Digital Compute-in-Memory (DCiM) accelerates neural networks by reducing data movement. Approximate DCiM can further improve power-performance-area (PPA), but demands accuracy-constrained co-optimization across coupled architecture and transistor-level choices. Building on OpenYield, we introduce Accuracy-Constrained Co-Optimization (ACCO) and present OpenACMv2, an open framework that operationalizes ACCO via two-level optimization: (1) accuracy-constrained architecture search of compressor combinations and SRAM macro parameters, driven by a fast GNN-based surrogate for PPA and error; and (2) variation- and PVT-aware transistor sizing for standard cells and SRAM bitcells using Monte Carlo. By decoupling ACCO into architecture-level exploration and circuit-level sizing, OpenACMv2 integrates classic single- and multi-objective optimizers to deliver strong PPA-accuracy tradeoffs and robust convergence. The workflow is compatible with FreePDK45 and OpenROAD, supporting reproducible evaluation and easy adoption. Experiments show that the proposed two-level ACCO framework achieves most of its accuracy-constrained efficiency gain at Level-1 through architecture exploration, delivering roughly 50%+ PDP reduction, while Level-2 transistor-level optimization provides a further single-digit PDP improvement while preserving accuracy, enabling rapid "what-if" exploration for approximate DCiM. The framework is available on GitHub (https://github.com/ShenShan123/OpenACM).

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