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How do you find out how much these outpatient codes pay for your area?

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  • How do you find out how much these outpatient codes pay for your area?

    Title, im looking up CMS website i dunno.

  • #2
    Medicare or private? Private practice or hospital?

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    • #3
      Originally posted by ENT Doc View Post
      Medicare or private? Private practice or hospital?
      medicare, private practice

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      • #4
        Medicare has a website that you plug in the code for any procedure or E&M code

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        • #5
          Medicare payment is calculated by:

          Conversion Factor x ((wRVU x PW GPCI) + (Non Facility PE RVU x PE GPCI) + (MP RVU x MP GPCI))

          GPCIs are based on your geographic location. All can be found on the most recent CMS PFS files:

          https://www.cms.gov/medicaremedicare...e-files/rvu21b

          CF for 2021 is tricky - make sure you have factored in the slight bump up we got in the Dec 2020 COVID relief package.

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          • #6
            Medicare is available on the CMS webite
            Private is impossible really, as they have different contracts with everyone. The best you could get is a rough estimate.

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            • #7
              https://www.cms.gov/medicare/physici...chedule/search

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