Original Medicare (Fee-for-Service) Outpatient

The Original 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
Monthly*: 2025 and 2026

*Data is only available to CCW VRDC users, and cannot be shipped.

Date Requests Can Be Accepted for Upcoming Releases:

Annual: 2025 may be requested after 12/1/2026
Quarterly: 2026 may be requested after 4/1/2026
Monthly: 2027 may be requested after 12/1/2026

See what is in this file