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Reasonable Charges Data Tables–Outpatient and Professional

Reasonable Charges are based on amounts that third parties pay for the same services furnished by private-sector health care providers in the same geographic area. In the past, VA used average cost-based, per diem rates for billing insurers. Reasonable charges are calculated for inpatient and outpatient facility charges, and for professional or clinician charges for inpatient and outpatient care.

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View License for use of Physicians' Current Procedural Terminology

2024 (v5.24)
Reasonable Charges Data Tables, Version 5.24 – Dated January 01, 2024
Table Table Name
C v5.24: Observation Care Facility Nationwide Base and Hourly Charges
D v5.24: Partial Hospitalization Facility Nationwide Per Diem Charge
E v5.24: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v5.24: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v5.24: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v5.24: Professional Anesthesia Nationwide Base Units by CPT Code
I v5.24: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v5.24: Pathology and Laboratory Services Relative Value Units (RVUs)
K v5.24: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v5.24: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v5.24: Charge Adjustment Factors for Professional Services Charge Modifiers
N v5.24: Acute Inpatient Facility Charges GAAFs by Zip Code
O v5.24: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v5.24: Outpatient Facility Charges GAAFs by Zip Code
Q v5.24: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v5.24: Outpatient Dental Professional Charges GAAFs by Zip Code
S v5.24: Professional Services Conversion Factors
2023 (v4.235)
Reasonable Charges Data Tables, Version 4.235 – Dated January 01, 2023
Table Table Name
C v4.235: Observation Care Facility Nationwide Base and Hourly Charges
D v4.235: Partial Hospitalization Facility Nationwide Per Diem Charge
E v4.235: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v4.235: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v4.235: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v4.235: Professional Anesthesia Nationwide Base Units by CPT Code
I v4.235: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v4.235: Pathology and Laboratory Services Relative Value Units (RVUs)
K v4.235: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v4.235: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v4.235: Charge Adjustment Factors for Professional Services Charge Modifiers
N v4.235: Acute Inpatient Facility Charges GAAFs by Zip Code
O v4.235: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v4.235: Outpatient Facility Charges GAAFs by Zip Code
Q v4.235: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v4.235: Outpatient Dental Professional Charges GAAFs by Zip Code
S v4.235: Professional Services Conversion Factors
2022 (v4.225)
Reasonable Charges Data Tables, Version 4.225 – Dated January 01, 2022
Table Table Name
C v4.225: Observation Care Facility Nationwide Base and Hourly Charges
D v4.225: Partial Hospitalization Facility Nationwide Per Diem Charge
E v4.225: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v4.225: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v4.225: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v4.225: Professional Anesthesia Nationwide Base Units by CPT Code
I v4.225: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v4.225: Pathology and Laboratory Services Relative Value Units (RVUs)
K v4.225: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v4.225: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v4.225: Charge Adjustment Factors for Professional Services Charge Modifiers
N v4.225: Acute Inpatient Facility Charges GAAFs by Zip Code
O v4.225: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v4.225: Outpatient Facility Charges GAAFs by Zip Code
Q v4.225: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v4.225: Outpatient Dental Professional Charges GAAFs by Zip Code
S v4.225: Professional Services Conversion Factors
2021 (v4.215)
Reasonable Charges Data Tables, Version 4.215 – Dated January 01, 2021
Table Table Name
C v4.215: Observation Care Facility Nationwide Base and Hourly Charges
D v4.215: Partial Hospitalization Facility Nationwide Per Diem Charge
E v4.215: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v4.215: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v4.215: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v4.215: Professional Anesthesia Nationwide Base Units by CPT Code
I v4.215: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v4.215: Pathology and Laboratory Services Relative Value Units (RVUs)
K v4.215: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v4.215: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v4.215: Charge Adjustment Factors for Professional Services Charge Modifiers
N v4.215: Acute Inpatient Facility Charges GAAFs by Zip Code
O v4.215: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v4.215: Outpatient Facility Charges GAAFs by Zip Code
Q v4.215: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v4.215: Outpatient Dental Professional Charges GAAFs by Zip Code
S v4.215: Professional Services Conversion Factors
2020 (v3.27)
Reasonable Charges Data Tables, Version 3.27 – Dated January 01, 2020
Table Table Name
C v3.27: Observation Care Facility Nationwide Base and Hourly Charges
D v3.27: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.27: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.27: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.27: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.27: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.27: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.27: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.27: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.27: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.27: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.27: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.27: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.27: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.27: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.27: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.27: Professional Services Conversion Factors
2019 (v3.25)
Reasonable Charges Data Tables, Version 3.25 – Dated January 01, 2019
Table Table Name
C v3.25: Observation Care Facility Nationwide Base and Hourly Charges
D v3.25: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.25: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.25: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.25: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.25: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.25: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.25: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.25: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.25: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.25: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.25: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.25: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.25: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.25: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.25: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.25: Professional Services Conversion Factors
2018 (v3.23)
Reasonable Charges Data Tables, Version 3.23 – Dated January 01, 2018
Table Table Name
C v3.23: Observation Care Facility Nationwide Base and Hourly Charges
D v3.23: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.23: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.23: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.23: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.23: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.23: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.23: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.23: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.23: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.23: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.23: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.23: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.23: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.23: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.23: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.23: Professional Services Conversion Factors
2017 (v3.21)
Reasonable Charges Data Tables, Version 3.21 – Dated January 01, 2017
Table Table Name
C v3.21: Observation Care Facility Nationwide Base and Hourly Charges
D v3.21: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.21: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.21: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.21: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.21: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.21: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.21: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.21: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.21: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.21: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.21: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.21: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.21: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.21: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.21: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.21: Professional Services Conversion Factors
2016 (v3.18)
Reasonable Charges Data Tables, Version 3.18 – Dated January 01, 2016
Table Table Name
C v3.18: Observation Care Facility Nationwide Base and Hourly Charges
D v3.18: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.18: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.18: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.18: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.18: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.18: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.18: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.18: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.18: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.18: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.18: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.18: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.18: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.18: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.18: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.18: Professional Services Conversion Factors
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