🩺 CMS Medicare Physician Fee Schedule Scraper

🚀 Export Medicare physician fee schedule rates in seconds. Look up RVUs, GPCIs, and reimbursement amounts by CPT/HCPCS code and locality. No API key, no registration, no manual CSV wrangling.

🕒 Last updated: 2026-05-31 · 📊 33 fields per record · 31,000+ code rows per year · 110 payment localities · 27 years (2000-2026)

The CMS Medicare Physician Fee Schedule Scraper pulls the official reimbursement data that drives every Medicare Part B claim. For any CPT or HCPCS code you give it, the actor returns the Work, Practice Expense, and Malpractice RVUs, the geographic practice cost indices (GPCIs) for the locality you pick, and the calculated non-facility and facility payment amounts plus their limiting charges. The pricing math mirrors the public CMS look-up tool exactly: RVUs are multiplied by the matching locality GPCIs and the annual conversion factor, so the numbers line up with what Medicare actually pays.

Medical billers and coders normally type codes one at a time into the cumbersome government search page. This actor turns that into a single bulk export. Pass a list of codes, a whole-year sweep, or a single locality, and receive clean CSV, Excel, JSON, or XML ready for spreadsheets, claim scrubbers, or reimbursement models. It covers all 110 Medicare localities, every year from 2000 through 2026, and surfaces the payment policy indicators (global period, multiple surgery, assistant surgery, supervision rules) that decide how a code is allowed to bill.

🎯 Target Audience	💡 Primary Use Cases
Medical billing specialists and coders	Verify reimbursement rates before submitting claims
Health insurance agents and analysts	Benchmark procedure rates for premium and network pricing
Healthcare administrators and RCM teams	Build fee schedules and appeal underpaid denials
Health-tech and data teams	Power reimbursement calculators and analytics tools

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📋 What the CMS Medicare Physician Fee Schedule Scraper does

• 🔢 Look up any CPT/HCPCS code. Pass a single code, a comma-separated list, or leave it blank to export every code for the year.
• 📍 Pick a locality or sweep them all. Choose NATIONAL for the unadjusted rate, one of 110 GPCI localities, or ALL to compare a code across the country.
• 💵 Get calculated payment amounts. Non-facility and facility prices, plus limiting charges, computed from RVUs, GPCIs, and the annual conversion factor.
• 📊 Read the full RVU breakdown. Work, practice expense, and malpractice RVUs alongside each locality GPCI component.
• 🗂️ Filter by modifier. Pull the global rate, professional component (26), technical component (TC), or discontinued (53) pricing.
• 📅 Reach back 27 years. Compare current rates against any year from 2000 to 2026, including the 2026 dual conversion factor for APM participants.

Each record describes one code at one locality: the code and short description, procedure status, the three RVU components, the three GPCI components, the conversion factor, both payment amounts and limiting charges, and the payment policy indicators that govern billing. The 2026 schedule additionally flags whether a row uses the standard or the APM qualifying conversion factor.

💡 Why it matters: Medicare sets the benchmark that most private insurers follow. Having the full schedule in a spreadsheet means faster claims, stronger appeals, and accurate patient cost estimates without re-typing codes into a slow web form.

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🎬 Full Demo

🚧 Coming soon: a 3-minute walkthrough showing a single-code lookup, a full-year export, and a national rate comparison.

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⚙️ Input

Field	Type	Description
hcpcsCodes	String	Comma or space separated CPT/HCPCS codes (e.g. 99213, 70450). Leave empty to export every code for the year.
maxItems	Integer	Cap on rows returned. Free users are limited to 10. Paid users up to 1,000,000.
year	Select	Fee schedule year, 2000 through 2026. Defaults to 2026.
modifier	Select	All modifiers, 26 (professional), TC (technical), or 53 (discontinued).
locality	Select	One of 110 Medicare localities, NATIONAL (0000000), or ALL to expand every locality per code.
acaKey	String	Public CMS data API key. Leave as-is.

Example: look up a few common office and imaging codes at the national rate.

{
    "hcpcsCodes": "99213, 99214, 70450",
    "year": "2026",
    "modifier": "all",
    "locality": "0000000",
    "maxItems": 50
}

Example: compare one code across every locality in the country.

{
    "hcpcsCodes": "99213",
    "year": "2026",
    "locality": "ALL",
    "maxItems": 500
}

⚠️ Good to Know: A code can return several rows per locality, one for each modifier and, in 2026, one for each conversion factor (standard vs APM qualifying). Use the modifier and qppPriceIndicator fields to tell them apart.

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📊 Output

Every run produces a flat table of fee schedule rows. One record is one code at one locality and modifier.

🧾 Schema

Field	Type	Example
🔢 hcpcsCode	string	"99213"
🏷️ modifier	string	"26"
📝 shortDescription	string	"Office o/p est low 20 min"
🚦 procStatus	string	"A"
📅 year	string	"2026"
🔗 url	string	"https://www.cms.gov/medicare/physician-fee-schedule/search"
📍 locality	string	"0000000"
🌎 localityName	string	"NATIONAL"
🏛️ mac	string	"00000"
🏢 macName	string	"NATIONAL"
💼 workRvu	number	1.3
🏥 nonFacilityPeRvu	number	1.35
🩹 facilityPeRvu	number	0.57
⚖️ malpracticeRvu	number	0.09
📐 workGpci	number	1.0
📐 peGpci	number	1.0
📐 malpracticeGpci	number	1.0
✖️ conversionFactor	number	33.4009
🧭 qppPriceIndicator	string	"Standard"
💵 nonFacilityPrice	number	95.19
🏨 facilityPrice	number	81.7
🧾 nonFacilityLimitingCharge	number	103.99
🧾 facilityLimitingCharge	number	89.26
🌐 global	string	"XXX"
🔪 multipleSurgery	string	"0"
↔️ bilateralSurgery	string	"0"
🤝 assistantSurgery	string	"0"
👥 coSurgery	string	"0"
👨‍⚕️ teamSurgery	string	"0"
🩺 physicianSupervision	string	"09"
🖼️ diagnosticImagingFamily	string	"99"
🕒 scrapedAt	string	"2026-05-31T10:27:06.118Z"
❌ error	string	null

📦 Sample records

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✨ Why choose this Actor

	Capability
⚡	Bulk lookups. Export a list of codes or an entire year in one run instead of typing codes one at a time.
🧮	Real payment math. Prices are computed from RVUs, GPCIs, and the conversion factor, matching the official tool.
📍	Full geographic coverage. All 110 Medicare localities, plus the NATIONAL unadjusted rate.
📅	Deep history. Every fee schedule year from 2000 to 2026 in the same shape.
🧭	2026 ready. Handles the dual conversion factor for APM qualifying participants.
📤	Any format. CSV, Excel, JSON, or XML, ready for spreadsheets and claim systems.
🔓	No setup. No login, no API token, no scraping infrastructure to maintain.

📊 The 2026 schedule alone holds 31,000+ priced code rows across 110 localities, all reachable in one run.

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📈 How it compares to alternatives

Approach	Cost	Coverage	Refresh	Filters	Setup
⭐ CMS Fee Schedule Scraper (this Actor)	Low, usage based	All codes, 110 localities, 27 years	On demand	Code, year, modifier, locality	Minutes
Official web look-up tool	Free	Full	Live	Manual, one code at a time	None, but slow
Paid billing platforms	High subscription	Full	Live	Rich	Account setup
Manual CSV downloads	Free	Full	Annual files	None, raw columns	Heavy cleanup

One run replaces hours of manual code-by-code lookups or raw file wrangling.

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🚀 How to use

1. 🔐 Sign up. Create a free Apify account at console.apify.com.
2. 🔎 Open the Actor. Find the CMS Medicare Physician Fee Schedule Scraper in your console.
3. ⚙️ Set your input. Enter codes, pick a year, modifier, and locality, then set a max items cap.
4. ▶️ Run it. Start the Actor and watch rows stream into the dataset.
5. 📥 Export. Download as CSV, Excel, JSON, or XML, or pull from the API.

⏱️ Total time: about two minutes from sign-up to your first export.

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💼 Business use cases

🧾 Medical billing and coding Verify the allowed amount before submitting a claim Build code-specific fee schedules per locality Support denial appeals with the exact published rate Estimate patient responsibility ahead of service	🏥 Revenue cycle management Load current RVUs into claim scrubbers Track conversion factor changes year over year Reconcile remittances against expected payment Model the revenue impact of new code sets
📊 Insurance and actuarial Benchmark procedure rates for premium setting Compare network reimbursement against Medicare Feed pricing models with locality-adjusted rates Analyze geographic cost variation across markets	💻 Health-tech and analytics Power reimbursement calculators and dashboards Enrich claims datasets with RVU and payment fields Train pricing and cost-estimation models Build patient cost-transparency features

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🌟 Beyond business use cases

Data like this powers more than commercial workflows. The same structured records support research, education, civic projects, and personal initiatives.

🎓 Research and academia Empirical datasets for papers, thesis work, and coursework Longitudinal studies tracking changes across snapshots Reproducible research with cited, versioned data pulls Classroom exercises on data analysis and ethical scraping	🎨 Personal and creative Side projects, portfolio demos, and indie app launches Data visualizations, dashboards, and infographics Content research for bloggers, YouTubers, and podcasters Hobbyist collections and personal trackers
🤝 Non-profit and civic Transparency reporting and accountability projects Advocacy campaigns backed by public-interest data Community-run databases for local issues Investigative journalism on public records	🧪 Experimentation Prototype AI and machine-learning pipelines with real data Validate product-market hypotheses before engineering spend Train small domain-specific models on niche corpora Test dashboard concepts with live input

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🔌 Automating CMS Medicare Physician Fee Schedule Scraper

Run the Actor from your own code or on a schedule.

• Node.js: call the Actor with the apify-client package.
• Python: use the apify-client library to trigger runs and read datasets.
• Docs: see the Apify API reference for run, dataset, and webhook endpoints.

Schedules let you refresh the fee schedule automatically. Point a weekly or monthly schedule at the Actor so new conversion factors and code updates land in your dataset without manual runs.

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❓ Frequently Asked Questions

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🔌 Integrate with any app

• Make - build no-code automations triggered by new runs.
• Zapier - connect fee schedule exports to thousands of apps.
• Google Sheets - push rows straight into a spreadsheet.
• Slack - notify a channel when a run finishes.
• Airbyte - sync datasets into your warehouse.
• Apify API - call runs and read datasets from any backend.

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• 📂 CMS Open Data Scraper - pull additional public datasets from the CMS open data catalog.

💡 Pro Tip: browse the complete ParseForge collection for more healthcare and public-data scrapers.

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🆘 Need Help? Open our contact form

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⚠️ Disclaimer: This is an independent tool and is not affiliated with or endorsed by CMS or the U.S. government. It collects only publicly available data from the CMS Physician Fee Schedule data service for lawful use.