How to Read the Medicare Physician Fee Schedule

The Medicare Physician Fee Schedule (PFS) is published annually by CMS and sets the maximum payment amounts for services provided by physicians, nurse practitioners, physician assistants, and other qualified healthcare professionals. Each HCPCS or CPT code on the fee schedule has two rates: the non-facility rate and the facility rate. Browse current physician fee schedule rates on this site.

The non-facility rate applies when the service is delivered in a setting where the physician bears the overhead — typically a private office or freestanding clinic. The facility rate applies when the service is delivered in a hospital outpatient department or ambulatory surgical center, where the facility bills separately for overhead costs. The non-facility rate is always higher because it includes practice expense components that the facility would otherwise cover.

Each code's payment amount is calculated by multiplying three relative value unit (RVU) components — work RVUs, practice expense RVUs, and malpractice RVUs — by a geographic practice cost index (GPCI) for the provider's locality, then applying the annual conversion factor. The conversion factor is set by CMS each year and represents the dollar value of one RVU.

To find the rate for a specific code, look it up in the code browser and scroll to the fee schedules section. You can also browse the full physician schedule by HCPCS code. Rates shown reflect the most recent year of data loaded into this system.