Lookup Medicare Fees
About the Code Sets
Nationally (USA/Medicare) recognized billing codes are from these code sets:
- CPT® - Current Procedural Termonology - copyright the American Medical Association (AMA) - the descriptions for these codes are subject to licensing thus only the code section title is shown here - to view the description of a CPT code you will need an account with the AMA
- HCPCS - Healthcare Common Procedure Coding System - produced by the Centers for Medicare and Medicaid Services (CMS)
- CDT - Current Dental Terminology - maintained by the American Dental Association (ADA) - also listed as "D####" codes in the HCPCS code set - the descriptions for these codes are subject to licensing thus only the code section title is shown here
- ICD-10-CM - International Classification of Diseases, 10th Revision, Clinical Modification - updated annually by the National Center for Health Statistics
- NDC – National Drug Codes - maintained by the U.S. Food & Drug Administration (FDA) - fees/costs for drugs are not currenlty shown
About the Fees
Both Medicare and Veterans Administration (VA) fees are shown when established. "n/e" means "not established" - which means either Medicare or the VA has not set a fee for the code.
Typically the Medicare fee will be lower than the VA fee. The VA fee amounts are generally closer to "real-world" fees charged by public and private medical organizations.
Fees are calculated based on the date of service and the location where the service was performed. Fee amounts vary based on the economy of the location.