Overview of the Medicare Physician Fee Schedule Search
This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10,000 physician services, the associated relative value units, a fee schedule status indicator and various payment policy indicators needed for payment adjustment (i.e., payment of assistant at surgery, team surgery, bilateral surgery, etc.). The Medicare physician fee schedule pricing amounts are adjusted to reflect the variation in practice costs from area to area. A geographic practice cost index (GPCI) has been established for every Medicare payment locality for each of the three components of a procedure's relative value unit (i.e., the RVUs for work, practice expense, and malpractice). The GPCIs are applied in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component.
The Physician Fee Schedule look-up website is designed to take you through the selection steps prior to the display of the information. The site allows you to:
- Search pricing amounts, various payment policy indicators, RVUs, and GPCIs by a single procedure code, a range and a list of procedure codes.
- Search for the national payment amount, a specific Medicare Administrative Contractor (MAC) or a specific MAC locality. Each page has associated Help/Hint available to complete your selections.
NOTE: In the CY 2010 PFS final rule with comment period (74 FR 61751) we provided for a 4-year transition to the new PE RVUs resulted from using the updated PPIS PE/HR data. This new PPIS data caused payment reductions for some specialties. In order to ease this impact, we finalized a gradual 4 year transition from the previous PE RVUs to the PE RVUs developed using the new PPIS data (75 percent old/25 percent new for CY 2010, 50 percent old /50 percent new for CY 2011, 25 percent old /75 percent new for CY 2012, and 100 percent new for CY 2013). CY 2013 is the final year of the transition to the new full PE values, resulting in the elimination of the Transitional PE RVUs.
Disclaimer: Please note that this display tool is created and maintained as a helpful aid for physicians and nonpractitioners looking for a quick look-up and reference to the Physician Fee Schedule (PFS) payment rates. Users of this display tool should note that the Centers for Medicare & Medicaid Services (CMS) make no warranties, expressed or implied, regarding errors or omissions and assume no legal liability or responsibility for loss or damage resulting from the use of information contained within. For the official and definitive CMS PFS payment files, please contact the local Medicare Administrative Contractor (MAC) in your payment jurisdiction.
Send email to: MedicarePhysicianFeeSchedule@cms.hhs.gov