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    v1.0.24
    OpenPayerToolsBilling Code Reimbursement Rates

    Want more rates, live policy updates, and more?

    These estimates are built from public benchmarks. Talk to us for negotiated-rate accuracy, real-time payer policy tracking, downloadable PNG and CSV reports, full access to the underlying dataset, and the rest of the OpenPayer product suite, plus a dedicated analyst for your team.

    Billing Code Reimbursement Rates

    Add billing codes and states to build a commercial vs. Medicare reimbursement rate report, chart it, and download the result.

    992139921490837
    Charts:
    One chart per state, codes averaged together, every payer
    Building report…

    Tool Description

    Build a reimbursement rate report for one billing code type at a time (CPT, HCPCS, or MS-DRG) across any mix of codes and states. The code search only suggests codes that actually have rate data for the type you picked.

    Each row averages commercial claims (Aetna, BCBS, Cigna, United Healthcare, and a BUCA average) against the Medicare physician fee schedule where it applies, plus a National row sourced from the same nationwide benchmark used elsewhere on OpenPayer.

    Choose how the charts are laid out: one per state (codes averaged together), one per code (states averaged together), or one per exact state/code pair. Then download the table as CSV, each chart as a PNG, or print the whole report.

    FAQ

    Pick a code type (CPT, HCPCS, or MS-DRG), then add billing codes; the search only suggests codes that actually have rate data for that type. Add states, or leave states blank to include all of them. The table and charts update on their own, comparing Aetna, BCBS, Cigna, United Healthcare, a BUCA average, and Medicare for each code and state, plus a National row for the nationwide benchmark.