All terms
Outpatient Prospective Payment System
Medicare's payment system for hospital outpatient services.
Reviewed by Christian Espinosa, Founder, Blue Goat CyberLast reviewed May 5, 2026
Definition
OPPS pays hospital outpatient departments via Ambulatory Payment Classifications (APCs) - bundled payment groups for outpatient procedures. ASCs are paid under a parallel ASC payment system tied to OPPS.What this means in practice
Annual OPPS rule sets APC weights, device pass-throughs, and ASC-payable procedure list - a major commercial determinant for outpatient devices.Primary references
3 sourcesLink health: 1 verified 2 needs review· last checked 2026-05-09
- 1
CMS OPPSVerifiedCMScms.gov
- 2
CMS - CoverageNeeds reviewCMScms.gov
- 3
CMS - CodingNeeds reviewCMScms.gov
Inline markers like [1] jump to the matching reference above.