Revenue Code (RC) Imputations
Use revenue code rates from hospital MRFs to impute HCPCS codes. RC = Revenue Code — the 4-digit codes hospitals use to report services at departmental level.
Why Revenue Codes
Some hospitals report rates at revenue code family level (e.g., "Operating Room" RC 036x) without breaking down by individual HCPCS procedure codes. A hospital might post a single OR rate covering hundreds of distinct surgical procedures. RC imputations reverse-engineer HCPCS rates from these family-level prices, expanding coverage significantly.
Three RC Imputation Types
RC Global
The payer posts a single rate for a revenue code family in core_rates (billing_code_type = 'RC'). This rate is applied to all HCPCS codes in that family.
- Scoped to inpatient revenue codes (codes starting with
00,01,020,021) - Source table:
tmp_int_imputations_rc_global
RC HCPCS
More granular than RC Global — uses the rc_to_hcpcs_cross_validated_75 crosswalk table to map a revenue code rate to specific HCPCS codes that are typically billed under that revenue code. The crosswalk captures the empirical relationship between revenue codes and procedure codes as observed across MRF data.
RC Carveout
Specific HCPCS codes with pricing that overrides the family rate are "carved out" and treated separately. Carveout logic prevents the family RC rate from being applied when the payer has already provided a more specific HCPCS-level rate.
RC imputations are not the final imputation output. They feed into the main imputations.sql chain alongside long rates, providing additional rate observations for the tier aggregations. A rate derived from an RC crosswalk competes against rates from other sources under the standard tier selection logic.