OPPS / APC Calculator

Medicare's Outpatient Prospective Payment System (OPPS) pays hospital outpatient departments via Ambulatory Payment Classifications (APCs). Each HCPCS code is assigned to an APC with a status indicator that determines how it's paid: separately (S, T, V), packaged (N, Q1-Q4), inpatient-only (C), or not paid under OPPS (B, E1, Y). Payment = APC rate × (60% wage-adjusted + 40% non-wage). This tool uses CMS OPPS Addendum B effective April 1, 2026.