# CMS PFS Payment-Policy Indicators (PPRRVU)

`medicare_silver.medicare_pfs_indicators` · Medicare Advantage, Part D, Medicaid · status live · 19,356 rows

Per HCPCS x modifier, the payment-policy indicators from the CMS PFS Relative Value File (PPRRVU) that the National Physician Fee Schedule pricing files drop: status_code (A/B/N/X...), global_period (000/010/090/XXX...), pctc_ind (PC/TC split), mult_proc_ind (the multiple-procedure reduction rule: 2=standard surgical MPPR 100/50/50, 3=endoscopy, 4=imaging, 5=therapy, 9=n/a), and bilat_ind (the bilateral rule: 1=150% adjustment applies). Used by the claims-repricing engine to apply the multiple-procedure reduction and bilateral adjustment so professional claims aren't paid in full where Medicare reduces. Quarterly CMS release (2026, rvu26c).

**Grain.** One row per HCPCS x modifier from the CMS PFS Relative Value File — the status / global / PC-TC / multiple-procedure / bilateral indicators.

| column | type | meaning |
|---|---|---|
| year | int |  |
| row_seq | bigint |  |
| hcpcs | string |  |
| modifier | string |  |
| status_code | string |  |
| pctc_ind | string |  |
| global_period | string |  |
| mult_proc_ind | string |  |
| bilat_ind | string |  |
| observed_period | date |  |
| asserted_at | date |  |
| effective_period_start | date |  |
| effective_period_end | date |  |
| cms_vintage_sequence | int |  |
| parse_revision | int |  |
| parser_artifact_hash | string |  |
| source_url | string |  |
| sha256_content_hash | string |  |
| source_id | string |  |
| is_current | boolean |  |
| bronze_object_key | string |  |
| s3_version_id | string |  |
| vintage_tag | string |  |
| drug_source_version_id | string |  |

Query it: `query_substrate` with `SELECT ... FROM medicare_silver.medicare_pfs_indicators WHERE ... LIMIT 100`; read `describe_data_source("medicare_silver.medicare_pfs_indicators")` first.