fee_components

What the Medicare Physician Fee Schedule states for a code: whether the code splits into a professional component and a technical component, and the relative values it states for each. Which part of this code is the reading and which part is the equipment is this tool. Codes: 91200, 0689T, 0690T, 76981, 76982, 76983, 76705, 0002M, 0003M, 81517, 0014M, 80076. `0689` is not a code, `0689T` is. Three rows, three different things. The row with no modifier is the global service. Modifier 26 is the professional component, the interpretation. Modifier TC is the technical component, the equipment and the staff who run it. The global row already contains both components, so adding a component to the global row counts the same work twice; this tool serves the rows and never sums them. A relative value is not a price. Turning relative values into dollars needs the annual conversion factor and a locality-specific geographic adjustment, neither of which this world holds, so this tool serves relative values and refuses a dollar figure. It does not read specialty or provider type either: the fee schedule does not carry which specialty may furnish the professional component, and that is what interpretation_requirement and a payer's own policy would settle. Where CMS states no national relative value for a code, the answer carries no relative-value field for that code at all, rather than a zero. Contractor-priced status means each Medicare contractor prices the code case by case after reading documentation, and a zero served there would report a price of zero where the fact is that no national price exists. Where the code's PC/TC indicator is not one this world holds CMS's own definition for, the answer carries no components object rather than an empty one, because a split this world cannot show is licensed is a split it does not report. Every figure is measured: this world read it from CMS's own Relative Value File, whose archive digest and release the answer names. That file's vintage is its own clock, separate from the rate extract's month and from the NCCI quarter.

Use this form for new arguments. Follow concrete links for known values. Fetch-only readers may be unable to submit new URLs.

Exact input contract

{
  "additionalProperties": false,
  "properties": {
    "code": {
      "description": "The billing code to look up on the Medicare Physician Fee Schedule. One of the codes in this enum, which is this tool's closed vocabulary; nothing outside it was read from the schedule.",
      "enum": [
        "0002M",
        "0003M",
        "0014M",
        "028",
        "029",
        "030",
        "0319U",
        "0320U",
        "0362T",
        "0540U",
        "0689T",
        "0690T",
        "20930",
        "20936",
        "22551",
        "22552",
        "22554",
        "22558",
        "22585",
        "22600",
        "22610",
        "22612",
        "22614",
        "22630",
        "22633",
        "22634",
        "22840",
        "22842",
        "22845",
        "22853",
        "22854",
        "27125",
        "27130",
        "27235",
        "27236",
        "27244",
        "27245",
        "27447",
        "3074F",
        "3075F",
        "3077F",
        "3078F",
        "3079F",
        "3080F",
        "402",
        "426",
        "427",
        "428",
        "429",
        "430",
        "447",
        "448",
        "450",
        "451",
        "453",
        "454",
        "455",
        "456",
        "457",
        "458",
        "459",
        "460",
        "471",
        "472",
        "473",
        "50200",
        "50360",
        "50365",
        "50370",
        "62380",
        "63005",
        "63030",
        "63042",
        "63047",
        "63048",
        "63052",
        "63056",
        "70450",
        "72131",
        "72141",
        "72148",
        "72158",
        "73502",
        "73521",
        "76705",
        "76770",
        "76981",
        "76982",
        "76983",
        "80048",
        "80053",
        "80061",
        "80076",
        "81479",
        "81517",
        "82043",
        "83036",
        "83718",
        "83880",
        "84443",
        "90785",
        "90791",
        "90792",
        "90832",
        "90833",
        "90834",
        "90836",
        "90837",
        "90838",
        "90839",
        "90840",
        "90846",
        "90847",
        "90853",
        "90887",
        "90935",
        "90937",
        "90945",
        "90960",
        "90961",
        "91200",
        "93000",
        "93010",
        "93306",
        "93307",
        "93308",
        "93784",
        "93786",
        "93788",
        "93790",
        "93797",
        "93798",
        "93880",
        "93975",
        "96127",
        "96130",
        "96131",
        "96136",
        "96137",
        "96138",
        "96139",
        "97012",
        "97014",
        "97032",
        "97035",
        "97110",
        "97112",
        "97116",
        "97140",
        "97151",
        "97153",
        "97155",
        "97161",
        "97162",
        "97163",
        "97164",
        "97530",
        "97535",
        "97750",
        "98975",
        "98976",
        "98977",
        "98978",
        "98979",
        "98980",
        "98981",
        "98984",
        "98985",
        "99091",
        "99213",
        "99214",
        "99215",
        "99283",
        "99284",
        "99285",
        "99408",
        "99409",
        "99453",
        "99454",
        "99457",
        "99458",
        "99473",
        "99474",
        "99484",
        "99487",
        "99490",
        "99491",
        "99492",
        "99493",
        "99494",
        "99495",
        "99496",
        "G0283",
        "G0396",
        "G0397",
        "G0422",
        "G0423",
        "G2067",
        "G2068",
        "G2069",
        "G2070",
        "G2074",
        "G2080",
        "G2214",
        "H0001",
        "H0015",
        "H0020",
        "H0038",
        "H0039",
        "H2011",
        "H2017",
        "S9480",
        "T1016"
      ],
      "type": "string"
    }
  },
  "required": [
    "code"
  ],
  "type": "object"
}

Ready links

• code: 0002M
• code: 0003M
• code: 0014M
• code: 028
• code: 029
• code: 030
• code: 0319U
• code: 0320U
• code: 0362T
• code: 0540U
• code: 0689T
• code: 0690T
• code: 20930
• code: 20936
• code: 22551
• code: 22552
• code: 22554
• code: 22558
• code: 22585
• code: 22600
• code: 22610
• code: 22612
• code: 22614
• code: 22630
• code: 22633
• code: 22634
• code: 22840
• code: 22842
• code: 22845
• code: 22853
• code: 22854
• code: 27125
• code: 27130
• code: 27235
• code: 27236
• code: 27244
• code: 27245
• code: 27447
• code: 3074F
• code: 3075F
• code: 3077F
• code: 3078F
• code: 3079F
• code: 3080F
• code: 402
• code: 426
• code: 427
• code: 428
• code: 429
• code: 430
• code: 447
• code: 448
• code: 450
• code: 451
• code: 453
• code: 454
• code: 455
• code: 456
• code: 457
• code: 458
• code: 459
• code: 460
• code: 471
• code: 472
• code: 473
• code: 50200
• code: 50360
• code: 50365
• code: 50370
• code: 62380
• code: 63005
• code: 63030
• code: 63042
• code: 63047
• code: 63048
• code: 63052
• code: 63056
• code: 70450
• code: 72131
• code: 72141
• code: 72148
• code: 72158
• code: 73502
• code: 73521
• code: 76705
• code: 76770
• code: 76981
• code: 76982
• code: 76983
• code: 80048
• code: 80053
• code: 80061
• code: 80076
• code: 81479
• code: 81517
• code: 82043
• code: 83036
• code: 83718
• code: 83880
• code: 84443
• code: 90785
• code: 90791
• code: 90792
• code: 90832
• code: 90833
• code: 90834
• code: 90836
• code: 90837
• code: 90838
• code: 90839
• code: 90840
• code: 90846
• code: 90847
• code: 90853
• code: 90887
• code: 90935
• code: 90937
• code: 90945
• code: 90960
• code: 90961
• code: 91200
• code: 93000
• code: 93010
• code: 93306
• code: 93307
• code: 93308
• code: 93784
• code: 93786
• code: 93788
• code: 93790
• code: 93797
• code: 93798
• code: 93880
• code: 93975
• code: 96127
• code: 96130
• code: 96131
• code: 96136
• code: 96137
• code: 96138
• code: 96139
• code: 97012
• code: 97014
• code: 97032
• code: 97035
• code: 97110
• code: 97112
• code: 97116
• code: 97140
• code: 97151
• code: 97153
• code: 97155
• code: 97161
• code: 97162
• code: 97163
• code: 97164
• code: 97530
• code: 97535
• code: 97750
• code: 98975
• code: 98976
• code: 98977
• code: 98978
• code: 98979
• code: 98980
• code: 98981
• code: 98984
• code: 98985
• code: 99091
• code: 99213
• code: 99214
• code: 99215
• code: 99283
• code: 99284
• code: 99285
• code: 99408
• code: 99409
• code: 99453
• code: 99454
• code: 99457
• code: 99458
• code: 99473
• code: 99474
• code: 99484
• code: 99487
• code: 99490
• code: 99491
• code: 99492
• code: 99493
• code: 99494
• code: 99495
• code: 99496
• code: G0283
• code: G0396
• code: G0397
• code: G0422
• code: G0423
• code: G2067
• code: G2068
• code: G2069
• code: G2070
• code: G2074
• code: G2080
• code: G2214
• code: H0001
• code: H0015
• code: H0020
• code: H0038
• code: H0039
• code: H2011
• code: H2017
• code: S9480
• code: T1016