Medicare Advantage, Part D, Medicaid

Clinical Laboratory Fee Schedule, local amounts by carrier locality

medicare_silver.medicare_clfs_locality_rates·live·silver

Rows

1,051,939

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1The CLFS by carrier locality: base fee, national limitation amount, median and pricing amount at the 60% and 62% levels, with the gap-fill indicator, per release.
2The national table (fact_clfs_national_rate) holds the limit only; this holds the local amounts.

Grain

Key	Grain
N/A	1One row per (release_label, hcpcs_code, modifier, carrier, locality): the local fee amounts and national limit for a lab code.

Columns (26)

Column	Type	Meaning
`release_label`	string
`calendar_year`	int
`effective_date`	date
`hcpcs_code`	string
`modifier`	string
`carrier`	string
`locality`	string
`carrier_locality`	string
`base_fee_amount_60_pct`	double
`base_fee_amount_62_pct`	double
`national_limit_amount_60_pct`	double
`national_limit_amount_62_pct`	double
`median_amount_60_pct`	double
`pricing_amount_60_pct`	double
`pricing_amount_62_pct`	double
`gap_fill_indicator`	string
`short_descriptor`	string
`floor_amount_60_pct`	double
`source_zip_url`	string
`source_zip_sha256`	string
`source_member`	string
`source_member_sha256`	string
`asserted_at`	date
`created_at`	timestamp
`source_id`	string
`is_current`	boolean

Query it

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

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`release_label,hcpcs_code,modifier,carrier,locality`
Join	`how_to_join(source_fqn="medicare_silver.medicare_clfs_locality_rates")`
Raw door	Athena (read-only via query_substrate): medicare_silver.medicare_clfs_locality_rates
Note	Product lane 2026-09-28: 1,051,939 rows, measured on Athena. Register source cms_clfs_national_rates.

This page as markdown: /docs-md/data/medicare_silver_medicare_clfs_locality_rates.md · every page in one file: /llms-full.txt