`medicare_opps_rate`

Pack: medicare-pricing · Connect: https://pipeworx.io/mcp (see Connect below for a single-pack URL)

No MCP client? Call it directly: GET https://gateway.pipeworx.io/v1/tools/medicare_opps_rate for the schema, then POST the same URL with its arguments for the data.

What does Medicare pay a HOSPITAL OUTPATIENT department for a procedure, device, or drug code? Returns the status indicator, Ambulatory Payment Classification (APC), relative weight, national payment rate, and beneficiary copayment for a HCPCS/CPT code under the Hospital Outpatient Prospective Payment System (OPPS) — the schedule that applies when the same service is billed by a hospital’s outpatient department rather than a physician office (medicare_physician_payment) or a lab (medicare_lab_rate). Answers “what does Medicare pay for CPT 33289 in a hospital outpatient setting”, “what is the APC for C2624”, “is this device on pass-through status”, “what is the OPPS payment rate and copay for this code”.

Parameters

Name	Type	Required	Description
`code`	string	yes	HCPCS or CPT code, e.g. “33289” (CardioMEMS implant procedure) or “C2624” (implantable wireless pulmonary artery pressure sensor).
`year`	number	no	Calendar year, e.g. 2026. Omit to use the newest loaded year, which is stated in the response.
`quarter`	string	no	Which quarterly release: “Q1”..”Q4”, or the release month CMS actually uses (“january”/“april”/“july”/“october”). Omit to use the newest loaded quarter for the resolved year.

Example call

Arguments

{
  "code": "33289"
}

curl

curl -X POST https://gateway.pipeworx.io/medicare-pricing/mcp \
  -H 'Content-Type: application/json' \
  -d '{"jsonrpc":"2.0","id":1,"method":"tools/call","params":{"name":"medicare_opps_rate","arguments":{"code":"33289"}}}'

TypeScript (@pipeworx/sdk)

import { Pipeworx } from '@pipeworx/sdk';
const pipeworx = new Pipeworx();

const result = await pipeworx.call('medicare_opps_rate', {
  "code": "33289"
});

More examples

{
  "code": "C2624"
}

{
  "code": "C1600",
  "year": 2026,
  "quarter": "Q4"
}

Connect

Add this to your MCP client config — every tool in the catalog, including this one — or use one-click install buttons:

{
  "mcpServers": {
    "pipeworx": {
      "url": "https://pipeworx.io/mcp"
    }
  }
}

Connect to just the medicare-pricing pack

{
  "mcpServers": {
    "medicare-pricing": {
      "url": "https://gateway.pipeworx.io/medicare-pricing/mcp"
    }
  }
}

See Getting Started for client-specific install steps.

medicare_opps_rate