Editorial & Corrections Policy

How Pages Are Produced

PlainProcedure's procedure, state, and hospital pages are generated from documented public datasets — principally the CMS Medicare Physician & Other Practitioners dataset (2023). We load CMS's published files into a structured database and render each page from that database. The figures you see — average Medicare payment, average submitted (billed) charge, the markup ratio between them, and per-state breakdowns — are computed directly from CMS's numbers, not hand-typed and not invented by us.

This is a data-publishing model: one template renders thousands of pages so every procedure and state is covered consistently. The editorial work goes into the data pipeline, the methodology, and the written guides — not into hand-authoring near-identical pages, which would add no accuracy and invite inconsistency.

How the Commercial & Cash Estimates Are Derived

CMS publishes what Medicare pays and what providers submit, but not what commercial insurers or self-pay patients actually pay. Where we show an estimated commercial or estimated cash price, that figure is derived, not observed: we apply published commercial-to-Medicare price ratios (based on the RAND Corporation's hospital price studies) to the Medicare allowed amount. These are clearly labeled as estimates throughout the site. They are useful as order-of-magnitude benchmarks, not as a quote for any specific patient, insurer, or facility.

Sourcing Standards

• Primary sources only. Payment and charge figures come from CMS's published Medicare datasets. Hospital details come from CMS Hospital Compare. Our methodology names each dataset and its vintage.
• Attribution in context. Each data page names its dataset and reference year near the figures, and links to the methodology.
• Derived values are labeled. The markup ratio and the commercial/cash estimates are presented as our analysis of CMS data, distinct from CMS's published payment and charge amounts.
• No invented data. Where a value is unavailable for a procedure or state, the page says so rather than filling the gap with a guess.
• Artifacts excluded from typical figures. A small number of drug- and vaccine-administration codes carry near-zero Medicare payments, which produces extreme markup ratios that are division artifacts rather than meaningful markups. We exclude these from "typical markup" figures and say so where they appear.

Update Cadence

CMS releases the Medicare Physician & Other Practitioners dataset annually, roughly a year in arrears. We refresh our database when each new release is published and recompute the derived figures. Between annual releases the numbers are stable because the source itself does not change. The reference year (currently 2023) is shown on the data pages and in the methodology.

Corrections Process

If a figure on PlainProcedure looks wrong, please tell us. Because our pages are generated from CMS data, a genuine error almost always traces back to either the source data or our processing of it — so this is how we handle a report:

1. Report. Email us through the contact page with the page URL and the number that looks off.
2. Verify. We compare the figure against the CMS source data for that procedure, state, and year.
3. Fix at the source. If the value is wrong on our side, we correct it in the database and pipeline that generate the page — not just on the single page — so every affected page is fixed at once. If the figure faithfully reflects CMS's published data, we explain that and add context where useful.
4. Note it. Material corrections are reflected the next time the page rebuilds, with the data reference year shown so you can see which release a page is based on.

We aim to acknowledge data-error reports within a few business days.

Editorial Independence

PlainProcedure is an independent publisher and is not affiliated with CMS, Medicare, or any government agency, hospital, or insurer. Our guides and analysis are not influenced by advertisers; advertising, where present, is clearly distinguishable from editorial content and never determines which procedures, prices, or rankings we show. Our rankings are computed mechanically from CMS figures, so no provider or state can pay to move up a list.

Appropriate Use

PlainProcedure is for general informational purposes only and does not constitute medical, financial, billing, or legal advice. Medicare payments are a national benchmark, and the commercial and cash figures are estimates — not a quote for any specific procedure, provider, or insurance plan. What you actually owe depends on your coverage, your provider's negotiated rates, and your individual circumstances. For decisions about your care or a specific bill, confirm prices with your provider and insurer and consult a qualified professional.