MPPR calculator

Enter a full claim and see the Multiple Procedure Payment Reduction Medicare actually applies — standard ranking, endoscopy family collapse, diagnostic imaging, therapy, cardiovascular, and ophthalmology, each reduction (and every non-reduction) cited to its CMS rule and effective date.

Pricing one code on its own? Use the single-code calculator.

Claim details

Enter every line on the claim. The multiple-procedure reduction is ranked automatically across all of them.

Date of service

Automatically picks the release and MPPR rules in effect.

Release

Override only when checking an older adjudication.

Locality

Choose where the service was performed.

No results found

National (GPCI 1.000)

00 — Alabama (AL)

01 — Alaska (AK)

00 — Arizona (AZ)

13 — Arkansas (AR)

01 — Atlanta (GA)

31 — Austin (TX)

54 — Bakersfield (CA)

01 — Baltimore/Surr. Counties (MD)

20 — Beaumont (TX)

09 — Brazoria (TX)

16 — Chicago (IL)

55 — Chico (CA)

01 — Colorado (CO)

00 — Connecticut (CT)

11 — Dallas (TX)

01 — Dc + Md/Va Suburbs (DC)

01 — Delaware (DE)

01 — Detroit (MI)

12 — East St. Louis (IL)

71 — El Centro (CA)

03 — Fort Lauderdale (FL)

28 — Fort Worth (TX)

56 — Fresno (CA)

15 — Galveston (TX)

57 — Hanford-Corcoran (CA)

01 — Hawaii, Guam (HI)

18 — Houston (TX)

00 — Idaho (ID)

00 — Indiana (IN)

00 — Iowa (IA)

00 — Kansas (KS)

00 — Kentucky (KY)

18 — Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County) (CA)

58 — Madera (CA)

01 — Manhattan (NY)

59 — Merced (CA)

01 — Metropolitan Boston (MA)

02 — Metropolitan Kansas City (MO)

01 — Metropolitan Philadelphia (PA)

01 — Metropolitan St. Louis (MO)

04 — Miami (FL)

00 — Minnesota (MN)

00 — Mississippi (MS)

60 — Modesto (CA)

01 — Montana (MT)

51 — Napa (CA)

00 — Nebraska (NE)

00 — Nevada (NV)

40 — New Hampshire (NH)

05 — New Mexico (NM)

01 — New Orleans (LA)

00 — North Carolina (NC)

01 — North Dakota (ND)

01 — Northern Nj (NJ)

02 — NYC Suburbs/Long Island (NY)

00 — Ohio (OH)

00 — Oklahoma (OK)

17 — Oxnard-Thousand Oaks-Ventura (CA)

01 — Portland (OR)

03 — Poughkpsie/N NYC Suburbs (NY)

20 — Puerto Rico (PR)

04 — Queens (NY)

61 — Redding (CA)

75 — Rest of California (CA)

99 — Rest of Florida (FL)

99 — Rest of Georgia (GA)

99 — Rest of Illinois (IL)

99 — Rest of Louisiana (LA)

99 — Rest of Maine (ME)

99 — Rest of Maryland (MD)

99 — Rest of Massachusetts (MA)

99 — Rest of Michigan (MI)

99 — Rest of Missouri (MO)

99 — Rest of New Jersey (NJ)

99 — Rest of New York (NY)

99 — Rest of Oregon (OR)

99 — Rest of Pennsylvania (PA)

99 — Rest of Texas (TX)

99 — Rest of Washington (WA)

01 — Rhode Island (RI)

62 — Riverside-San Bernardino-Ontario (CA)

63 — Sacramento-Roseville-Folsom (CA)

64 — Salinas (CA)

72 — San Diego-Chula Vista-Carlsbad (CA)

52 — San Francisco-Oakland-Berkeley (Marin County) (CA)

05 — San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County) (CA)

65 — San Jose-Sunnyvale-Santa Clara (San Benito County) (CA)

09 — San Jose-Sunnyvale-Santa Clara (Santa Clara County) (CA)

73 — San Luis Obispo-Paso Robles (CA)

66 — Santa Cruz-Watsonville (CA)

74 — Santa Maria-Santa Barbara (CA)

67 — Santa Rosa-Petaluma (CA)

02 — Seattle (King County) (WA)

01 — South Carolina (SC)

02 — South Dakota (SD)

03 — Southern Maine (ME)

68 — Stockton (CA)

15 — Suburban Chicago (IL)

35 — Tennessee (TN)

09 — Utah (UT)

53 — Vallejo (CA)

50 — Vermont (VT)

00 — Virginia (VA)

50 — Virgin Islands (VI)

69 — Visalia (CA)

16 — West Virginia (WV)

00 — Wisconsin (WI)

21 — Wyoming (WY)

70 — Yuba City (CA)

Place of service

Apply sequestration (−2% of Medicare's portion)

Claim lines

One to 50 lines. Blank rows are ignored.

#	Code	Modifier	Units
1
2

Enter at least one claim line above to see the MPPR reduction.

MPPR calculator

Claim details

Claim lines

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