APC's or Ambulatory Payment Classifications are outpatient services allocated into groups with assigned fixed payment amounts that are maintained by CMS as part of the Medicare Outpatient Prospective Payment System (OPPS). The APC coding system allows hospitals to be reimbursed by the U.S. government for Medicare outpatient services. APC codes are reported on claims with HCPCS Level I (CPT) codes and HCPCS Level II codes.
The APC detail page gives you a list of all associated CPT/HCPCS codes that are paid under the respective APC.
How Do I View APC Codes?
Quick Search
- Enter an APC code into the quick search field.
- Press Enter on your keyboard or click the magnifying glass. The APC detail page opens in a new tab.
From the CPT/HCPCS Detail Page
- Perform a CPT/HCPCS code search. The CPT/HCPCS Detail page opens in a new tab.
- Click the Reimbursement icon
in the icon bar. The Reimbursement detail page opens. - In the Status Indicator section, click the hyperlinked APC code. The APC detail page opens in a new tab.