2020 Customized Fee Analyzer Data File (All Codes)

Optum360 | 2020 | Nichole VanHorn; Kristin Bentley


Customized Fee Analyzer provides physicians with percentiles of physician charge data for their geographic area and the CPT® codes most frequently used in their specialty. Under-priced fees can cost a practice thousands of dollars each year. To set the most appropriate fees, you need specific information for your geographic locality, as fees vary widely across the country. Relying on national averages can result in reimbursement that is too low or billed charges that are too high.
  • Seven reference points of charge data (50th, 60th, 75th, 80th, 85th, 90th and 95th). Perform competitive analyses with confidence and help make more accurate adjustments of charges. 

  • Real-life claims from the FAIR Health database of over 1.2 billion current charge records. Develop and help maintain competitive fees while having defensible data during contract negotiations.

  • Follow-up days listed by procedure.  Quickly identify the number of days a physician is responsible for services under a CPT® code. 

  • Professional (PC) and technical (TC) component splits of global services for all CPT® codes.  Estimate allocation and reimbursement for the physician and technical portion of a specific service.

  • Available by specialty or for all CPT® codes. Data for the codes applicable to your specialty with a one- or two-specialty order or for all CPT® codes. (Anesthesia codes not included.)

  • Printed book or data file. Choose from two format options.

    CPT is a registered trademark of the American Medical Association.

Nichole VanHorn, CPC, CCS-P

Ms. VanHorn has more than 15 years of experience in the health care profession. Her areas of expertise include CPT© and ICD-9-CM coding in multiple specialties, auditing, and education. Most recently she served as Clinical Auditor for the Children’s Hospital Physicians at Blank Children’s Hospital, Des Moines, Iowa where she functioned as an auditor for a multi-specialty group. Ms. VanHorn was responsible for the oversight of the physician coding and education section of the Corporate Compliance Program. She has been an active member of her local American Academy of Professional Coders chapter for several years and served as an officer.

Kristin Bentley, CPC

Ms. Bentley has 10 years of experience in the health care profession. She has an extensive background in professional component coding, with expertise in radiation therapy, chemotherapy, radiology, and ambulatory surgery procedure coding. She has conducted chart-to-claim audits and physician education. Ms. Bentley has functioned as a billing specialist and has extensive denial management experience. She is an active member of the American Academy of Professional Coders.