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Out-of-network reimbursement rate calculator

Non-anesthesia-related procedures calculator

This web tool is for informational purposes only. Reimbursement for out of network procedures is governed by ORS 743B.287 and OAR 836-053-1600.

*If one of the following modifiers apply to the claim, additional adjustments may be made according to the CMS CY 2018 Physician Fee Schedule Final Rule:
AS, FX, FY, SA, UE, 22, 23, 25, 47, 50, 51, 52, 53, 54, 55, 56, 62, 66, 73, 78, 80, 81, 82

Rating areas
1 Clackamas, Multnomah, Washington and Yamhill
2 Benton, Lane and Linn
3 Marion and Polk
4 Deschutes, Klamath and Lake
5 Clatsop, Columbia, Coos, Curry, Lincoln and Tillamook
6 Baker, Crook, Gilliam, Grant, Harney, Hood River, Jefferson, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wasco and Wheeler
7 Douglas, Jackson and Josephine