Home / Tools / Medicare Fee
Rate Leverage

See your Medicare floor and what commercial pays

The exact locality-adjusted Medicare allowed for any CPT, computed the CMS way (RVU x GPCI x conversion factor), office and facility. Then see what your local peers actually collect commercially, as the percent of Medicare every contract negotiation runs on.

Open in the app →Book a call
No PHI. No card required. Commercial figures modeled from public data, not guaranteed.
$104
The exact locality Medicare allowed for a 99213 in California - RVU x GPCI x the 2026 conversion factor.
CMS Physician Fee Schedule + Geographic Practice Cost Indices (public)
Why it exists

Every payer prices off Medicare. Most practices never run the number.

Almost every commercial contract and Medicare Advantage plan is written as a percentage of the Medicare fee schedule, yet most practices never compute their own locality-adjusted allowed. Without the exact RVU x GPCI x CF figure, you cannot tell whether a payer's offer is 85% or 240% of Medicare, so you walk into every negotiation blind. The number is public and knowable. Most just never run it.

See it on a real code
Pulling the local-peer benchmark...
Live from Reddenda's dataset - public federal Transparency-in-Coverage + CMS. Local-peer median, never national. No PHI. Modeled, not guaranteed.
How it works

From the CMS file to your negotiation number

STEP 1

Pull the CMS inputs

We read the public Medicare PFS RVU file and Geographic Practice Cost Indices for your exact state and locality.

STEP 2

Compute the allowed

The CMS formula runs live - (Work x GPCI + PE x GPCI + MP x GPCI) times the 2026 conversion factor - for both office and facility.

STEP 3

Read the % of Medicare

Your local-peer commercial median from cpt_peer_stats lands beside it, so you see exactly what the market collects as a percent of Medicare.

What it does for you

Real math, public data, no PHI

$33.4009
CY2026 CMS conversion factor, built in
up to 3.9x
top-of-market commercial vs Medicare (local P90)
0 PHI
public CMS + Transparency-in-Coverage data only
Independent practiceWalk into every renewal knowing your exact Medicare allowed and whether the payer's offer is 90% or 200% of it.
Billing & RCMBenchmark each client's fee schedule against locality Medicare in seconds and flag the payers paying below the floor.
Specialty groupPrice high-RVU procedures like 20610 or 27447 against Medicare and your local P90 before you counter.
MSOStandardize a Medicare-indexed rate baseline across every location and NPI. Schedule a call for portfolio scoring.

Know your number before the payer does

Open the free calculator and pull the exact Medicare allowed for any CPT in any locality, with your local commercial percent of Medicare right beside it.

Open in the app →Book a call
Multi-NPI or a whole book? Schedule a call - never a listed price.