Public-domain federal data
What Medicare pays for 7,835 procedure codes.
The Centers for Medicare & Medicaid Services publishes a national-average reimbursement amount for every covered CPT and HCPCS code. We mirror it here, refreshed quarterly, with each code cross-linked to dispute scenarios where the same code commonly appears.
Have a code in mind?
Enter the 5-digit CPT or HCPCS code from your bill. We’ll show the Medicare benchmark and what it usually means.
ER & Emergency
ER visit codes (99281–99285) are among the highest-volume codes reviewed for documentation-vs-billing alignment. Levels 4 and 5 (99284, 99285) are the most frequently audited by CMS and OIG. Knowing the federal benchmark is step one.
Office visits
Office E/M codes 99202–99215 cover most outpatient visits. The level chosen drives the dollar amount — and the level should match the documented complexity, not the time you remember spending in the waiting room.
- CPT 99202$77
Office visit, new patient, straightforward
- CPT 99203$120
Office visit, new patient, low complexity
- CPT 99204$182
Office visit, new patient, moderate complexity
- CPT 99205$242
Office visit, new patient, high complexity
- CPT 99213$98
Office visit, established patient, low complexity
- CPT 99214$139
Office visit, established patient, moderate complexity
- CPT 99215$197
Office visit, established patient, high complexity
Imaging
X-ray, CT, MRI, and ultrasound codes split into a technical component (the scan) and a professional component (the radiologist's read). The bill should match what was actually performed.
Lab & Pathology
Common labs paid under Medicare's Clinical Laboratory Fee Schedule. Watch for panels billed alongside their individual components — that's an unbundling pattern the National Correct Coding Initiative explicitly flags.
- CPT 80048$11
BMP — basic blood chemistry panel (8 tests: glucose, electrolytes, kidney markers)
- CPT 80053$14
CMP — 14-test blood chemistry panel (glucose, electrolytes, kidney + liver markers)
- CPT 80061$17
Lipid blood panel (total cholesterol, LDL, HDL, triglycerides)
- CPT 85025$11
CBC — complete blood count with differential
- CPT 83036$14
Hemoglobin A1c
- CPT 84443$24
Thyroid stimulating hormone (TSH)
Drug J-codes
Per-unit Medicare rates for physician-administered drugs. The chargemaster-to-NADAC ratio is largest in this category — saline (J7030) Medicare allowed amount is around $3/L while chargemasters routinely show $200–$500/L per published HPT files.
Common procedures
High-volume surgical codes — total knee, total hip, gallbladder, colonoscopy. The Medicare global package generally bundles pre-op and routine post-op care into the surgery payment.
- CPT 27447$1170
Total knee arthroplasty (knee replacement)
- CPT 27130$1173
Total hip arthroplasty (hip replacement)
- CPT 47562$635
Laparoscopic cholecystectomy (gallbladder removal)
- CPT 45378$390
Colonoscopy, diagnostic
- CPT 45385$515
Colonoscopy with polyp removal (snare)
- CPT 66984$474
Cataract surgery with IOL, one stage
Browse every code by category
Every CPT and HCPCS code we track, grouped by the part of the body or the type of service it covers. Open a category to find the exact code from your bill and its federal benchmark.
- Anesthesia
Sedation and anesthesia delivered alongside surgery and other procedures. These services are billed in time-based units.
- Skin & integumentary surgery
Procedures on the skin and the tissue just beneath it: biopsies, lesion and cyst removal, wound repair, and breast procedures.
- Musculoskeletal surgery
Procedures on bones, joints, muscles, and tendons, including fracture care, joint replacement, casting, and arthroscopy.
- Respiratory & cardiovascular surgery
Procedures on the lungs, airway, heart, blood vessels, and lymphatic system, from bronchoscopy to cardiac catheterization.
- Digestive system surgery
Procedures on the mouth, esophagus, stomach, intestines, liver, and gallbladder, including upper endoscopy and colonoscopy.
- Urinary, genital & maternity
Procedures on the urinary tract and reproductive organs, plus prenatal care, labor, and delivery services.
- Endocrine & nervous system surgery
Procedures on the thyroid and other endocrine glands and on the brain, spine, and peripheral nerves.
- Eye & ear surgery
Procedures on the eyes and ears, including cataract surgery, retinal work, and ear-tube placement.
- Imaging & radiology
X-ray, CT, MRI, ultrasound, and nuclear-medicine studies. Many split into a technical component (the scan) and a professional component (the read).
- Lab & pathology
Blood tests, panels, cultures, and pathology services. Most are paid under the Clinical Laboratory Fee Schedule rather than the Physician Fee Schedule.
- Medicine, office & ER visits
Office, emergency, and hospital visits (evaluation and management), plus vaccines, dialysis, cardiology, and other non-surgical care.
- Drugs (J-codes)
Physician-administered drugs billed per unit: IV antibiotics, anti-nausea medication, contrast agents, and infusion therapies. The total is units multiplied by the per-unit rate.
- Other HCPCS Level II
Supplies, equipment, transport, drugs, and Medicare-specific services billed outside the main CPT numbering system.
If you’re holding a bill
Skip the lookup — we’ll audit every code on your bill at once.
Upload your bill. Minutes later, every line is benchmarked, every potential error is flagged, and every dispute letter is drafted. Sign and mail.
Audit my bill — $19.9730-day money-back guarantee on single audits.