Nothing but Drugs Moved in the October Rate Book

Three days ago we wrote that a hospital outpatient department would bill C9312 on Thursday morning with nobody outside CMS able to tell it what the line pays. The code's own long descriptor closes off the obvious shortcut: "Injection, trabectedin (apotex), not therapeutically equivalent to j9362, 0.01 mg."

C9312 pays $46.71.

The October 2026 OPPS Addendum B went up at 8:58 Thursday morning, Eastern, on the day its rates took effect. Addendum A followed at 9:34 and Addendum Q a minute after that.

The CSV inside the zip is named 2026_October_Web_Addendum_B.09.28.26.csv. CMS finished the file on September 28 and the quarterly addenda page carried nothing for October as late as 5pm Wednesday.

571 Lines Moved and Every One Is a Drug

We diffed the new file against July's, line by line.

October carries 19,278 HCPCS lines, 7,392 of them with a payment rate. 145 codes arrived and 18 left.

571 payment rates changed, and every single one carries an October status indicator of K, G or K1 (chart below).

Not one relative weight moved. Parse that column as a number in both quarters and the difference is exactly zero across all 19,135 codes present in both, so no procedure, no clinic visit and no imaging study repriced on October 1.

There are 512 rows that look changed in a text diff, and all 512 are the string 1.487 becoming 1.4870.

So the outpatient quarter turned over and the only thing in the rate book that moved was the pharmacy.

258 of the 571 went up and 313 went down, at a median move of 0.8%, which is the ordinary drift off a new ASP cycle.

The tail is where the money is. 71 lines moved more than 10% and 29 moved more than a quarter.