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Describe a service in plain words, or type a CPT/HCPCS code.

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Medicare expected-payment calculator

Enter a code, service location, and date to calculate an allowed amount with CMS evidence.

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CPT / HCPCS code
Location
ZIP
Locality
Date of service
Date of service
CMS release

CMS release: 2026 C

Place of service Office (non-facility) Facility
Modifiers: None
Supplied modifier

Select a supplied modifier. Click it again to remove it.

Code does not support a professional/technical split (PCTC indicator 0).
Code does not support a professional/technical split (PCTC indicator 0).
Bilateral adjustment does not apply to this code (indicator 0).
Assistant-at-surgery is never separately payable for this code (statutory restriction).
Assistant-at-surgery is never separately payable for this code (statutory restriction).
Assistant-at-surgery is never separately payable for this code (statutory restriction).
Assistant-at-surgery is never separately payable for this code (statutory restriction).
Co-surgeon is not permitted for this code.
Team surgery is not permitted for this code.

Single-line modifiers only. Pricing -51? Use the MPPR calculator.

45346 Save this calculation
Release:
2026 C
Locality:
National (GPCI 1.000)
Date of service:
Not supplied
Setting:
Office (non-facility)
Participation:
Participating provider
National PFS baseline
$2,492.38
in a doctor’s own office or clinic
Medicare payment
$1,993.90
Sequestration (−2%)
−$39.88
Net Medicare payment
$1,954.02
Patient / secondary
$498.48
Expected total to provider
$2,452.50

Patient / secondary and expected total to provider assume the Part B annual deductible is already met. If it isn't, the patient owes more than the amount shown here.

Compare a remittance
Allowed amount on remittance
Payer paid
Optional: compare allocation, not just the allowed amount. Patient responsibility
Optional. If allowed is blank, payer paid + patient responsibility becomes the remittance allowed.
Use a commercial contract based on Medicare

Commercial payer contracts usually price off the Medicare amount above ("BCBS pays 115% of Medicare"). Enter your contract's percentage to see what 45346 pays at that rate.

Your contract's % of Medicare For commercial contracts priced as a percentage of Medicare (for example, 115%).

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