ProFee Coder

RVUs, NCCI edits, LCD/NCD lookup, modifier crosswalk, and fee schedules — the physician coding reference, free with API access

Everything a physician-side coder needs. RVUs, NCCI edits, fee schedules, modifiers. Free.

The ProFee Coder is RCI’s public tool for professional fee coding — covering what AAPC’s Codify charges $480/year for. RVU lookups from CMS, NCCI edit checks, LCD/NCD policies, modifier crosswalks, and Medicare fee schedules — with year toggling and API access.

Try it at rcintell.com/tools

What’s included

RVU Lookup (from CMS MPFS)

Enter any CPT/HCPCS code. See the full RVU breakdown, with GPCI adjustment for any location.

CPT: 99213 | Year: 2026

┌──────────────────────────────────────────────────────────────┐
│  Code: 99213                                                  │
│  Description: Office/outpatient visit, established patient,  │
│               low medical decision making                     │
│  Status: Active                                               │
│  Global Period: XXX                                           │
│                                                               │
│  Component       │  RVU    │  GPCI (KS) │  Adjusted          │
│──────────────────│─────────│────────────│────────────────────│
│  Work            │  1.30   │  1.000     │  1.300             │
│  PE (facility)   │  0.99   │  0.891     │  0.882             │
│  PE (non-fac)    │  1.72   │  0.891     │  1.532             │
│  Malpractice     │  0.10   │  0.407     │  0.041             │
│──────────────────│─────────│────────────│────────────────────│
│  Total (fac)     │  2.39   │            │  2.223             │
│  Total (non-fac) │  3.12   │            │  2.873             │
│                                                               │
│  CF: $32.35                                                   │
│  Payment (facility):     $71.91                               │
│  Payment (non-facility): $92.94                               │
│                                                               │
│  ☐ Toggle: 2026 ▼  (2025: $72.10 | 2024: $74.32)            │
└──────────────────────────────────────────────────────────────┘

Year toggle: Switch between 2024, 2025, and 2026 data. See how conversion factors, RVU changes, and GPCI updates affect payment.

NCCI Edits Checker (Physician Side)

Enter up to 50 code pairs. See which can be billed together, which are bundled, and which modifiers allow unbundling.

Check: 99213 + 36415

┌──────────────────────────────────────────────────────────────┐
│  Column 1: 99213 (Office visit, established, low)            │
│  Column 2: 36415 (Venipuncture)                              │
│                                                               │
│  Edit: BUNDLED                                                │
│  Modifier Indicator: 1 (modifier allowed)                    │
│  Effective: 2013-01-01                                        │
│                                                               │
│  Resolution:                                                  │
│  ├─ Modifier 59 or XE/XS/XP/XU allows separate billing      │
│  ├─ Documentation must support distinct service               │
│  └─ Auto-sequenced by RVU (99213 first)                      │
│                                                               │
│  MUE for 99213: 1 unit/day (Date of Service)                 │
│  MUE for 36415: 3 units/day (Date of Service)                │
└──────────────────────────────────────────────────────────────┘

LCD/NCD Lookup

Enter a CPT code. See the Local Coverage Determinations and National Coverage Determinations that apply — with the covered ICD-10 codes for each.

CPT: 93000 | MAC: Jurisdiction 5

LCDs:
├─ L33543: Electrocardiography (EKG)
│  ├─ Covered ICD-10: I25.10, I48.0, I48.1, R00.0, R00.1...
│  ├─ Limitations: Not covered for routine screening
│  └─ Contractor: WPS (J5)
│
NCDs:
├─ 220.1: Electrocardiographic Services
│  └─ Coverage: Covered when medically necessary

Modifier Crosswalk

Enter a CPT code. See all allowed modifiers, when to use them, and payment impact.

CPT: 99213

Allowed Modifiers:
├─ 25: Significant, separately identifiable E/M → allows E/M + procedure same day
├─ 95: Synchronous telemedicine → enables telehealth billing
├─ GT: Via interactive audio/video → telehealth (legacy)
├─ AI: Principal physician of record → inpatient E/M
├─ GC: Resident under teaching physician → teaching setting
├─ GE: Physician or practitioner → per CMS audit policy
└─ CR: Catastrophe/disaster-related → PHE flexibilities

Medicare Fee Schedules

All three CMS fee schedules in one place:

Schedule	What it covers	Data source
MPFS (Physician Fee Schedule)	Professional services, E/M, surgical, radiology	CMS Relative Value File
DMEPOS	Durable medical equipment, prosthetics, orthotics	CMS DMEPOS Fee Schedule
CLAB (Clinical Lab)	Laboratory tests	CMS CLFS

CPT/HCPCS Code Search

AI-powered code search. Describe a procedure in plain English — get matching CPT and HCPCS codes with lay descriptions.

Search: "knee replacement total"

Results:
├─ 27447: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments
│  ├─ Work RVU: 20.72
│  ├─ Total RVU (fac): 27.39
│  ├─ Global: 090 (90-day global period)
│  └─ NCCI: bundled with 27445, 27446
│
├─ 27446: Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
├─ 27445: Arthroplasty, knee, hinge prosthesis
└─ HCPCS L8699: Prosthetic implant (not otherwise classified)

How it compares to AAPC Codify

Feature	AAPC Codify (Pro Fee)	RCI ProFee Coder
RVU lookup	Yes	Yes, with GPCI adjustment
Year toggle	Yes	Yes (2024-2026)
NCCI edits	25 codes at a time	50 codes, with MUE data
LCD/NCD lookup	Yes	Yes, with covered ICD-10 list
Modifier crosswalk	Yes	Yes, with payment impact
Fee schedules	MPFS, DMEPOS, CLAB	MPFS, DMEPOS, CLAB
Code search	AI-powered	AI-powered + lay terms
CMS-1500 scrubber	Yes	Yes (via API)
API access	No	Full REST API
MCP server	No	Yes — AI agent access
Price	$480/year	Free (public tool)
		API: pay-as-you-go

API access

# RVU lookup with GPCI
curl "https://api-dev.rcintell.com/v1/profee/rvu?cpt=99213&locality=0400000&year=2026" \
  -H "X-API-Key: kp_test_..."

# NCCI edit check
curl -X POST "https://api-dev.rcintell.com/v1/profee/ncci-check" \
  -H "X-API-Key: kp_test_..." \
  -H "Content-Type: application/json" \
  -d '{"codes": ["99213", "36415", "81002"]}'

# LCD lookup
curl "https://api-dev.rcintell.com/v1/profee/lcd?cpt=93000&mac=05" \
  -H "X-API-Key: kp_test_..."

# Modifier crosswalk
curl "https://api-dev.rcintell.com/v1/profee/modifiers?cpt=99213" \
  -H "X-API-Key: kp_test_..."

# AI code search
curl -X POST "https://api-dev.rcintell.com/v1/profee/code-search" \
  -H "X-API-Key: kp_test_..." \
  -d '{"query": "knee replacement total", "type": "cpt"}'

Data sources

All data comes directly from CMS public files, updated on the same schedule as CMS releases:

Data	Source	Update frequency
RVUs	CMS MPFS Relative Value File	Annually + quarterly
GPCI	CMS GPCI File	Annually
NCCI PTP	CMS NCCI PTP Edits	Quarterly
MUEs	CMS MUE Files	Quarterly
LCDs	CMS Medicare Coverage Database	Ongoing
NCDs	CMS NCD Database	Ongoing

Free to use

The ProFee Coder is free at rcintell.com/tools. No account required. API access requires a free API key.