Medicare fee schedule changes: Q1 2016
Comparing national non-facility payment amounts in the Q1 2016 Physician Fee Schedule release against Q4 2015. Of 6,916 codes payable in both, 1,596 increased, 4,921 decreased, and 399 were unchanged.
Largest increases Copy link
| Code | Q4 2015 | Q1 2016 | Change |
|---|---|---|---|
| 86490 | $6.83 | $70.53 | +932.7% increase |
| 44382 | $83.73 | $324.75 | +287.9% increase |
| 45334 | $168.17 | $619.06 | +268.1% increase |
| 44380 | $70.43 | $224.13 | +218.2% increase |
| 89230 | $2.52 | $5.37 | +113.1% increase |
| 76948 | $33.42 | $70.53 | +111.0% increase |
| 31626 | $458.51 | $926.97 | +102.2% increase |
| 88377 | $214.88 | $412.11 | +91.8% increase |
| 43227 | $407.13 | $706.42 | +73.5% increase |
| 88374 | $205.54 | $345.87 | +68.3% increase |
| 43255 | $445.58 | $741.51 | +66.4% increase |
| 45331 | $166.73 | $260.30 | +56.1% increase |
| 44391 | $510.26 | $779.46 | +52.8% increase |
| 62190 | $609.43 | $925.54 | +51.9% increase |
| 88344 | $117.50 | $174.01 | +48.1% increase |
| 88369 | $74.02 | $108.49 | +46.6% increase |
| 88364 | $97.74 | $135.34 | +38.5% increase |
| 28226 | $457.43 | $627.29 | +37.1% increase |
| 64862 | $1,190.48 | $1,607.61 | +35.0% increase |
| 63195 | $1,209.52 | $1,625.87 | +34.4% increase |
| 88341 | $67.91 | $90.23 | +32.9% increase |
| 45382 | $615.18 | $806.31 | +31.1% increase |
| 28570 | $176.43 | $228.43 | +29.5% increase |
| 64605 | $600.45 | $767.64 | +27.8% increase |
| 27280 | $1,119.33 | $1,412.84 | +26.2% increase |
Largest decreases Copy link
| Code | Q4 2015 | Q1 2016 | Change |
|---|---|---|---|
| 77790 | $97.38 | $15.04 | -84.6% decrease |
| 41530 | $3,321.69 | $1,025.44 | -69.1% decrease |
| 67228 | $1,016.20 | $345.15 | -66.0% decrease |
| 67227 | $620.57 | $293.24 | -52.7% decrease |
| 20240 | $223.87 | $159.33 | -28.8% decrease |
| 45342 | $243.27 | $184.03 | -24.4% decrease |
| 97033 | $33.06 | $26.50 | -19.8% decrease |
| 68801 | $126.13 | $101.68 | -19.4% decrease |
| 68810 | $244.71 | $197.28 | -19.4% decrease |
| 69200 | $125.77 | $101.33 | -19.4% decrease |
| 88325 | $216.68 | $174.72 | -19.4% decrease |
| 11750 | $226.74 | $182.96 | -19.3% decrease |
| 20982 | $3,815.06 | $3,077.38 | -19.3% decrease |
| 26356 | $1,109.99 | $895.47 | -19.3% decrease |
| 28636 | $362.93 | $292.88 | -19.3% decrease |
| 30300 | $236.08 | $190.48 | -19.3% decrease |
| 32998 | $3,019.49 | $2,435.77 | -19.3% decrease |
| 43754 | $134.03 | $108.13 | -19.3% decrease |
| 46500 | $246.14 | $198.71 | -19.3% decrease |
| 49428 | $555.17 | $447.91 | -19.3% decrease |
| 50592 | $3,210.66 | $2,589.73 | -19.3% decrease |
| 55866 | $1,788.41 | $1,442.91 | -19.3% decrease |
| 61480 | $2,074.80 | $1,674.21 | -19.3% decrease |
| 61708 | $2,723.40 | $2,197.67 | -19.3% decrease |
| 62117 | $2,097.80 | $1,692.83 | -19.3% decrease |
Impact by specialty, weighted by observed volume
This is the net payment change each specialty sees from this release, with every code weighted by how much of it the specialty's clinicians actually billed in CY2024 Medicare FFS. Each row shows how much of that observed volume the calculation covers.
| Specialty | Impact vs Q4 2015 | Priceable coverage |
|---|---|---|
| Gastroenterology | -6.0% decrease | 52.0% of CY2024 services |
| Hematology & Oncology | -1.2% decrease | 9.4% of CY2024 services |
| Urology | -0.8% decrease | 25.5% of CY2024 services |
| General Surgery | -0.6% decrease | 68.9% of CY2024 services |
| Primary Care | -0.6% decrease | 51.8% of CY2024 services |
| Neurology | -0.6% decrease | 16.2% of CY2024 services |
| Endocrinology | -0.6% decrease | 29.1% of CY2024 services |
| Nephrology | -0.6% decrease | 60.9% of CY2024 services |
| Pulmonology | -0.5% decrease | 79.2% of CY2024 services |
| Podiatry | -0.5% decrease | 84.8% of CY2024 services |
| Ophthalmology | -0.5% decrease | 34.4% of CY2024 services |
| Rheumatology | -0.5% decrease | 3.2% of CY2024 services |
| Obstetrics & Gynecology | -0.4% decrease | 40.5% of CY2024 services |
| Psychiatry | -0.4% decrease | 82.7% of CY2024 services |
| Physical Medicine & Rehabilitation | -0.4% decrease | 37.2% of CY2024 services |
| Orthopedics | -0.4% decrease | 27.5% of CY2024 services |
| Allergy & Immunology | +0.3% increase | 64.8% of CY2024 services |
| Dermatology | +0.3% increase | 77.9% of CY2024 services |
| Otolaryngology (ENT) | -0.3% decrease | 92.5% of CY2024 services |
| Cardiology | -0.2% decrease | 75.9% of CY2024 services |
| Chiropractic | -0.2% decrease | 100.0% of CY2024 services |
| Pain Management | -0.2% decrease | 26.2% of CY2024 services |
| Physical Therapy | -0.1% decrease | 97.9% of CY2024 services |
| Behavioral Health | +0.1% increase | 83.4% of CY2024 services |
Weights are CY2024 Medicare FFS observed services from the CMS Physician & Other Practitioners dataset, grouped by rendering-provider specialty. Only services with a payment amount in both releases are included. The coverage column shows that share, so a partial result isn't mistaken for a specialty's whole book. Using one year's volume as weights doesn't mean volumes were the same across years. Specialty labels here map to observed CMS rendering-provider specialty groups, which are not identical to the curated code list on each specialty's page. Specialties whose impact can't be computed from observed data are omitted rather than shown as 0%.
Get notified when rates change
Medicare updates the fee schedule every quarter. We'll email you when a release moves rates.
Source file: rvu16a.zip Copy link
CMS published the Q1 2016 Physician Fee Schedule as the RVU16A release (rvu16a.zip). Every amount on this page was computed from the files inside it. CMS reshuffles columns between releases and sometimes re-publishes files in place, so we read columns by header name and keep every version CMS posts. That keeps the numbers here reproducible. Checksums, download links, and a column-by-column guide to what's inside are on the RVU16A source page.
- ANES_V0105.csv — Anesthesia conversion factors (ANES) 90 rows
- CY2016_GPCIs.csv — Geographic practice cost indices (GPCI) 90 rows
- OPPSCAP_V0105.csv — OPPS site-of-service payment caps 15,750 rows
- PPRRVU16_V0122.csv — Physician relative value file (PPRRVU) 16,289 rows
Method Copy link
Amounts are national non-facility figures (GPCI 1.000, before sequestration), computed from each release's RVUs and conversion factor. Only codes payable in both releases are compared. See how Medicare pays.
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