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Table 1 Reference Files

From: Developing a standardized healthcare cost data warehouse

File Source File Name
Physician Services https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/Clinical-Laboratory-Fee-Schedule-Files.html http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/How_to_MPFS_Booklet_ICN901344.pdf PPRVUYY_VMMDD csv, txt, or xlsx RVUPUFYY.docx
Clinical laboratory http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/clinlab.html CLABYYYY.EffJan1.Full plus CLABYYYY.EffMMM.XCodes if available csv, txt, or xlsx
DMEPOS http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html DMEYYYY MMM csv, txt, or xlsx
Parenteral and enteral nutrition items and services http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html DMEYYYY MMM PEN PUF csv, txt, or xlsx
Part B drug average sales price http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/index.html ASP pricing files csv or xlsx
Gap codes https://www.optum360coding.com/Category/100037/100197/ (Optum360, Inc)  
Modifiers https://www.wpsgha.com/wps/portal/mac/site/claims/guides-and-resources/modifiers/ By modifier
Anesthesia conversion factors http://www.cms.gov/Center/Provider-Type/Anesthesiologists-Center.html Conversion factors
Anesthesia base units http://www.cms.gov/Center/Provider-Type/Anesthesiologists-Center.html Base units
Cost to charge ratiosa ResDAC: http://www.resdac.org/media/calculating-cost-cost-charge-ratios  
UB revenue code by line Internal list mapped for each institution  
Inflation factors http://www.bea.gov/iTable/iTable.cfm?ReqID=9&step=1#reqid=9&step=3&isuri=1&903=13 Table 1.1.9. Implicit Price Deflators for Gross Domestic Product
Impute rates Internally calculated on a year-to-date basis for every service year for each institution  
  1. Abbreviations: DMEPOS Durable medical equipment, prosthetics/orthotics and supplies, ResDAC Research Data Assistance Center, UB uniform billing
  2. aCost to charge ratios are calculated from cost center costs and charges