> ## Documentation Index > Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt > Use this file to discover all available pages before exploring further. # 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](https://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 ```bash theme={null} # 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](https://rcintell.com/tools). No account required. API access requires a free API key.