# Medicare Physician Fee Schedule by Locality

> 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.

## Facts

- Endpoint: GET https://data.spencermcw.com/v1/medicare/pfs/localities?utm_source=zero.xyz
- Price: $0.02/call
- Payment: x402
- Status: unknown
- Last checked: 2026-10-23
- Activations on Zero: 0
- Tags: x402
- Canonical page: https://www.zero.xyz/c/medicare-physician-fee-schedule-by-locality-28f3f2dc
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_mvgiJ7SG6jtMRtoE44J4w

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 medicare-physician-fee-schedule-by-locality-28f3f2dc
```

Example prompt: What does Medicare pay for CPT code 99213 across all US localities right now — give me the national rate and the full range by locality.

## When to prefer this

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.

## Known failure modes

- 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

## 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.

## Request schema (JSON Schema)

```json
{
 "type": "object",
 "$schema": "https://json-schema.org/draft/2020-12/schema",
 "required": [
  "input"
 ],
 "properties": {
  "input": {
   "type": "object",
   "required": [
    "type",
    "method"
   ],
   "properties": {
    "type": {
     "type": "string",
     "const": "http"
    },
    "method": {
     "enum": [
      "GET"
     ],
     "type": "string"
    },
    "queryParams": {
     "type": "object",
     "required": [
      "code"
     ],
     "properties": {
      "code": {
       "type": "string",
       "pattern": "^[0-9A-Za-z]{5}$"
      },
      "date": {
       "type": "string",
       "pattern": "^\\d{4}-\\d{2}-\\d{2}$"
      },
      "state": {
       "type": "string",
       "pattern": "^[A-Za-z]{2}$"
      },
      "release": {
       "type": "string",
       "pattern": "^\\d{4}[A-Da-d]$"
      },
      "modifier": {
       "type": "string",
       "pattern": "^[0-9A-Za-z]{2}$"
      }
     }
    }
   },
   "additionalProperties": false
  },
  "output": {
   "type": "object",
   "required": [
    "type"
   ],
   "properties": {
    "type": {
     "type": "string"
    },
    "example": {
     "type": "object",
     "properties": {
      "data": {
       "type": "object",
       "required": [
        "code",
        "modifier",
        "code_type",
        "description",
        "status",
        "priced",
        "release",
        "national",
        "summary",
        "localities"
       ],
       "properties": {
        "code": {
         "type": "string"
        },
        "priced": {
         "type": "boolean"
        },
        "status": {
         "type": "string"
        },
        "release": {
         "type": "object",
         "required": [
          "id",
          "effective_from",
          "effective_to"
         ],
         "properties": {
          "id": {
           "type": "string"
          },
          "effective_to": {
           "type": [
            "string",
            "null"
           ]
          },
          "effective_from": {
           "type": "string"
          }
         },
         "additionalProperties": false
        },
        "summary": {
         "type": "object",
         "required": [
          "localities",
          "nonfacility",
          "facility"
         ],
         "properties": {
          "facility": {
           "anyOf": [
            {
             "type": "object",
             "required": [
              "min",
              "max"
             ],
             "properties": {
  
… (truncated)
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/medicare-physician-fee-schedule-by-locality-28f3f2dc/health.json
- [Zero catalog index](https://www.zero.xyz/llms.txt)
- [Other services from data.spencermcw.com](https://www.zero.xyz/host/data.spencermcw.com/llms.txt)