- Codes
- 1,599
- Rows
- 1,690
- Localities
- 4
- % of Medicare
- on 1,311 rows
- Edition
- 2026-09-06
Prices
Single-organization license, internal use, no redistribution. No refunds after download. Read the license. Secure checkout by Stripe; the link arrives by email and works 5 times in 30 days.
Need updates and alerts instead of a snapshot? The Rates plan is $29 a month or $290 a year, every state and category, kept current. A file is offered where a state publishes enough priced rows for a usable file and does not derive its schedule; bundles follow the same rule and list what they leave out below.
What is in every file
Medical files carry 29 columns; dental files carry 6. Every ZIP includes README-and-license.txt with this dictionary, the source and verified date for each state, and the license.
- Code
- The HCPCS or CPT code.
- Code system
- CPT or HCPCS.
- Description
- ProviderSignal's own plain-language label for the code, never the state's or the AMA's text.
- Category
- The fee-schedule category the code is filed under.
- Locality
- The locality, region, program or schedule string exactly as the state publishes it.
- Modifier
- The first modifier the row is priced under, if any.
- Modifier 2
- The second modifier, if any.
- TOS
- Type of service or rate class as the state publishes it: a CMS type-of-service code in some states, a distance or service band in others.
- Unit
- The billing unit the rate applies to, as the state states it (for example 15 minutes, daily, monthly).
- Age min
- Lower bound of the age band the row applies to, if any.
- Age max
- Upper bound of the age band the row applies to, if any.
- Non-facility rate
- The published non-facility (office) amount.
- Facility rate
- The published facility amount, where the state prices one.
- PA flag
- The state's prior-authorization indicator as published (Y or N in most states; a few use other letter codes).
- Effective year
- The year the published rate took effect.
- Effective date
- The effective date, where the state publishes one.
- Schedule
- ProviderSignal's typed label for the locality: program, provider type and setting.
- Setting
- facility, non_facility or home, read from the locality.
- Provider type
- The provider type the schedule prices, where the state splits by it (physician, dentist, dme, lab, hospital, asc and others).
- Population
- The population the schedule prices for, where the state splits by it: adult, child, elderly, pregnant or women.
- Region
- The pricing region, where the state prices by region.
- Price basis
- What the rate is priced per, where the schedule says: purchase, rental (daily or monthly), unit, hourly, encounter, per trip, per mile, per client, per group, or a maximum fee.
- Tier
- The pricing tier the schedule names, where the state prices by tier (for example base, enhanced, specialist, sole community hospital).
- Rate
- The amount that applies to the row: the facility rate for facility-setting rows, otherwise the non-facility rate.
- Medicare rate
- The like-for-like Medicare amount for the row: the ASC payment for ASC rows, the PFS facility amount for facility rows, otherwise the best professional amount. Blank for modifier rows and for outpatient or inpatient bundles.
- % of Medicare
- Rate divided by the Medicare rate, as a percentage.
- Median % of Medicare (state x category)
- The state's median % of Medicare across this category's benchmark codes.
- Medicare source
- Which Medicare schedule the Medicare rate came from: pfs (physician fee schedule), clfs (clinical lab), dmepos or asc.
- Medicare vintage
- The edition of that Medicare schedule, for example 2026Q3.
What each category bundle covers
A category bundle carries one CSV per qualifying state. The states it leaves out, and why, so you know before you buy.
Physician: 47 states, 1,047,921 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Maryland: the state publishes this schedule only as an online lookup, not as a file, so the rows ProviderSignal holds are not the schedule a buyer expects.
- South Dakota, Tennessee: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
Lab & Imaging: 47 states, 428,633 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Maryland, South Dakota, Tennessee: the state publishes no schedule in this category.
DME & Supplies: 46 states, 153,058 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Alaska, Rhode Island, Tennessee: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
- South Dakota: the state publishes no schedule in this category.
Drugs: 33 states, 87,279 rows
- Colorado, Delaware, Hawaii, Maryland, Massachusetts, Ohio, Pennsylvania, West Virginia: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
- Alaska, Florida, Georgia, Missouri, Nevada, New York, North Dakota, Oregon, South Dakota, Tennessee: the state publishes no schedule in this category.
Vision: 47 states, 19,327 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Maryland: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
- South Dakota, Tennessee: the state publishes no schedule in this category.
Behavioral Health: 41 states, 9,205 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Florida, Georgia, Hawaii, Idaho, Nebraska, Oklahoma, Rhode Island, Tennessee, West Virginia: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
Anesthesia: 12 states, 6,047 rows
- Arkansas, Connecticut, Georgia, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Nevada, New Hampshire, North Carolina, Texas, Virginia, Washington, Wisconsin, Wyoming: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
- Alabama, Alaska, District of Columbia, Idaho, Indiana, Maryland, Massachusetts, Michigan, Nebraska, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah: the state publishes no schedule in this category.
Hearing: 30 states, 2,910 rows
- Arkansas, Delaware, District of Columbia, Hawaii, Indiana, Kentucky, Massachusetts, Minnesota, New Mexico, North Carolina, South Carolina, Washington, West Virginia: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
- Alabama, Arizona, Georgia, Maryland, Oregon, Rhode Island, South Dakota, Tennessee: the state publishes no schedule in this category.
Transport: 28 states, 1,086 rows
- Connecticut, Delaware, Hawaii, Idaho, Massachusetts, Nevada, New Hampshire, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Texas, Washington: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
- Alabama, Florida, Georgia, Illinois, Kentucky, Maryland, Ohio, Oregon, Tennessee: the state publishes no schedule in this category.
State-Specific Services: 44 states, 33,411 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Delaware, Florida, Georgia, Hawaii, Maryland, New York: fewer priced rows than a usable file needs; the state prices most of this category elsewhere, or ProviderSignal has not standardized it in full yet.
Dental: 51 states, 19,867 rows
Every jurisdiction that publishes this category is included.
How the file is built
Rates are collected from each state's published fee schedule, kept to the current edition, and standardized into one layout across states. Labels are ProviderSignal's own plain-language names, never the state's or a code set owner's descriptor text. The Medicare comparison divides each rate by the like-for-like Medicare amount for the same setting. A file is a snapshot of its edition; your link serves the latest edition for 30 days and 5 downloads. Read the license. Questions before you buy: support@providersignal.com.
Questions before you buy
What is in a file?
A medical file has 29 columns: the code and code system, ProviderSignal's own plain-language label, the category, the locality exactly as the state publishes it, modifiers, type of service, unit, age band, prior-authorization flag, effective year and date, the non-facility and facility rates, the rate used for comparison, the like-for-like Medicare rate, the percent of Medicare, the state and category median, and the Medicare source and vintage. Dental files have 6. Every ZIP also carries README-and-license.txt with this dictionary, the source and verified date for each state, and the license.
How is the file delivered?
You pay by card through Stripe, no account needed. The download page opens right after payment and the same link arrives by email. The link works 5 times within 30 days and serves the latest edition on the day you download.
Can my whole team use it?
Yes, inside one organization. The license covers the company, practice or agency that bought the file and everyone in it. It does not allow redistribution, resale or publishing the data. There are no refunds after download.
Which states and categories are sold?
428 state and category files, 51 state bundles and 11 category bundles in edition 2026-09-06. A file is offered where the state publishes enough priced rows for a usable file and does not derive its schedule from Medicare relative values. The coverage list on this page names what each bundle leaves out and why.
How current is the data, and what if a state changes its rates?
Each file is a snapshot of its edition (2026-09-06). States republish on their own schedule and ProviderSignal rebuilds the files after each monthly refresh. For rates kept current, with an alert when a state changes them, the Rates plan is $29 a month or $290 a year.