Medicare payment calculator by CPT code
A practice billing 20 99214 visits a month at the wrong place of service — office instead of facility — loses about $12,266 a year. In the Q3 2026 release, 99214's national non-facility allowed amount is $135.61; billed as facility instead, it's $84.50 — a $51.11 gap per visit before any locality adjustment, times 20 visits/month (an assumed volume, not a claims count) times 12 months.
That's the kind of error this calculator catches on a single claim. Enter a code, date of service, locality, and setting to see the expected Medicare allowed amount, the 80/20 split, sequestration, and — if you enter what the payer actually paid — the variance. Only have an RVU figure? Convert RVUs to dollars.
This is a single-line calculator, and it's free. Batch reconciliation (upload a remittance or a CSV of claims to flag underpayments across a whole book), modifier-adjusted pricing, and API access aren't built yet — they're what we're working toward. See the plan.
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