About PlainProcedure

Our Mission

We believe that healthcare pricing should not be a mystery. PlainProcedure exists to make medical procedure costs transparent, searchable, and understandable for every American. When patients can see what Medicare actually pays versus what providers charge, they gain the knowledge they need to ask better questions and make informed decisions about their care.

Why we built this: the gap between what hospitals bill and what insurers pay is one of the most opaque areas of the US economy. Government data that could illuminate this gap has been publicly available for years, but it is buried in massive CSV files that few people have the tools or time to explore. PlainProcedure bridges that gap by transforming raw CMS datasets into an accessible, modern research tool.

Our philosophy is simple: present the data faithfully, let users draw their own conclusions, and never editorialize the numbers. We serve patients researching procedure costs, journalists investigating healthcare pricing, policy researchers studying payment variation, and anyone who wants to understand where their healthcare dollars go.

Data Sources

All data comes directly from the Centers for Medicare & Medicaid Services (CMS), the federal agency that administers Medicare and publishes provider-level payment data. Our primary data source is the CMS Medicare Physician & Other Practitioners dataset for 2023. This includes:

9,297 procedures: Every CPT/HCPCS code billed to Medicare, with national and state-level pricing
5,426 hospitals: CMS Hospital Compare data including quality ratings and emergency services
162,808 providers: Individual Medicare providers with their procedure volumes and charges
198,292 state-level price records: How procedure costs vary across 56 states and territories

We also incorporate CMS Hospital Compare data to provide hospital quality ratings, bed counts, ownership type, and emergency service availability. All source data is downloaded directly from data.cms.gov and processed without modification to the underlying payment figures.

Methodology

Our approach to processing CMS data prioritizes fidelity and transparency. We download raw datasets from data.cms.gov, validate file integrity, and load them into a structured database through our ETL pipeline. No data is modified, interpolated, or editorialized. Medicare payment amounts reflect the actual average amounts paid by Medicare for each procedure. Submitted charges reflect what providers bill (their "chargemaster" rates).

For every procedure, we calculate the markup ratio between submitted charges and Medicare payment amounts, revealing how much provider list prices diverge from what Medicare actually pays. Hospital profiles are enriched with CMS Hospital Compare quality ratings. Provider-level records show individual procedure volumes and charges. All payment figures represent actual Medicare-reported averages, not estimates or projections.

Medicare Payment: What Medicare actually pays the provider, based on the procedure code and geographic adjustment factor. Submitted Charge: What the provider bills (their list price), typically much higher than what insurers pay. Markup: The ratio between submitted charge and Medicare payment — a 3.0x markup means the billed charge is three times the Medicare rate.

Data Freshness and Update Schedule

CMS releases updated Medicare provider data annually, typically in the spring. Our current database reflects the 2023 data year, which is the most recent complete dataset available from CMS. We update our database within weeks of each new CMS data release to ensure data currency across all procedure, provider, and hospital records.

Hospital Compare quality ratings are updated on a separate schedule by CMS. When new quality rating data becomes available, we incorporate it into our hospital profiles. The last updated date for each data dimension is tracked in our ETL pipeline metadata to ensure transparency about data vintage.

Editorial Independence

Content on PlainProcedure is compiled by our editorial team. Raw data from CMS, HHS, CDC, FDA, and HRSA is transformed into readable profiles by our continuous editorial pipeline, validated against the source before publication. The PlainProcedure editorial team, operating under Kiznis Studio, is responsible for editorial standards, methodology, and corrections.

We do not accept payment, sponsorship, or promoted placement from providers, hospitals, manufacturers, or any healthcare entity. Our only revenue source is contextual display advertising served by Google AdSense — advertisers do not influence which entities we cover or how we present data, and they do not receive preferential placement.

Limitations and Disclaimer

This site is for informational purposes only and does not provide medical advice. The data presented comes from government sources and is not a substitute for professional medical consultation. Important caveats to understand when using this data:

Medicare payment data represents averages — your actual costs may differ based on your insurance, provider, and specific circumstances
Submitted charges (list prices) rarely reflect what privately insured patients actually pay
Not all procedures are covered by Medicare, so some specialized procedures may be absent
Geographic variation in payments reflects CMS geographic adjustment factors, not necessarily differences in care quality
Provider counts and volumes reflect Medicare billing only and do not capture a provider's full practice

PlainProcedure is not affiliated with CMS, Medicare, or any government agency. We are an independent data portal providing public information in a more accessible format. Always consult your healthcare provider and insurance company for actual pricing information relevant to your situation.

Contact

For questions, feedback, or data correction requests, email us at hello@plainprocedure.com. We welcome reports of data discrepancies and suggestions for improving the site. Our goal is to make this resource as accurate and useful as possible for patients, researchers, and the public.