Questions billers ask › What Is the Final CY 2026 Medicare OPPS Conversion Factor?
What Is the Final CY 2026 Medicare OPPS Conversion Factor?
The rule, word for word
“the cancer hospital payment adjustment of 1.0000, and the adjustment of 0.07 (or 0.37 less 0.30) percentage point of projected OPPS spending for the difference in pass-through spending that results in a conversion factor for CY 2026 of $91.415. We are also finalizing a reduced conversion factor of $89.632 in the calculation of payments for hospitals that fail to meet the Hospital OQR Program requirements (a difference of −1.783 in the conversion factor relative to hospitals that met the requirements).”
Published2025-11-25 Captured2025-11-25
sha256:1b6c7a74…93778914 · Source
What our AI found in the sources
The final CY 2026 OPPS conversion factor is $91.415 for hospitals meeting Hospital OQR Program reporting requirements. Hospitals that fail to meet OQR reporting requirements use a reduced conversion factor of $89.632. Note there's a correction notice (2026-03578) that fixes two typographical errors in the wage index adjustment to the conversion factor on page 53493 of the final rule, so double-check the corrected figure if you're working directly from the Federal Register text.
Where the sources stop: The correcting document (2026-03578) references fixes to the wage index adjustment language on page 53493 but doesn't restate the corrected conversion factor value itself in the excerpt available -- if your figure needs to reconcile exactly with the corrected published rule, pull the full text of that correction notice to confirm whether $91.415 changed.
Also cited
Published2025-11-25 Captured2025-11-25
sha256:1b6c7a74…93778914 · Source
Published2026-02-23 Captured2026-02-23
sha256:a194ea97…55b68221 · Source
If this comes up on one of your claims
The quoted paragraph above is what you would put in the appeal or the audit file, with its citation and dates. Verbatim does not tell you how to bill; it shows you the rule as published so the decision is yours and the proof is in writing.
Ask it your own question and get the same thing back: the governing rule, quoted, with a citation that still verifies later.
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