Sample format of APC-F

Element 1 CPT/ HCPCS
Element 2 Status Indicator
	A-Services not paid under OPPS 
	B-Non-allowed item or service for OPPS 
	C-Inpatient procedure 
	E-Non allowed item or service 
	F-Corneal tissue acquisition 
	G-Drug/Biological Pass-through 
	H-Device pass-through 
	J-New drug or new biological pass-through
	K-Non pass-through drug or device 
	N-Packaged incidental service 
	P-Partial hospitalization service 
	S-Significant procedure not subject to multiple procedure discounting 
	T-Significant procedure subject to multiple procedure discounting 
	V-Medical visit to clinic or emergency department 
	X-Ancillary service 
Element 3 APC Description
Element 4 APC number
Element 5 Relative Weight
Element 6 Payment Rate
Element 7 National Unadjusted Co-payment
Element 8 Minimum Unadjusted Co-payment

...
"13122","T","Repair wound/lesion add-on","0024","2.00","$104.02","$37.45","$20.80"
"13131","T","Repair of wound or lesion","0024","2.00","$104.02","$37.45","$20.80"
"13132","T","Repair of wound or lesion","0024","2.00","$104.02","$37.45","$20.80"
"13133","T","Repair wound/lesion add-on","0024","2.00","$104.02","$37.45","$20.80"
"13150","T","Repair of wound or lesion","0025","5.89","$306.33","$116.41","$61.27"
"13151","T","Repair of wound or lesion","0024","2.00","$104.02","$37.45","$20.80"
"13152","T","Repair of wound or lesion","0025","5.89","$306.33","$116.41","$61.27"
"13153","T","Repair wound/lesion add-on","0024","2.00","$104.02","$37.45","$20.80"
"13160","T","Late closure of wound","0027","15.73","$818.10","$343.60","$163.62"
"14000","T","Skin tissue rearrangement","0027","15.73","$818.10","$343.60","$163.62"
"14001","T","Skin tissue rearrangement","0027","15.73","$818.10","$343.60","$163.62"
"14020","T","Skin tissue rearrangement","0027","15.73","$818.10","$343.60","$163.62"
"14021","T","Skin tissue rearrangement","0027","15.73","$818.10","$343.60","$163.62"
...