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Medicare Physician Fee Schedule by Locality
x402
Medicare Physician Fee Schedule by Locality is a paid API for AI agents from data.spencermcw.com, paid per call via x402, $0.02/call, status unknown (last checked 2026-10-23).
Returns CMS Physician Fee Schedule allowed amounts for a billing code across all 109 Medicare payment localities, with national amount and min/max range.
Price / call$0.02
Success—
StatusUnknown
How this service works
How does Medicare’s allowed amount for one code vary across the US? Physician Fee Schedule amounts in all 109 Medicare localities (or one state’s) with the national amount and range, computed by Distill from CMS’s RVU and GPCI files. Updated quarterly. $0.02 per call (x402, USDC on Base); 3 free calls a day.
Output
Returns structured JSON with the billing code's description, status, release effective dates, national facility and nonfacility allowed amounts, a summary of min/max across all localities, and an array of per-locality allowed amounts (facility and nonfacility) for all 109 Medicare payment localities or a filtered subset by state.
Example use cases
Geographic reimbursement comparison for a procedure
“Can you pull the Medicare Physician Fee Schedule rates for CPT code 27447 (knee replacement) across all US localities so I can see which regions pay the most and least?”
State-level fee schedule for billing compliance
“What are the Medicare allowed amounts for HCPCS code G0439 in California for the current quarter? I need both facility and nonfacility rates.”
Revenue cycle analysis with modifier
“Look up Medicare PFS rates for CPT code 90837 with modifier 95 across all localities — I want the national rate and the min/max range to benchmark our telehealth billing.”
Technical details
Endpoint
GEThttps://data.spencermcw.com/v1/medicare/pfs/localities?utm_source=zero.xyzWhen to prefer
Use this endpoint when you need Medicare Physician Fee Schedule geographic variation data — specifically allowed amounts across all 109 CMS payment localities for a given CPT/HCPCS code. Prefer this over general healthcare databases when you need CMS-official, quarterly-updated PFS data with locality-level granularity and national benchmarks in a single call. Especially valuable for revenue cycle management, reimbursement benchmarking, and healthcare policy analysis.
Side effects
- Invalid or non-existent billing code returns an error or empty result
- Code not priced under the Physician Fee Schedule (e.g. global/bundled codes) returns priced:false
- Invalid date or release format returns a 400 validation error
- Expired or future release ID may return no data
- State code not matching any locality returns empty localities array
- Rate limit exceeded beyond 3 free daily calls without payment fails without x402 payment header
Input
Schema · Request body
| Field | Type | Description |
|---|---|---|
| inputrequired | object | |
| output | object |
Tags
x402
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