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You are here > Home > Reading Lists > Finance & Accounting > Medical Fees in the U.S.

Medical Fees: A Comprehensive Listing of Current UCR and Medicare Fees with Relative Value Units
Nationwide Charges for Medicine, Surgery, Laboratory, Radiology
Practice Management Information Corporation

Please note: Please make your selection according to publication dates. Please also keep in mind that any title not-yet-published can now be pre-ordered here - so that you can easily plan ahead.

2012 Perfect Paperback Edition
750 pages
ISBN 1936977060
978-1936977062
PMIC
January 2012
(click button below for best currently available price for this title)

2011 Perfect Paperback Edition
750 pages
ISBN 1570666601
978-1570666605
PMIC
January 2011
(click button below for best currently available price for this title)

Are you cheating yourself, and your patients, by not charging enough?

Maximize your payments with our best-selling medical fees guide! The fees provided in this book are based on an analysis of millions of health insurance claims submitted to third party payers. Medical Fees in the United States includes everything you need to:

  • review your fees
  • set fees for new services
  • challenge low payments from third party payers, and 
  • evaluate managed care contracts
  • suggested fees for most new CPT codes
  • expanded definitions for procedures and services
For every health care professional that may be charging “too much” according to the scare stories you read in the newspapers, there are at least nine that aren’t charging enough. That’s right, many doctors are not charging enough for their services and procedures, which costs them, and their patients, billions of dollars in un-reimbursed care. If a doctor doesn’t charge as much as the third party payer would pay, the doctor loses the difference. If a doctor bills the patient for the difference, the patient loses the difference. In either case, the third party payer is the winner because it winds up paying less than it should. The best practices charge the right amount.

Includes suggested fees for most new CPT codes! The fees are based on an analysis of over 60 million health insurance claims submitted to third party payers. Includes a comprehensive introduction and listings for over 6000 CPT codes with short descriptions, fees at the 50th, 75th and 90th percentiles, plus Medicare fees and relative values (RVUs). Also includes geographic adjustment factors to help you fine-tune the data to your geographic area of practice.

So how do you set fees for new services and adjust your fees to account for increased cost of practice?  Where do you get credible data to challenge low payments by third party payers? What do you use to evaluate managed care contracts? How do you find out if your fees are too low or too high when medical associations are prevented from publishing the results of fee surveys and just talking to your colleagues about fees on the golf course could result in antitrust action against you?

You can view a sample of this book here.

This reference book includes a comprehensive introduction and listings for over 6,000 CPT codes with short descriptions, fees at the 50th, 75th and 90th percentiles, plus Medicare fees and relative values (RVUs). Also includes geographic adjustment factors to help you fine-tune the data to your geographic area of practice.

  • Maximize your payments from Medicare and private carriers
  • Challenge low allowances and payments by health insurance companies
  • Review managed care contracts to determine if payments are fair and reasonable

For its softbound compact books, PMIC uses Smythe-Sewn® binding. In the Smythe-Sewn binding process the pages of the book are first sewn together, then bound into the cover. The result is a book that is virtually indestructible and that lays flat during use.

PMIC was founded in 1986. By 1989, from a humble one-book beginning, PMIC became the nation's leading independent publisher and value-added reseller of medical coding, reimbursement and practice management books with a reputation for quality, service and value. Coding and compliance information changes constantly and it is our job to keep up with it so you don't have to. You can trust us to provide you with books that contain the most complete, current, accurate and "official" information available. While our books win a lot of awards, what is more important to us is that our customers love them. That's because we consider our books as "tools" and spend a lot of time thinking about how, when and where our customers will use our products. You can order with confidence, knowing that you will always receive the best, most innovative books available. Because of the industry standard features we introduced to this market, such as spiral binding, thumb-indexing, enhanced color-coding and compact sizing, our publications represent exceptional values to our customers.

James B. Davis, known as "The Billion dollar Biller," has written or edited over 200 books on medical coding, billing, reimbursement and practice management. He has been in the health care industry for over 40 years, working in clinics, hospitals, insurance companies, and has experience in providing patient care. His expertise in the medical coding field is the result of billing over $1 billion dollars in health insurance claims for physicians and other health care providers. He is the founder and President of Practice Management Information Corporation, dba PMIC, the nation's leading independent publisher of medical coding and compliance books, forms and software.

Please remember that the government no longer allows a grace period for annual code sets. The new HIPAA Transaction and Code Set Rule requires providers to use national medical code sets that are valid at the time that a service is provided. ICD-9-CM code revisions become effective October 1st each year while CPT and HCPCS code revisions become effective January 1st. In order for you to meet this requirement, you must have the revised CPT, HCPCS, and ICD-9-CM codes in your possession before the implementation dates. The best way to do this is to order your code books early. Review current coding resources.

You may also be interested: Coding Resources

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