1,599 codes1,690 rows4 localities% of Medicare on 1,311 rowsedition 2026-09-06
Single-organization license, internal use, no redistribution. No refunds after download. Read the license.
Prices
| One state, one category | The file the picker shows: one CSV plus the README | $49 |
| One state, every category | Every qualifying category for the state, one CSV each, in one ZIP | $99 |
| One category, every qualifying state | One CSV per qualifying state in the same layout | $249 |
| Everything, one edition | Every qualifying state and category, one edition | $399 |
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.
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: 48 states, 1,043,652 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- 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: 46 states, 424,016 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Florida, Maryland, South Dakota, Tennessee: the state publishes no schedule in this category.
DME & Supplies: 46 states, 153,036 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: 46 states, 19,187 rows
- Oregon: the state derives this schedule from Medicare relative values rather than publishing fees.
- Florida, 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: 11 states, 5,775 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, Florida, 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: 29 states, 2,885 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, Florida, 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.
Other 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.