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If HCPCS codes are added to an APC and, after recalibrating its relative payment weight, holding its unadjusted copayment amount constant results in an increase in the coinsurance percentage for the reconfigured APC, the copayment amount would be calculated as the product of the payment rate of the reconfigured APC and the lowest coinsurance percentage of the codes being added to the reconfigured APC

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We used the 1-year charge inflation factor used in the FY 2026 IPPS/LTCH PPS final rule (90 FR 37227) of 5.5 percent (1.05505) to increase charges on the CY 2024 claims, and we used the overall CCR in the July 2025 Outpatient Provider-Specific File (OPSF) to estimate outlier payments for CY 2025

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