curl --request GET \
--url https://sandbox.rcintell.com/v1/codes/{code}/payment \
--header 'X-API-Key: <api-key>'import requests
url = "https://sandbox.rcintell.com/v1/codes/{code}/payment"
headers = {"X-API-Key": "<api-key>"}
response = requests.get(url, headers=headers)
print(response.text)const options = {method: 'GET', headers: {'X-API-Key': '<api-key>'}};
fetch('https://sandbox.rcintell.com/v1/codes/{code}/payment', options)
.then(res => res.json())
.then(res => console.log(res))
.catch(err => console.error(err));<?php
$curl = curl_init();
curl_setopt_array($curl, [
CURLOPT_URL => "https://sandbox.rcintell.com/v1/codes/{code}/payment",
CURLOPT_RETURNTRANSFER => true,
CURLOPT_ENCODING => "",
CURLOPT_MAXREDIRS => 10,
CURLOPT_TIMEOUT => 30,
CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
CURLOPT_CUSTOMREQUEST => "GET",
CURLOPT_HTTPHEADER => [
"X-API-Key: <api-key>"
],
]);
$response = curl_exec($curl);
$err = curl_error($curl);
curl_close($curl);
if ($err) {
echo "cURL Error #:" . $err;
} else {
echo $response;
}package main
import (
"fmt"
"net/http"
"io"
)
func main() {
url := "https://sandbox.rcintell.com/v1/codes/{code}/payment"
req, _ := http.NewRequest("GET", url, nil)
req.Header.Add("X-API-Key", "<api-key>")
res, _ := http.DefaultClient.Do(req)
defer res.Body.Close()
body, _ := io.ReadAll(res.Body)
fmt.Println(string(body))
}HttpResponse<String> response = Unirest.get("https://sandbox.rcintell.com/v1/codes/{code}/payment")
.header("X-API-Key", "<api-key>")
.asString();require 'uri'
require 'net/http'
url = URI("https://sandbox.rcintell.com/v1/codes/{code}/payment")
http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true
request = Net::HTTP::Get.new(url)
request["X-API-Key"] = '<api-key>'
response = http.request(request)
puts response.read_body{
"code": "<string>",
"conversion_factor": 123,
"applicable_blocks": [
"<string>"
],
"ccn": "<string>",
"date_of_service": "<string>",
"dme": {
"allowed_dme_payment": 123,
"dme_payment_rate": 123,
"is_rural": false,
"rate_used": "non_rural",
"state": "<string>"
},
"estimated_payment": 123,
"facility": {
"ccn": "<string>",
"cbsa": "<string>",
"county": "<string>",
"facility_type": "<string>",
"is_rural": true,
"locality_name": "<string>",
"locality_number": "<string>",
"name": "<string>",
"pos_code": "<string>",
"registered": true,
"state": "<string>",
"wage_index": 123
},
"facility_rate": true,
"lab": {
"allowed_lab_payment": 123,
"lab_payment_rate": 123,
"indicator": "<string>"
},
"locality": "<string>",
"mp_gpci": 123,
"mp_rvu_adjusted": 123,
"outpatient_facility": {
"allowed_fac_payment": 123,
"opps_payment_rate": 123,
"apc_code": "<string>",
"labor_share": 0.6,
"non_labor_share": 0.4,
"relative_weight": 123,
"status_indicator": "<string>",
"wage_index": 1
},
"pe_gpci": 123,
"pe_rvu_adjusted": 123,
"physician": {
"allowed_phy_payment": 123,
"conversion_factor": 123,
"mp_gpci": 123,
"mp_rvu": 123,
"mp_rvu_adjusted": 123,
"pe_gpci": 123,
"pe_rvu": 123,
"pe_rvu_adjusted": 123,
"pw_gpci": 123,
"total_adjusted_rvu": 123,
"work_rvu": 123,
"work_rvu_adjusted": 123,
"pe_rvu_source": "facility",
"rvu_quarter": 123,
"rvu_source": "postgres",
"rvu_year": 123
},
"policy_rules": [
{
"code": "<string>",
"doc_id": "<string>",
"kind": "<string>",
"pdf_uri": "<string>",
"rule_text": "<string>",
"source_key": "<string>",
"action": "<string>",
"change_type": "<string>",
"discovery_depth": 0,
"effective_from": "<string>",
"license_kind": "public",
"lineage_root_doc_id": "<string>",
"parent_doc_id": "<string>",
"trigger_condition": "<string>"
}
],
"pw_gpci": 123,
"qpp": true,
"reliability": {
"generated_at": "<string>",
"data_sources": {},
"dataset_versions": {},
"degraded": false,
"warnings": [
"<string>"
]
},
"total_adjusted_rvu": 123,
"work_rvu_adjusted": 123
}{
"detail": [
{
"loc": [
"<string>"
],
"msg": "<string>",
"type": "<string>",
"ctx": {},
"input": "<unknown>"
}
]
}Calculate payment for a code
Compose payment for a code at a CCN.
Returns up to four blocks — physician (MPFS), outpatient_facility
(OPPS with wage index), lab (CLFS), and dme (DMEPOS) — populated
based on which fee schedules carry the code.
Logic for each block:
- physician —
allowed = ((work*pw_gpci) + (pe*pe_gpci) + (mp*mp_gpci)) * CFwhereCFis QPP (33.5675) or non-QPP (33.4009) for 2026 andpeis the facility or non-facility PE-RVU based on the CCN’s facility_type. - outpatient_facility —
allowed = (rate*0.6*wage_index) + (rate*0.4)using the FY26 wage index for the facility’s CBSA. - lab — flat CLFS rate (national, no geographic adjustment).
- dme — rural or non-rural rate based on the facility’s
is_ruralflag.
curl --request GET \
--url https://sandbox.rcintell.com/v1/codes/{code}/payment \
--header 'X-API-Key: <api-key>'import requests
url = "https://sandbox.rcintell.com/v1/codes/{code}/payment"
headers = {"X-API-Key": "<api-key>"}
response = requests.get(url, headers=headers)
print(response.text)const options = {method: 'GET', headers: {'X-API-Key': '<api-key>'}};
fetch('https://sandbox.rcintell.com/v1/codes/{code}/payment', options)
.then(res => res.json())
.then(res => console.log(res))
.catch(err => console.error(err));<?php
$curl = curl_init();
curl_setopt_array($curl, [
CURLOPT_URL => "https://sandbox.rcintell.com/v1/codes/{code}/payment",
CURLOPT_RETURNTRANSFER => true,
CURLOPT_ENCODING => "",
CURLOPT_MAXREDIRS => 10,
CURLOPT_TIMEOUT => 30,
CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
CURLOPT_CUSTOMREQUEST => "GET",
CURLOPT_HTTPHEADER => [
"X-API-Key: <api-key>"
],
]);
$response = curl_exec($curl);
$err = curl_error($curl);
curl_close($curl);
if ($err) {
echo "cURL Error #:" . $err;
} else {
echo $response;
}package main
import (
"fmt"
"net/http"
"io"
)
func main() {
url := "https://sandbox.rcintell.com/v1/codes/{code}/payment"
req, _ := http.NewRequest("GET", url, nil)
req.Header.Add("X-API-Key", "<api-key>")
res, _ := http.DefaultClient.Do(req)
defer res.Body.Close()
body, _ := io.ReadAll(res.Body)
fmt.Println(string(body))
}HttpResponse<String> response = Unirest.get("https://sandbox.rcintell.com/v1/codes/{code}/payment")
.header("X-API-Key", "<api-key>")
.asString();require 'uri'
require 'net/http'
url = URI("https://sandbox.rcintell.com/v1/codes/{code}/payment")
http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true
request = Net::HTTP::Get.new(url)
request["X-API-Key"] = '<api-key>'
response = http.request(request)
puts response.read_body{
"code": "<string>",
"conversion_factor": 123,
"applicable_blocks": [
"<string>"
],
"ccn": "<string>",
"date_of_service": "<string>",
"dme": {
"allowed_dme_payment": 123,
"dme_payment_rate": 123,
"is_rural": false,
"rate_used": "non_rural",
"state": "<string>"
},
"estimated_payment": 123,
"facility": {
"ccn": "<string>",
"cbsa": "<string>",
"county": "<string>",
"facility_type": "<string>",
"is_rural": true,
"locality_name": "<string>",
"locality_number": "<string>",
"name": "<string>",
"pos_code": "<string>",
"registered": true,
"state": "<string>",
"wage_index": 123
},
"facility_rate": true,
"lab": {
"allowed_lab_payment": 123,
"lab_payment_rate": 123,
"indicator": "<string>"
},
"locality": "<string>",
"mp_gpci": 123,
"mp_rvu_adjusted": 123,
"outpatient_facility": {
"allowed_fac_payment": 123,
"opps_payment_rate": 123,
"apc_code": "<string>",
"labor_share": 0.6,
"non_labor_share": 0.4,
"relative_weight": 123,
"status_indicator": "<string>",
"wage_index": 1
},
"pe_gpci": 123,
"pe_rvu_adjusted": 123,
"physician": {
"allowed_phy_payment": 123,
"conversion_factor": 123,
"mp_gpci": 123,
"mp_rvu": 123,
"mp_rvu_adjusted": 123,
"pe_gpci": 123,
"pe_rvu": 123,
"pe_rvu_adjusted": 123,
"pw_gpci": 123,
"total_adjusted_rvu": 123,
"work_rvu": 123,
"work_rvu_adjusted": 123,
"pe_rvu_source": "facility",
"rvu_quarter": 123,
"rvu_source": "postgres",
"rvu_year": 123
},
"policy_rules": [
{
"code": "<string>",
"doc_id": "<string>",
"kind": "<string>",
"pdf_uri": "<string>",
"rule_text": "<string>",
"source_key": "<string>",
"action": "<string>",
"change_type": "<string>",
"discovery_depth": 0,
"effective_from": "<string>",
"license_kind": "public",
"lineage_root_doc_id": "<string>",
"parent_doc_id": "<string>",
"trigger_condition": "<string>"
}
],
"pw_gpci": 123,
"qpp": true,
"reliability": {
"generated_at": "<string>",
"data_sources": {},
"dataset_versions": {},
"degraded": false,
"warnings": [
"<string>"
]
},
"total_adjusted_rvu": 123,
"work_rvu_adjusted": 123
}{
"detail": [
{
"loc": [
"<string>"
],
"msg": "<string>",
"type": "<string>",
"ctx": {},
"input": "<unknown>"
}
]
}Authorizations
Path Parameters
Billing or terminology code value (CPT/HCPCS/NDC/etc depending on endpoint context).
Query Parameters
CCN — drives facility-aware composition
Optional HCPCS modifier (e.g. 26, TC, LT)
ISO date — reserved for future fee-schedule versioning
Use QPP conversion factor (True) or non-QPP (False)
0=non-QPP, 1=QPP — overrides qpp when supplied
GPCI locality override (legacy; ignored when ccn is set)
POS code (e.g. 11 office, 22 on-campus outpatient). Pins the facility vs non-facility PE-RVU choice; overrides facility_type/CCN defaults.
Legacy: use facility PE rate when no CCN is supplied
Response
Successful Response
Multi-block payment composition for a HCPCS / CPT code at a facility.
When ccn is provided, the response is composed against the facility's
geography (LOCCO → GPCI, CBSA → wage_index). When omitted, only the
physician block is populated using the supplied locality query
param (legacy GPCI-only behavior).
applicable_blocks lists which sub-blocks have data — drives display
on the consuming UI.
DMEPOS payment — picks rural vs non-rural rate by facility flag.
Show child attributes
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Facility context used to drive payment composition.
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Clinical Lab Fee Schedule payment (national rate, no geographic adjustment).
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OPPS / outpatient hospital facility payment block.
payment = (rate * 0.6 * wage_index) + (rate * 0.4)
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Show child attributes
MPFS payment block — work + PE + MP, GPCI-adjusted, then * conversion factor.
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QPP-participating conversion factor used
User-visible reliability metadata for this payment composition.
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