All PlansReimbursementMedium impact
Outpatient Procedure Grouper Exhibit annual reimbursement update, effective July 1
UnitedHealthcare·Network News
Effective date
Jul 1, 2026
We identified it
Jun 3, 2026
Summary
UnitedHealthcare is updating their Outpatient Procedure Grouper (OPG) Exhibits effective July 1, 2026, which determine reimbursement levels for outpatient procedures. While 99.86% of codes remain at the same grouper level, 0.02% increased and 0.12% decreased in reimbursement level assignment.
Action Required
Before July 1, 2026: Billing team must review the updated Outpatient Procedure Grouper (OPG) Exhibits to identify any codes with changed reimbursement levels that affect your practice. Update billing software and fee schedules to reflect any new grouper level assignments. Ensure all outpatient procedure claims include appropriate CPT, HCPCS and revenue codes as required for reimbursement.