`medicare_physician_payment`

Pack: medicare-pricing · Endpoint: https://gateway.pipeworx.io/medicare-pricing/mcp

What does Medicare pay a doctor for a procedure code, in a specific place? Returns the relative value units (work, practice expense, malpractice) and the actual dollar payment for a HCPCS/CPT code, adjusted for the Medicare LOCALITY — payment varies geographically, not just by state. Answers “how much does Medicare pay for 99213”, “what is code 27130 worth in Los Angeles”, “reimbursement rate for an office visit in Texas”, and fee-schedule or contract-rate benchmarking.

Parameters

Name	Type	Required	Description
`code`	string	yes	HCPCS or CPT code, e.g. “99213” (office visit) or “27130” (hip replacement).
`locality`	string	no	Where the service is provided — a state code (“CA”), state name, or Medicare locality name (“Bakersfield”, “Manhattan”). Payment varies by locality; omit only if you want the national picture.
`year`	number	no	Fee-schedule year, e.g. 2026. Omit to use the newest loaded year, which is stated in the response.
`modifier`	string	no	Optional HCPCS modifier, e.g. “26” (professional component) or “TC” (technical component).

Example call

Arguments

{
  "code": "99213",
  "locality": "CA"
}

curl

curl -X POST https://gateway.pipeworx.io/medicare-pricing/mcp \
  -H 'Content-Type: application/json' \
  -d '{"jsonrpc":"2.0","id":1,"method":"tools/call","params":{"name":"medicare_physician_payment","arguments":{"code":"99213","locality":"CA"}}}'

TypeScript (@pipeworx/sdk)

import { Pipeworx } from '@pipeworx/sdk';
const pipeworx = new Pipeworx();

const result = await pipeworx.call('medicare_physician_payment', {
  "code": "99213",
  "locality": "CA"
});

More examples

{
  "code": "99213",
  "locality": "Bakersfield",
  "year": 2026
}

Connect

Add this to your MCP client config, or use one-click install buttons:

{
  "mcpServers": {
    "medicare-pricing": {
      "url": "https://gateway.pipeworx.io/medicare-pricing/mcp"
    }
  }
}

See Getting Started for client-specific install steps.

medicare_physician_payment