pediatric	Identifies percentage of pediatric patients			
		1=Less than 2%			
		2=From 2% to 49%			
		3=50% or more			
R	Size	Identifies size of facility based on total number of hemo-equivalent treatments (including treatments for non-Medicare patients)			
		"1=Less than 3,000 treatments"			
		"2=3,000 to 3,999 treatments"			
		"3=4,000 to 4,999 treatments"			
		"4=5,000 to 5,999 treatments"			
		"5=6,000 to 6,999 treatments"			
		"6=7,000 to 7,999 treatments"			
		"7=8,000 treatments or more"			
S	Ownership	Identifies type of ownership by:			
		1=Large dialysis organization			
		2=Regional chain			
		3=Independent			
		4=Hospital-based			
		5=Unknown			
T	For Profit	Identifies facilities profit status			
		1) Yes			
		2) No			
U	CBSA	Core-Based Statistical Area			
V	2026 Wage Index	Final Wage Index for 2026			
V	"2027 Wage Index, Capped"	Proposed Wage Index for 2027			
