Medicare Advantage, Part D, Medicaid

Medicare Physician Fee Schedule (PFS)

medicare_silver.fact_pfs_rvu·live·silver·Medicare Physician Fee Schedule (PFS)

Rows

642,307

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1The universal benchmark denominator for the commercial-to-Medicare ratio ("is this rate fair?").
2National payment is DERIVED (fact_pfs_rvu stores components, not precomputed totals): office = total_non_facility_rvu*conversion_factor, facility = total_facility_rvu*conversion_factor.
3MATCH MODIFIER vs commercial (26 read / TC technical / global = NULL).
4No locality column; join medicare_gpci_locality / medicare_zip5_locality for a locality-adjusted rate.

Grain

Key	Grain
N/A	1One row per (hcpcs_code, modifier, calendar_year) -- CMS PFS RVU components (work/PE/MP RVUs + conversion_factor). 2DEEP CY2003-2026. 3Filter conversion_factor BETWEEN 20 AND 50. 4RBP prices at the claim service year (as-of). 5The shallow medicare_physician_fee_schedule is the deprecated recent-years RDS mirror.

Columns (43)

Column	Type	Meaning
`calendar_year`	int
`hcpcs_code`	string
`modifier`	string
`status_code`	string
`code_description`	string
`work_rvu`	decimal(38,12)
`non_facility_pe_rvu`	decimal(38,12)
`facility_pe_rvu`	decimal(38,12)
`mp_rvu`	decimal(38,12)
`total_non_facility_rvu`	decimal(38,12)
`total_facility_rvu`	decimal(38,12)
`conversion_factor`	decimal(38,12)
`global_period`	string
`pre_service_time`	decimal(38,12)
`intra_service_time`	decimal(38,12)
`post_service_time`	decimal(38,12)
`mult_proc_indicator`	string
`bilateral_surgery_indicator`	string
`assistant_surgery_indicator`	string
`co_surgeon_indicator`	string
`team_surgery_indicator`	string
`pc_tc_indicator`	string
`diagnostic_imaging_family`	string
`physician_supervision_indicator`	string
`endo_base_code`	string
`source_zip_sha256`	string
`source_member`	string
`source_row_number`	bigint
`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

describe_data_source(source_fqn="medicare_silver.fact_pfs_rvu")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.fact_pfs_rvu WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	medicare_allowed
Identity key	`hcpcs_code`
Join	`how_to_join(source_fqn="medicare_silver.fact_pfs_rvu")`
Raw door	Athena (read-only via query_substrate): medicare_silver.fact_pfs_rvu -- JOIN vlada_curated.fact_rate ON code=hcpcs_code, match modifier+calendar_year for the ratio.
Note	CERTIFIED through the Source Acceptance Gate (product1-cert-pfs-v1). Proven: 99213 cigna 0.93x, premera 1.54x Medicare. The old medicare_silver.dim_medicare_pfs name was never built; no get_medicare_rate tool exists — write the SQL.

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