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Rate Leverage

Turn your weak contract into a leverage worklist.

Every CPT paying below your local-peer median, ranked by per-unit gap - plus the payer clauses quietly costing you, in plain English. Modeled from public rate data, no PHI required.

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No PHI required. No card. Modeled from public rate data, not a guarantee of recovery.
$239
The local-market P90 on CPT 99213 against an $86 median - a 2.78x spread your contract may be leaving on the table. Modeled, not guaranteed.
Reddenda local-peer commercial rate index (CA, CPT 99213)
Why it exists

Your contract underpays you in places you never see.

Payer contracts bury the leverage: a timely-filing window short enough to forfeit revenue, a silent-PPO clause renting your rates to networks you never joined, E/M codes quietly paying below what your local peers collect. Most practices never line their own rates up against the local market, so the underpaid codes and the weak terms both go unchallenged, renewal after renewal. The room is real - on CPT 99213 the local-market P90 runs $239 against an $86 median - but you cannot negotiate a gap you cannot see.

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

How Contract Review works

STEP 1

Line up your rates

We match your rate on every CPT against the local-peer P50 and P90 from the peer-stats index - your own payers, your own metro, never a national average.

STEP 2

Rank the gaps and flag the terms

Every code paying below your local-peer median is ranked by per-unit gap, largest first, then cross-checked against the standard weak clauses - silent PPO, unilateral amendment, timely-filing, downcoding, behavioral-health parity - each with the in-force statute to cite.

STEP 3

Export or draft the memo

Pull a per-payer evidence CSV or hand the biggest gap straight into a leverage memo to take to that payer.

What it does for you

Why it matters

2.78x
The P50→P90 spread on 99213 - the room hiding in your own local market
5
Weak-term flags checked, each with the lever and in-force authority to fix it
P90
Your renegotiation target: top of the local market, never national
Independent practiceSee exactly which E/M and procedure codes pay below your local peers, and walk into your next renewal with the per-unit gaps in hand instead of a hunch.
Billing & RCMRun every client's fee schedule against the local market and surface the underpaid codes plus the contract clauses to renegotiate - the same worklist, at scale.
Specialty groupCatch the high-dollar procedure gaps before you re-sign - a knee replacement models $1,746 at the local P50 against $5,749 at P90.
Behavioral healthLine up your BH rates against their medical equivalent and cite the in-force parity statutes when a payer pays you below par.

Stop re-signing a contract that underpays you.

Load your NPI and see the underpaid codes and weak clauses in seconds, then hand the biggest gap straight into a leverage memo. Multi-NPI or a portfolio? Book a call.

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Multi-NPI or a whole book? Schedule a call - never a listed price.