Outpatient Definitions and Methodology

Statistics for the Top 20 Medical Diagnoses

All information in this report is taken from the Medicare Outpatient Prospective Payment System (OPPS) Limited Data Set which is updated annually by CMS based on the calendar year.  The file includes billing data for 100% of all Medicare fee-for-service claims for hospital outpatient services during the twelve months ending December 31.  The report is based on the most recent period available and is consistent with CMS cell size suppression policy.

The twenty primary ICD-9 diagnosis codes with the highest levels of payment are ranked by total payment and all others are summarized.  All averages in the report are calculated on a per claim basis.  Claims without a diagnosis coded are excluded: