curl -X POST https://win.oneshotagent.com/v1/tools/lookup/market-medicare-fees \
-H "Content-Type: application/json" \
-H "payment-signature: <base64 x402 payment>" \
-d '{
"code": "99213"
}'
const response = await fetch("https://win.oneshotagent.com/v1/tools/lookup/market-medicare-fees", {
method: "POST",
headers: {
"Content-Type": "application/json",
"payment-signature": paymentProof,
},
body: JSON.stringify({
"code": "99213"
}),
});
const result = await agent.tool('lookup/market-medicare-fees', {
code: '99213'
});
console.log(result.result);
console.log(result.evidence);
{
"success": true,
"data": {
"request_id": "uuid",
"receipt_id": "rcpt_...",
"status": "completed",
"tool": "market_medicare_fees",
"result": {
"code": "99213",
"year": 2026,
"status": "A",
"status_meaning": "Active code: paid separately under the physician fee schedule when covered",
"rates": [
{
"modifier": null,
"conversion_factor_usd": 33.5675,
"rvu_work": 1.3,
"rvu_practice_expense_non_facility": 1.46,
"rvu_practice_expense_facility": 0.33,
"rvu_malpractice": 0.09,
"rvu_total_non_facility": 2.85,
"rvu_total_facility": 1.72,
"national_payment_non_facility_usd": 95.67,
"national_payment_facility_usd": 57.74,
"global_days": "XXX",
"label": "qualifying alternative payment model participants"
},
{
"modifier": null,
"conversion_factor_usd": 33.4009,
"rvu_work": 1.3,
"rvu_practice_expense_non_facility": 1.46,
"rvu_practice_expense_facility": 0.33,
"rvu_malpractice": 0.09,
"rvu_total_non_facility": 2.85,
"rvu_total_facility": 1.72,
"national_payment_non_facility_usd": 95.19,
"national_payment_facility_usd": 57.45,
"global_days": "XXX",
"label": "all other clinicians"
}
]
},
"evidence": {
"source": "US Centers for Medicare & Medicaid Services",
"source_kind": "public",
"retrieved_at": "2026-01-15T12:00:00.000Z",
"calls": [
{
"retrieved_at": "2026-01-15T12:00:00.000Z"
}
],
"as_of": null
}
}
}
Health
Medicare Fee Schedule
Look up national Medicare Physician Fee Schedule relative value units and payment amounts for a procedure code.
POST
/
v1
/
tools
/
lookup
/
market-medicare-fees
curl -X POST https://win.oneshotagent.com/v1/tools/lookup/market-medicare-fees \
-H "Content-Type: application/json" \
-H "payment-signature: <base64 x402 payment>" \
-d '{
"code": "99213"
}'
const response = await fetch("https://win.oneshotagent.com/v1/tools/lookup/market-medicare-fees", {
method: "POST",
headers: {
"Content-Type": "application/json",
"payment-signature": paymentProof,
},
body: JSON.stringify({
"code": "99213"
}),
});
const result = await agent.tool('lookup/market-medicare-fees', {
code: '99213'
});
console.log(result.result);
console.log(result.evidence);
{
"success": true,
"data": {
"request_id": "uuid",
"receipt_id": "rcpt_...",
"status": "completed",
"tool": "market_medicare_fees",
"result": {
"code": "99213",
"year": 2026,
"status": "A",
"status_meaning": "Active code: paid separately under the physician fee schedule when covered",
"rates": [
{
"modifier": null,
"conversion_factor_usd": 33.5675,
"rvu_work": 1.3,
"rvu_practice_expense_non_facility": 1.46,
"rvu_practice_expense_facility": 0.33,
"rvu_malpractice": 0.09,
"rvu_total_non_facility": 2.85,
"rvu_total_facility": 1.72,
"national_payment_non_facility_usd": 95.67,
"national_payment_facility_usd": 57.74,
"global_days": "XXX",
"label": "qualifying alternative payment model participants"
},
{
"modifier": null,
"conversion_factor_usd": 33.4009,
"rvu_work": 1.3,
"rvu_practice_expense_non_facility": 1.46,
"rvu_practice_expense_facility": 0.33,
"rvu_malpractice": 0.09,
"rvu_total_non_facility": 2.85,
"rvu_total_facility": 1.72,
"national_payment_non_facility_usd": 95.19,
"national_payment_facility_usd": 57.45,
"global_days": "XXX",
"label": "all other clinicians"
}
]
},
"evidence": {
"source": "US Centers for Medicare & Medicaid Services",
"source_kind": "public",
"retrieved_at": "2026-01-15T12:00:00.000Z",
"calls": [
{
"retrieved_at": "2026-01-15T12:00:00.000Z"
}
],
"as_of": null
}
}
}
Returns the status indicator, relative value units, conversion factors and national payment amounts, before the locality adjustment, on Medicare’s physician payment schedule for a procedure code and modifier. Non-facility is an office, where the practice bears the overhead; facility is a hospital or other facility paid separately for it. Codes and amounts only; procedure descriptions are licensed and not returned.
Authentication
Requires x402 payment in thepayment-signature header.
Request Body
string
required
Five-character procedure code, for example 99213 or G0439. five letters or digits.
string
Two-character modifier, for example 26 or TC; without it, rows with no modifier are returned. two letters or digits.
integer
Calendar year of the schedule; defaults to the newest published year. From 2025 to 2026. Defaults to
2026.Response (200 OK)
Top-level envelope:success (boolean) and data (object). All fields below are nested under data.
string
Durable job ID for audit and lookup
string
Job status:
completedstring
Always
market_medicare_feesobject
The answer, described under Result below
object
Where the answer came from and when
string
The public body the data comes from. Always
US Centers for Medicare & Medicaid Services.string
public when the data comes from a public body, commercial otherwisestring
When the lookup was made, as an ISO 8601 UTC time
string | null
The amounts are for the calendar year given. The source rows carry no date, so as_of is null.
Result
Nested underdata.result.
string
The procedure code looked up, upper-cased.
integer
Calendar year of the schedule.
string | null
Source status indicator, for example A for an active code; null when the code is not on the schedule for the year.
string | null
What the status indicator means; null when the source does not document it.
object[]
One entry per conversion factor the year uses, for the requested modifier; empty when there is no match.
string | null
Two-character modifier; null for the unmodified code.
number
US dollars per relative value unit for this rate.
number
Work relative value units.
number | null
Practice expense relative value units outside a facility; null when the source marks it not applicable.
number | null
Practice expense relative value units in a facility; null when the source marks it not applicable.
number
Malpractice relative value units.
number | null
Total relative value units outside a facility; null when not applicable.
number | null
Total relative value units in a facility; null when not applicable.
number | null
Total non-facility relative value units times the conversion factor, rounded to cents: the national amount before the geographic locality adjustment; null when not applicable or when the contractor sets the payment (status C or L).
number | null
Total facility relative value units times the conversion factor, rounded to cents: the national amount before the geographic locality adjustment; null when not applicable or when the contractor sets the payment (status C or L).
string
Global surgery period: 000, 010 or 090 days; XXX when the concept does not apply; YYY set by the contractor; ZZZ for an add-on code; MMM for maternity.
string
Who this conversion factor applies to.
curl -X POST https://win.oneshotagent.com/v1/tools/lookup/market-medicare-fees \
-H "Content-Type: application/json" \
-H "payment-signature: <base64 x402 payment>" \
-d '{
"code": "99213"
}'
const response = await fetch("https://win.oneshotagent.com/v1/tools/lookup/market-medicare-fees", {
method: "POST",
headers: {
"Content-Type": "application/json",
"payment-signature": paymentProof,
},
body: JSON.stringify({
"code": "99213"
}),
});
const result = await agent.tool('lookup/market-medicare-fees', {
code: '99213'
});
console.log(result.result);
console.log(result.evidence);
{
"success": true,
"data": {
"request_id": "uuid",
"receipt_id": "rcpt_...",
"status": "completed",
"tool": "market_medicare_fees",
"result": {
"code": "99213",
"year": 2026,
"status": "A",
"status_meaning": "Active code: paid separately under the physician fee schedule when covered",
"rates": [
{
"modifier": null,
"conversion_factor_usd": 33.5675,
"rvu_work": 1.3,
"rvu_practice_expense_non_facility": 1.46,
"rvu_practice_expense_facility": 0.33,
"rvu_malpractice": 0.09,
"rvu_total_non_facility": 2.85,
"rvu_total_facility": 1.72,
"national_payment_non_facility_usd": 95.67,
"national_payment_facility_usd": 57.74,
"global_days": "XXX",
"label": "qualifying alternative payment model participants"
},
{
"modifier": null,
"conversion_factor_usd": 33.4009,
"rvu_work": 1.3,
"rvu_practice_expense_non_facility": 1.46,
"rvu_practice_expense_facility": 0.33,
"rvu_malpractice": 0.09,
"rvu_total_non_facility": 2.85,
"rvu_total_facility": 1.72,
"national_payment_non_facility_usd": 95.19,
"national_payment_facility_usd": 57.45,
"global_days": "XXX",
"label": "all other clinicians"
}
]
},
"evidence": {
"source": "US Centers for Medicare & Medicaid Services",
"source_kind": "public",
"retrieved_at": "2026-01-15T12:00:00.000Z",
"calls": [
{
"retrieved_at": "2026-01-15T12:00:00.000Z"
}
],
"as_of": null
}
}
}
See Pricing for this tool’s price. A wallet (x402) call receives it in the 402 quote before anything is charged; a call paid from prepaid credits is charged when the API accepts the request and answers
200.Notes
- Without a modifier, the rows with no modifier are returned; with one, only that modifier’s rows (for example 26 for the professional component and TC for the technical component).
- From 2026 each code has one rate per conversion factor: one for qualifying alternative payment model participants and one for all other clinicians, in that order. Earlier years have one rate.
- A practice expense the source marks not applicable gives null practice expense, total and payment for that setting, never zero.
- When the Medicare Administrative Contractor sets the amount (status C, or L for a local code), both national payments are null. The relative value units are returned as the source lists them.
- The source is the US Centers for Medicare & Medicaid Services indicators table of the physician payment schedule for the year; locality adjustments are not applied.
- No match, including a code not on the schedule for the year, completes with rates: [] and a null status.
- Results return inline. The finished job stays available at
/v1/requests/{request_id}