This user-friendly tool is intended to help consumers understand what health care facilities are paid by Medicare for many common outpatient services in the Commonwealth of Pennsylvania. The information in this database has been obtained from the Centers for Medicare and Medicaid Services (CMS) public website.

Medicare reimbursement rates are sometimes considered “benchmark” payment rates within the health care payment system. While Medicare payments are typically below the cost of the care to which they relate, consumers can use this information to understand the relative cost of some outpatient services. In particular, those consumers who are in high-deductible health insurance plans and are trying to make the most efficient use of their health care dollars can use these data to get a realistic sense of the amount paid by Medicare to healthcare providers. The CMS payment amount, which combines the payment to the facility and the patient’s co-payment amount, can provide information to assist in fee negotiation and help consumers look for the best price for common services (like MRIs, cataract surgeries or biopsies).

HOWEVER: it is also important to note that decisions about where to receive health care services should not be made solely on the basis of costs and charges. The quality reputation of the facility and its experience in treating patients for a particular procedure or providing a specific service should also be decisive factors in making the final selection of a facility.

This interactive database allows you to select specific procedures or services that you’re interested in and see what CMS paid Hospital Outpatient Departments (HOPD) and Ambulatory Surgery Centers (ASC) in particular counties to treat Medicare beneficiaries in 2009. Please note: the payment amounts reported in this database reflect only the Medicare payment to the facility and DO NOT include professional fees (e.g., physician) and, possibly, other fees that may be associated with the procedure. (A more detailed version of this database can be found here.)