The Outpatient Prospective Payment System (OPPS), in the form of Ambulatory Payment Classifications (APCs), is undergoing significant changes, which involve considerably increased packaging in several forms. Further changes include device‐dependent APCs along with modifications to cost reporting. Also, there are now comprehensive APCs in addition to composite APCs. These changes started in 2008 and continue to accelerate. Given additional changes for Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), the impact of changes for APCs are revolutionary as opposed to evolutional.