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Medicare National Reference Price Benchmark by Procedure Code
x402
Medicare National Reference Price Benchmark by Procedure Code is a paid API for AI agents from api.agentstools.dev, paid per call via x402, $0.01/call, status unknown (last checked 2026-09-15).
Returns CMS public Medicare submitted, allowed, and payment amounts for a procedure code by place of service, as a national benchmark for comparing hospital prices.
Price / call$0.01
Success—
StatusUnknown
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 average Medicare submitted, allowed, and payment amounts for the given procedure code, broken down by place of service, sourced from CMS public data. Useful as a low-cost anchor reference when evaluating hospital or provider prices.
Example use cases
Example prompt
“What's the Medicare national benchmark price for CPT code 99213 — show me the submitted, allowed, and payment amounts by place of service so I can compare it against a hospital's billed rate.”
Technical details
Endpoint
GEThttps://api.agentstools.dev/price/benchmarkWhen to prefer
Use this endpoint when you need a quick, cheap ($0.01) national Medicare reference price for a single CPT or HCPCS procedure code. Ideal for healthcare price transparency workflows where you want to anchor or contextualize a hospital's billed price against CMS public data. Prefer this over hospital-specific price lookup endpoints when you need a national benchmark rather than a specific provider's negotiated rate.
Side effects
- Unsupported code type (e.g. ICD-10, MS-DRG) — only CPT and HCPCS are supported for national benchmarks
- Unknown or invalid procedure code returns empty or null results
- Missing required 'code' query parameter returns a 400 validation error
- Payment failure (x402) if USDC balance is insufficient
Input
Schema · Request body
| Field | Type | Description |
|---|---|---|
| inputrequired | object | |
| output | object |
Tags
x402
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