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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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2024 (v5.24)
2023 (v4.235)
2022 (v4.225)
2021 (v4.215)
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