> For the complete documentation index, see [llms.txt](https://docs.payerset.com/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.payerset.com/using-the-payerset-platform/data-dictionary/claims-data/medicare-outpatient-data.md). # Medicare Outpatient Data ### Outpatient Data | Field Name | Friendly Name | Description / Sample Value | | ---------------------------------------- | ----------------------------------------------- | -------------------------------------------------------------------------- | | **HCPCS Code** | HCPCS Procedure Code | Healthcare Common Procedure Coding System code. e.g. `0275T` | | **Modifier** | HCPCS Modifier | Optional two-character modifier. e.g. `""` (empty if none) | | **Short Description** | Service Short Description | Brief description of the procedure. e.g. `Perq lamot/lam lumbar` | | **Mac Locality** | MAC Locality Code | Medicare Administrative Contractor locality code. e.g. `111205` | | **Locality County** | County | County that corresponds with Mac Locality | | **Locality State** | State | State that corresponds with Mac Locality | | **Non-Facility Price** | Non-Facility Price | Allowed charge in a non-facility setting. e.g. `"$0.00"` | | **Facility Price** | Facility Price | Allowed charge in a facility setting. e.g. `"$0.00"` | | **Non-Facility Limiting Charge** | Non-Facility Limiting Charge | Payment limit for non-facility. e.g. `"$0.00"` | | **Facility Limiting Charge** | Facility Limiting Charge | Payment limit for facility. e.g. `"$0.00"` | | **GPCI Work** | Work GPCI Factor | Geographic practice cost index for work. e.g. `1.088` | | **GPCI PE** | Practice Exp. GPCI Factor | Geographic practice cost index for practice expense. e.g. `1.419` | | **GPCI MP** | Malpractice GPCI Factor | Geographic malpractice cost index. e.g. `0.445` | | **Proc Stat** | Procedure Status | Status indicator (e.g. R=revised). e.g. `"R"` | | **Work RVU** | Work RVU | Relative value unit for physician work. e.g. `0.00` | | **NA Flag for Trans Non-FAC PE RVU** | Flag: Transitional Non-Facility PE RVU Missing | `"NA"` if no transitional practice-expense RVU available | | **Transitioned Non-FAC PE RVU** | Transitional Non-Facility PE RVU | Transitional practice-expense RVU, non-facility. e.g. `0.00` | | **NA Flag for Fully IMP Non-FAC PE RVU** | Flag: Fully Implemented Non-FAC PE RVU Missing | `"NA"` if no fully implemented practice-expense RVU available | | **Fully Implemented Non-FAC PE RVU** | Fully Impl. Non-Facility PE RVU | Final practice-expense RVU, non-facility. e.g. `0.00` | | **NA Flag for Trans Facility PE RVU** | Flag: Transitional Facility PE RVU Missing | `"NA"` if no transitional practice-expense RVU for facility available | | **Transitioned Facility PE RVU** | Transitional Facility PE RVU | Transitional practice-expense RVU, facility. e.g. `0.00` | | **NA Flag for Fully IMP FAC PE RVU** | Flag: Fully Implemented Facility PE RVU Missing | `"NA"` if no fully implemented practice-expense RVU for facility available | | **Fully Implemented Facility PE RVU** | Fully Impl. Facility PE RVU | Final practice-expense RVU, facility. e.g. `0.00` | | **MP RVU** | Malpractice RVU | Relative value unit for malpractice. e.g. `0.00` | | **Transitioned Non-FAC Total** | Transitional Non-Facility Total RVU | Sum of work + PE + MP RVUs (transitional)(non-facility). e.g. `0.00` | | **Transitioned Facility Total** | Transitional Facility Total RVU | Sum of work + PE + MP RVUs (transitional)(facility). e.g. `0.00` | | **Fully Implemented Non-Fac Total** | Fully Impl. Non-Facility Total RVU | Sum of RVUs (work+PE+MP) final, non-facility. e.g. `0.00` | | **Fully Implemented Facility Total** | Fully Impl. Facility Total RVU | Sum of RVUs (work+PE+MP) final, facility. e.g. `0.00` | | **PCTC** | Multiple-Procedure Indicator | Indicator for multiple-procedure payment reduction. e.g. `"YYY"` | | **Global** | Global Surgical Indicator | Global surgery period indicator (0=no global). e.g. `0` | | **Pre Op** | Pre-Operative RVU | RVU for pre-operative period. e.g. `0.00` | | **Intra Op** | Intra-Operative RVU | RVU for intra-operative period. e.g. `0.00` | | **Post Op** | Post-Operative RVU | RVU for post-operative period. e.g. `0.00` | | **Mult Surg** | Multiple Surgery RVU | RVU adjustment for multiple surgeries. e.g. `0.00` | | **Bilt Surg** | Bilateral Surgery RVU | RVU adjustment for bilateral procedures. e.g. `0.00` | | **Asst Surg** | Assistant Surgeon RVU | RVU for assistant surgeon. e.g. `0.00` | | **Co Surg** | Co-Surgeon RVU | RVU for co-surgeon. e.g. `0.00` | | **Team Surg** | Team Surgery RVU | RVU for team surgery. e.g. `0.00` | | **Phys Supv** | Physician Supervision RVU | RVU for physician supervision. e.g. `0.00` | | **Endobase** | Endoscopic Base RVU Indicator | Indicator if code is endoscopic base. e.g. `""` | | **Conv Fact** | Conversion Factor | Dollar-to-RVU conversion factor. e.g. `32.3465` | | **Not Used for Medicare** | Excluded from Medicare | Flag if code is not payable by Medicare. e.g. `""` | | **Diag Imaging Family Ind** | Diagnostic Imaging Family Indicator | Family group code. e.g. `99` | | **Opps Non-Facility Payment Amount** | OPPS Non-Facility Payment | Payment amount under OPPS non-facility. e.g. `"NA"` | | **Opps Facility Payment Amount** | OPPS Facility Payment | Payment amount under OPPS facility. e.g. `"NA"` | | **Non-Fac PE Used For Opps PMT AMT** | Non-Facility PE Weight for OPPS Payment | Practice-expense index used in OPPS non-facility calculation. e.g. `0.0` | | **Facility PE Used For Opps PMT AMT** | Facility PE Weight for OPPS Payment | Practice-expense index used in OPPS facility calculation. e.g. `0.0` | | **Malpractice Used For Opps PMT AMT** | Malpractice PE Weight for OPPS Payment | Malpractice index used in OPPS payment calculation. e.g. `0.0` | --- # Agent Instructions This documentation is published with GitBook. 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