localis
API key

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

Medicare expected-payment calculator

Enter one claim line. Localis resolves the applicable fee-schedule release and payment locality, then shows the expected allowed amount, Medicare payment, patient share, and source calculation.

Only have an RVU figure? Convert RVUs to dollars.

73221 2026 C · QUEENS (NY) A Active
Non-facility Facility
Allowed amount
$237.99
in a doctor’s own office or clinic

116% of the $205.08 national baseline

Medicare payment
$190.39
Sequestration (−2%)
−$3.81
Net Medicare payment
$186.58
Patient / secondary
$47.60
Expected total to provider
$234.18

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.

Locality-adjusted Physician Fee Schedule pricing

CPT / HCPCS code
Modifiers
Professional component
Technical component
Bilateral procedure
Payable only if supporting documentation establishing the medical necessity of an assistant at surgery is submitted.
Payable only if supporting documentation establishing the medical necessity of an assistant at surgery is submitted.
Payable only if supporting documentation establishing the medical necessity of an assistant at surgery is submitted.
Payable only if supporting documentation establishing the medical necessity of an assistant at surgery is submitted.
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.

Service ZIP ZIP Locality

Preferred: resolves the Medicare payment locality for this line.

Date of service Release Date

Used to select the release in effect on the claim date.

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