Billing IQ

Medicare Rate Tool · Auctus Group
Locality ZIP Defaults to national average if not entered ZIP not found
Locality ZIP Defaults to national average if not entered ZIP not found
Add CPT Codes
Bundle Interactions
Medicare Rate Pro Forma
 ·   ·   · 
ZIP Nat'l avg ZIP not found
Volume
Providers
Step 1 — Provider Configuration
Set your provider mix before adding procedures. NPP rates are 85% of Medicare (standalone billing) or 100% (incident-to under MD supervision).
Number of providers
Blended effective rate:
⚠ Percentages must total 100% (currently %)
✓ Ready
Locality ZIP Defaults to national average if not entered ZIP not found
Format CPT, Payer, Rate 99213, Aetna, 82.00 11400 UHC $110.50
CPT Code
Insurance / Payer
Your Rate ($)
Global Period Tracker
Enter surgery date + CPT codes to see what's included in the global package vs. separately billable.
Medical Necessity & Policy Intelligence
Documentation checklists · Payer policy links
Specialty
Type
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Disclaimer: This tool is provided for informational and planning purposes only and does not constitute legal, financial, coding, or billing advice. Rates shown are estimates derived from publicly available CMS fee schedule data and may not reflect actual payer contract terms, individual claim adjudication, or reimbursement outcomes. Do not use these figures for claim submission, contract negotiations, or financial reporting without independent verification by a qualified medical billing professional or healthcare attorney. Denial and recovery estimates are industry averages from published sources and are not a guarantee of any individual practice's experience. Auctus Group makes no representation or warranty, express or implied, as to the accuracy, completeness, or fitness of this data for any particular purpose. Use of this tool constitutes acceptance of these terms.  ·  © 2026 Auctus Group