Fee-for-Service Outpatient

The Medicare Fee-for-Service (FFS) Outpatient (OP) file contains fee-for-service claims submitted by institutional outpatient providers. Examples of institutional outpatient providers include hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, comprehensive outpatient rehabilitation facilities, Federally Qualified Health Centers and community mental health centers. The file includes facility charge amounts.

This file is based on information from the CMS form 1450 (UB04).

What does this file include? (variable highlights)

  • Diagnosis (ICD diagnosis)
  • Procedure (ICD procedure code)
  • Healthcare Common Procedure Coding System (HCPCS) codes, including CPT codes
  • Dates of service
  • Medicare FFS reimbursement amount
  • Outpatient facility provider number 

Availability of this file

Availability:
Annual: 1999-2024
Quarterly: 2024 Q1-Q4; 2025 Q1-Q3

Date Requests Can Be Accepted for Upcoming Releases:

2025 Annual may be requested after 11/1/2026; quarterly updates available in August (Q1), November (Q2), February (Q3), and May (Q4)

See what is in this file