Fee Schedule Viewer¶

The Fee Schedule Viewer provides access to all Medicare fee schedules loaded into Bedrock Billing, allowing you to search, browse, and analyze pricing data for healthcare services.

Overview¶

Fee schedules define the payment amounts for medical services, procedures, and items under various Medicare payment systems. The viewer consolidates multiple fee schedule types into a single, searchable interface.

Available Fee Schedule Types¶

Physician Fee Schedule (PFS)¶

CPT/HCPCS codes for professional services

• Office visits and consultations
• Surgical procedures
• Diagnostic tests
• Therapy services
• Includes: National payment amounts, RVU values, modifiers, status indicators

Clinical Laboratory Fee Schedule¶

Laboratory tests and analyses

• Blood tests and panels
• Urinalysis
• Microbiology
• Molecular pathology
• Includes: National limitation amounts, gap-fill amounts

DME Fee Schedule¶

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

• Wheelchairs and walkers
• Hospital beds
• Oxygen equipment
• Prosthetic devices
• Includes: Fee schedule amounts by locality

Ambulance Fee Schedule¶

Emergency and non-emergency transport

• Ground ambulance (basic, advanced)
• Air ambulance (fixed-wing, rotary-wing)
• Mileage rates
• Includes: Base rates, mileage rates by locality

Using the Fee Schedule Viewer¶

Accessing the Viewer¶

Navigate to Pricing Data → Fee Schedules from the main sidebar.

Search and Filter¶

Search by Code¶

1. Enter a CPT or HCPCS code in the search box
2. Partial matches are supported (e.g., "9921" finds all codes starting with 9921)
3. Press Enter or click Search

Filter by Schedule Type¶

Use the dropdown to filter by specific fee schedule: - All Schedules - Physician Fee Schedule - Clinical Lab - DME - Ambulance

Filter by Modifiers¶

• Search for codes with specific modifiers
• View modifier-specific pricing
• Compare base rates vs modified rates

Understanding the Results¶

Each search result displays:

Viewing Detailed Information¶

Click on any row to expand and see:

Physician Fee Schedule Details¶

• Work RVU: Physician work component
• Practice Expense RVU: Practice costs
• Malpractice RVU: Professional liability
• Total RVU: Sum of components
• Conversion Factor: Dollar multiplier
• Price Indicator: 1 = QP, 9 or NULL = Standard
• National Payment Amount: RVU × Conversion Factor
• Status Indicator: Active, bundled, invalid, etc.

Clinical Lab Details¶

• National Limitation Amount: Maximum payment
• Gap-Fill Amount: If applicable

Pagination¶

• Default: 25 results per page
• Navigation: Use First, Previous, Next, Last buttons
• Page Info: Shows current page and total results
• Jump to Page: Click page numbers to navigate directly

Common Use Cases¶

Finding Current Payment for a Service¶

1. Enter the CPT/HCPCS code (e.g., "99213")
2. Leave date filter at default (current)
3. View the national payment amount
4. Check for any modifiers that might apply

Comparing Rates Over Time¶

1. Search for a code
2. Adjust the date range to span multiple years
3. Sort by Start Date
4. Compare rate changes year-over-year

Checking Modifier Impact¶

1. Search for a base code (e.g., "27447")
2. Look for entries with modifiers (e.g., "27447-LT")
3. Compare base vs modified rates
4. Note any pricing adjustments

Understanding Fee Schedule Data¶

Temporal Validity¶

Fee schedules include start and end dates: - Open-ended: End date of 12/31/2199 means currently active - Historical: Past end dates indicate superseded rates - Future: Future start dates show pending changes

Modifiers¶

Modifiers affect payment: - Bilateral (50): Often 150% of base - Multiple procedures (51): Often reduced payment - Assistant surgeon (80): Percentage of primary surgeon fee - Reduced services (52): Reduced from full service fee

Status Indicators¶

Troubleshooting¶

Code Not Found¶

• Check spelling: Verify the code is correct
• Check schedule type: May be in a different fee schedule
• Historical codes: Some codes are retired/deleted

Unexpected Rates¶

• Locality-specific: Some rates vary by geography (use Localities viewer)
• Modifier impact: Modified codes have different rates
• Date sensitivity: Rates change quarterly or annually

Missing Data¶

• Recent updates: Data may not be loaded yet
• Admin privileges: Contact admin to trigger data reload
• CMS delays: Sometimes CMS delays releasing files

API Access¶

For programmatic access to fee schedule data, see the Fee Schedules API Documentation.

Related Topics¶

• MUE Data Viewer - Check unit limits for codes
• Localities Viewer - View GPCI adjustments by location
• Claims Processing - Use fee schedules in claims

Last updated: November 18, 2025