# Hospital Price Benchmark (Medicare Reference Prices)

> Hospital Price Benchmark (Medicare Reference Prices) is a paid API for AI agents from payai.agentstools.dev, paid per call via x402, $0.01/call, status unknown (last checked 2026-09-15).

Returns Medicare national average submitted, allowed, and payment amounts for a CPT or HCPCS procedure code, broken down by place of service, from CMS public data.

## Facts

- Endpoint: GET https://payai.agentstools.dev/price/benchmark
- Price: $0.01/call
- Payment: x402
- Status: unknown
- Last checked: 2026-09-15
- Activations on Zero: 0
- Tags: x402
- Canonical page: https://www.zero.xyz/c/hospital-price-benchmark-medicare-reference-prices-f443d0e5
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_tI7AbYJWnmjyOfEt6hMeI

Status and success rate cover calls made through Zero and Zero's own probes. Third-party monitors may report differently.

## How to call it through Zero

Zero handles the 402 payment challenge and records the run. With the Zero CLI installed (`npm i -g @zeroxyz/cli`):

```sh
zero fetch --capability hospital-price-benchmark-medicare-reference-prices-f443d0e5
```

Example prompt: What are the Medicare benchmark prices — submitted, allowed, and payment amounts — for CPT code 99213? I want to compare it against what a hospital is charging me.

## When to prefer this

Use this endpoint when you need a fast, cheap ($0.01) national Medicare reference price to anchor or benchmark against hospital or insurer charges. Prefer this over proprietary pricing databases when you specifically need CMS/Medicare averages rather than commercial payer rates or actual negotiated prices.

## Known failure modes

- Unknown or invalid procedure code returns no results or an error
- Code type not supported (only CPT and HCPCS are supported for national benchmark; MS-DRG, APC, etc. may not return data)
- CMS data may not include very new or recently deprecated codes
- Missing required 'code' query parameter returns a validation error

## How this service works

Medicare national reference price for a procedure code — a cheap anchor to compare hospital prices against. Returns the average Medicare submitted, allowed and payment amounts per place of service from CMS public data. Informational.

## Output

Returns the Medicare national average prices for the requested procedure code, including average submitted amount, allowed amount, and payment amount, segmented by place of service (e.g., facility vs. non-facility), sourced from CMS public data.

## Request schema (JSON Schema)

```json
{
 "type": "object",
 "$schema": "https://json-schema.org/draft/2020-12/schema",
 "required": [
  "input"
 ],
 "properties": {
  "input": {
   "type": "object",
   "required": [
    "type",
    "method"
   ],
   "properties": {
    "type": {
     "type": "string",
     "const": "http"
    },
    "method": {
     "enum": [
      "GET",
      "HEAD",
      "DELETE"
     ],
     "type": "string"
    },
    "queryParams": {
     "type": "object",
     "required": [
      "code"
     ],
     "properties": {
      "code": {
       "type": "string",
       "description": "Procedure billing code, e.g. 99213"
      },
      "code_type": {
       "type": "array",
       "items": {
        "enum": [
         "CPT",
         "HCPCS",
         "MS-DRG",
         "DRG",
         "APC",
         "NDC",
         "ICD-10",
         "CDM",
         "local"
        ],
        "type": "string"
       },
       "description": "Billing-code system; national benchmark supports CPT and HCPCS"
      }
     }
    }
   },
   "additionalProperties": false
  },
  "output": {
   "type": "object",
   "required": [
    "type"
   ],
   "properties": {
    "type": {
     "type": "string"
    },
    "example": {
     "type": "object"
    }
   }
  }
 }
}
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/hospital-price-benchmark-medicare-reference-prices-f443d0e5/health.json
- [Zero catalog index](https://www.zero.xyz/llms.txt)
- [Other services from payai.agentstools.dev](https://www.zero.xyz/host/payai.agentstools.dev/llms.txt)