Outpatient Procedure Grouper Exhibit annual reimbursement update

Effective for dates of service beginning July 1, 2026, we will update the UnitedHealthcare Outpatient Procedure Grouper (OPG) Exhibits to define the CPT^® and HCPCS code assignments to grouper levels. The exhibits determine reimbursement for outpatient procedures by listing valid codes and their eligible reimbursement levels.

What you need to do

• Review the updated Outpatient Procedure Grouper (OPG) Exhibits. The July exhibit list includes codes that were recently added and removed. Many codes remain the same:
  • 99.86% are assigned to the same grouper level
  • 0.02% have increased in level assignment
  • 0.12% have decreased in level assignment
• Ensure you submit complete claims. When billing for outpatient procedures, please include the appropriate CPT, HCPCS and revenue codes. They’re required for reimbursement.