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We note that, for purposes of identifying significant procedure codes for examination under the 2 times rule, we consider procedure codes that have more than 1,000 single major claims or procedure codes that both have more than 99 single major claims and contribute at least 2 percent of the single major claims used to establish the APC cost to be significant (75 FR 71832)

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As we discussed in the CY 2026 OPPS/ASC proposed rule (90 FR 33792 through 33793), and in agreement with commenters, we continue to believe that requiring the median, 10th percentile, and 90th percentile allowed amounts will provide greater context and clarity with respect to the payer-specific negotiated charge than the estimated allowed amount

But retatrutide adds a third target: the glucagon receptor