Paste a CCN. See everything about how billing works at that facility. Free.The CCN Resolver is RCI’s public lookup tool. Enter any Medicare provider number and see the complete billing context — from geographic location through payment system to the codes that apply there. Try it at rcintell.com/tools
How it works
Enter a CCN:170001
Get the full L1-L6 breakdown:
┌─────────────────────────────────────────────────────────────────┐
│ CCN: 170001 │
│ Facility: Stormont Vail Health │
│ City: Topeka, KS │
│ Status: Active │
├─────────────────────────────────────────────────────────────────┤
│ │
│ L1 — PHYSICAL LOCATION │
│ ├─ State: Kansas (17) │
│ ├─ CBSA: 45820 (Topeka, KS) │
│ ├─ MAC: Jurisdiction 5 (Wisconsin Physicians Service) │
│ ├─ GPCI Work: 1.000 │
│ ├─ GPCI PE: 0.891 │
│ ├─ GPCI MP: 0.407 │
│ ├─ HPSA: No │
│ └─ Medicaid: Kansas Medicaid (KanCare) │
│ │
│ L2 — FACILITY TYPE │
│ ├─ CCN Range: 0001-0879 → Short-term acute care hospital │
│ ├─ Outpatient Payment: OPPS │
│ ├─ Inpatient Payment: MS-DRG / IPPS │
│ ├─ Professional Payment: MPFS │
│ ├─ Billing Form: UB-04 (institutional) / CMS-1500 (prof) │
│ └─ EDI: 837I (institutional) / 837P (professional) │
│ │
│ L3 — CARE SETTINGS AVAILABLE │
│ ├─ Inpatient (POS 21) → Facility rate, TOB 011x │
│ ├─ Outpatient (POS 22) → Facility rate, TOB 013x │
│ ├─ ER (POS 23) → Facility rate, TOB 013x │
│ └─ Observation (POS 22) → Outpatient, Rev 0762 │
│ │
│ L4 — PAYER CONTEXT (when specified) │
│ └─ Pass payer_id for payer-specific rules │
│ │
│ L5 — SERVICE GROUPS │
│ └─ Pass cpt for service-group-specific rules │
│ │
│ L6 — SERVICE DETAIL │
│ └─ Pass cpt for code-specific RVUs and payment calculation │
│ │
└─────────────────────────────────────────────────────────────────┘
Deep resolution
Add a CPT code and payer to go deeper: CCN:170001 CPT: 99213 Payer: Medicare
┌─────────────────────────────────────────────────────────────────┐
│ L4 — PAYER: Medicare (CMS) │
│ ├─ Timely filing: 12 months from date of service │
│ ├─ Appeal level 1: Redetermination (120 days) │
│ ├─ Appeal level 2: QIC Reconsideration (180 days) │
│ ├─ Prior auth: Not required for 99213 │
│ ├─ LCD: Check MAC Jurisdiction 5 LCDs │
│ └─ NCD: No NCD for E/M services │
│ │
│ L5 — SERVICE GROUP: E/M (Evaluation & Management) │
│ ├─ Documentation: MDM or time-based │
│ ├─ Split/shared: Incident-to rules apply │
│ ├─ Same-day procedure: Modifier 25 if significant/separate │
│ └─ Telehealth: Allowed (POS 02 or 10) │
│ │
│ L6 — SERVICE: 99213 │
│ ├─ Description: Office visit, established, low complexity │
│ ├─ Work RVU: 1.30 │
│ ├─ PE RVU (facility): 0.99 │
│ ├─ PE RVU (non-facility): 1.72 │
│ ├─ MP RVU: 0.10 │
│ ├─ Total RVU (facility): 2.39 │
│ ├─ Total RVU (non-facility): 3.12 │
│ ├─ │
│ ├─ GPCI-Adjusted Payment: │
│ │ Facility: $71.91 │
│ │ Non-facility: $95.25 │
│ │ (CF: $32.35 × Adjusted RVUs) │
│ └─ Global period: XXX (no global) │
│ │
└─────────────────────────────────────────────────────────────────┘
Use cases
| Who | What they resolve |
|---|---|
| Billers | ”What TOB do I use for this facility?” |
| Coders | ”Which modifiers are required at this POS?” |
| Revenue cycle | ”What’s the expected payment for this CPT here?” |
| Compliance | ”Is this facility billing on the right form?” |
| Integrations | ”What payment system does this CCN fall under?” |
| New hires | ”What does this CCN even mean?” |
API equivalent
# Quick L1-L2 lookup (just the CCN)
curl https://api-dev.rcintell.com/v1/knowledge/layers/170001 \
-H "X-API-Key: kp_test_..."
# Full L1-L6 resolution
curl -X POST https://api-dev.rcintell.com/v1/knowledge/resolve \
-H "X-API-Key: kp_test_..." \
-H "Content-Type: application/json" \
-d '{
"ccn": "170001",
"cpt": "99213",
"payer": "Medicare"
}'