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This variable is contained in the following files: Inpatient (Fee-for-Service), Skilled Nursing Facility (Fee-for-Service)
Short SAS Name
SAS Name

The amount of the outlier portion of the PPS payment for capital.

This is one component of the total amount that is payable for capital PPS for the claim. The total capital amount, which includes this variable, is in the variable CLM_TOT_PPS_CPTL_AMT.


Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics” (see:

Also in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series” (see:

Source: NCH