Set 3: Locality-Specific Medicare Physician Fee Schedules


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Item #: 7883
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You provide us with the areas you are interested in and we provide you with the actual dollar amount reimbursed under the Medicare Physician Fee Schedule for those areas. Choose one or more localities or the entire nation. This data set gives you the actual Medicare fees by area and procedure for nonparticipating and participating providers.

Data includes budget-neutrality and calculation flag adjustments when required by CMS.

Data Elements: CPT®/HCPCS code, code description, Medicare status code, modifier, non-facility par fee schedule amount, facility par fee schedule, non-facility non-par fee schedule amount, facility non-par fee schedule, OPPS amounts, and global surgery periods.

All data sets are available as .txt files, available to download from the web. Data sets are available via the web services team. Call for pricing. Custom formats may require custom pricing.

CPT is a registered trademark of the American Medical Association.