data.cms.gov
Medicare Physician & Other Practitioners - by Geography and Service
The Medicare Physician & Other Practitioners by Geography and Service dataset contains information on use, payments, submitted charges, and beneficiary demographic and health characteristics organized by geography,...
Freshness
- Last posted
- Period covered
- Jan 1, 2024 to Dec 31, 2024
- Update frequency
- Annually
Dates as CMS lists them in its catalog.
Columns 15
| Column | What it means | Type |
|---|---|---|
Geography LevelRndrng_Prvdr_Geo_Lvl | Identifies the level of geography that the data in the row has been aggregated. A value of 'State' indicates the data in the row is aggregated to a single state identified in the Rendering Provider State column for a given HCPCS Code Level. A value of 'National' indicates the data in the row is aggregated across all states for a given HCPCS Code Level. | string |
Rendering Provider Geography CodeRndrng_Prvdr_Geo_Cd | FIPS code of the referring provider state. This variable is blank when reported at the national level. | string |
Rendering Provider Geography DescriptionRndrng_Prvdr_Geo_Desc | The state name where the provider is located, as reported in NPPES. The values include the 50 United States, District of Columbia, U.S. territories, Armed Forces areas, Unknown and Foreign Country. Data aggregated at the National level are identified by the word 'National'. | string |
HCPCS CodeHCPCS_Cd | HCPCS code used to identify the specific medical service furnished by the provider. HCPCS codes include two levels. Level I codes are the Current Procedural Terminology (CPT) codes that are maintained by the American Medical Association and Level II codes are created by CMS to identify products, supplies and services not covered by the CPT codes (such as ambulance services). CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA). Please review the complete CMS AMA CPT License agreement which is presented to users when accessing the data. For additional information on HCPCS codes, visit the HCPCS general information page. | string |
HCPCS DescriptionHCPCS_Desc | Description of the HCPCS code for the specific medical service furnished by the provider. HCPCS descriptions associated with CPT codes are consumer friendly descriptions provided by the AMA. CPT Consumer Friendly Descriptors are lay synonyms for CPT descriptors that are intended to help healthcare consumers who are not medical professionals understand clinical procedures on bills and patient portals. CPT Consumer Friendly Descriptors should not be used for clinical coding or documentation. All other descriptions are CMS Level II descriptions provided in long form. Due to variable length restrictions, the CMS Level II descriptions have been truncated to 256 bytes. As a result, the same HCPCS description can be associated with more than one HCPCS code. For complete CMS Level II descriptions, please visit the HCPCS Release Code Sets page. | string |
HCPCS Drug IndicatorHCPCS_Drug_Ind | Identifies whether the HCPCS code for the specific service furnished by the provider is a HCPCS listed on the Medicare Part B Drug Average Sales Price (ASP) File. Please visit the ASP drug pricing page for additional information. | string |
Place of ServicePlace_Of_Srvc | Identifies whether the place of service submitted on the claims is a facility (value of ‘F’) or non-facility (value of ‘O’). Non-facility is generally an office setting; however other entities are included in non-facility. | string |
Number of ProvidersTot_Rndrng_Prvdrs | Number of providers within HCPCS code and place of service. | number |
Number of Medicare BeneficiariesTot_Benes | Number of distinct Medicare beneficiaries receiving the service for each Rndrng_Prvdr_Geo_Desc and HCPCS_Cd, Place_Of_Srvc. | number |
Number of ServicesTot_Srvcs | Number of services provided; note that the metrics used to count the number provided can vary from service to service. | number |
Number of Distinct Medicare Beneficiary/Per Day ServicesTot_Bene_Day_Srvcs | Number of distinct Medicare beneficiary/per day services. Since a given beneficiary may receive multiple services of the same type (e.g., single vs. multiple cardiac stents) on a single day, this metric removes double-counting from the line service count to identify whether a unique service occurred. | number |
Average Submitted Charge AmountAvg_Sbmtd_Chrg | Average of the charges that providers submit for the service. | number |
Average Medicare Allowed AmountAvg_Mdcr_Alowd_Amt | Average of the Medicare allowed amount for the service. Medicare allowed amounts includes the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying. | number |
Average Medicare Payment AmountAvg_Mdcr_Pymt_Amt | Average amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item service. | number |
Average Medicare Standardized Payment AmountAvg_Mdcr_Stdzd_Amt | Average amount that Medicare paid after beneficiary deductible and coinsurance amounts have been deducted for the line item service and after standardization of the Medicare payment has been applied. Standardization removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices and makes Medicare payments across geographic areas comparable, so that differences reflect variation in factors such as physicians’ practice patterns and beneficiaries’ ability and willingness to obtain care. Additional information on the standardization of Medicare payments can be found in the “Geographic Variation Public Use File: Technical Supplement on Standardization.” | number |
No column matches that filter.
At a glance
- Catalog
- data.cms.gov
- Publisher
- Office of Enterprise Data and Analytics (OEDA)
- Rows
- 268,350
- Columns
- 15
- State column
- None found
API
Free, no key needed. This request returns the first 10 rows as JSON:
https://data.cms.gov/data-api/v1/dataset/6fea9d79-0129-4e4c-b1b8-23cd86a4f435/data?size=10
Versions 12
The newest version is the one linked above. Older releases stay on the official site.
- 2024-12-01posted May 21, 2026
- 2023-12-31posted Oct 28, 2025
- 2022-12-01posted Jun 4, 2024
- 2021-12-31posted Mar 8, 2024
- 2020-12-31posted May 10, 2023
- 2019-12-31posted May 10, 2023
- 2018-12-31posted May 10, 2023
- 2017-12-31posted May 10, 2023
Show 4 older versions
- 2016-12-31posted May 10, 2023
- 2015-07-31posted May 10, 2023
- 2014-12-31posted May 10, 2023
- 2013-12-31posted May 10, 2023
CMS's description
The Medicare Physician & Other Practitioners by Geography and Service dataset contains information on use, payments, submitted charges, and beneficiary demographic and health characteristics organized by geography, Healthcare Common Procedure Coding System (HCPCS) code, and place of service.
Methodology and other documents from CMS:
The summary at the top is the first sentence of this description. Record id cms:6fea9d79-0129-4e4c-b1b8-23cd86a4f435. This record as JSON.