Medicare Fee Schedules
Medicare payment rates for HCPCS Level II codes by schedule type.
CMS publishes separate fee schedules for each major provider and care setting. The rate a provider receives depends on the schedule type — a J-code for an injected drug may pay differently under the Physician Fee Schedule (outpatient office) versus the Hospital Outpatient Prospective Payment System (OPPS). Understanding which schedule applies to your billing setting prevents underpayments and improper billing.
Physician Fee Schedule
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DMEPOS Fee Schedule
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Ambulatory Surgical Center
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Clinical Lab Fee Schedule
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OPPS/Hospital Outpatient
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About Fee Schedules
CMS publishes multiple fee schedules for different provider types and settings. A single HCPCS code may have different payment rates under each schedule.
- Physician Fee Schedule (PFS): Rates paid to physicians and non-physician practitioners for services delivered in office or outpatient settings. Includes both facility and non-facility rates, where the non-facility rate is higher because it incorporates overhead.
- DMEPOS: Durable medical equipment, prosthetics, orthotics, and supplies. Covers E-codes (equipment), K-codes (temporary DME), and L-codes (orthotics/prosthetics) billed by DMEPOS suppliers.
- ASC: Ambulatory Surgical Center facility payment rates for procedures performed in outpatient surgery centers. ASC rates are separate from the surgeon's professional fee.
- Clinical Lab: Rates for diagnostic lab tests billed by independent laboratories. Includes P-codes and many automated panel codes.
- OPPS: Hospital Outpatient Prospective Payment System rates for services provided in a hospital outpatient department. Often the highest rate for the same service compared to physician office.
Data updated annually from CMS. Learn about our data sources →