Optum

Optum Code Fee API

The Code Fee API from Optum — 4 operation(s) for code fee.

Documentation GitHub OpenAPI

Operations 4

GET /codetype/{codetype}/{code}/mpfs List of Medicare Localities and links to them. This can be used to get MPFS data #

GET /codetype/{codetype}/{code}/mpfs/{carrier-locality}/non-facility Return all Medicare Physician non facility Fees #

GET /codetype/{codetype}/{code}/mpfs/global-info Return all Medicare Global information for the supplied {code} #

GET /codetype/{codetype}/{code}/mpfs/{locality} Links to data available for the locality #

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OpenAPI Specification

openapi: 3.2.0
info:
  title: Optum Real-Time eContent Web services Code Fee API
  description: Optum® Real-Time eContent web services provides access to both ondemand medical coding data and Optum coding tool logic required by your applications. The information you or your clients need is delivered to your application in real time, when you need it, and customized to how you want it displayed. Optum Real-Time eContent service provides access to the content of 37 printed coding resources and proprietary data and offers the power of the Optum CodeLogic™ search engine.
  contact:
    name: Ken Kracker
    email: ken.kracker@optum.com
  version: 1.0.0
servers:
- url: sandbox-apigw.optum.com/ci/rtec/v1/ws
security:
- bearerAuth: []
tags:
- name: Code Fee
paths:
  /codetype/{codetype}/{code}/mpfs:
    get:
      tags:
      - Code Fee
      summary: List of Medicare Localities and links to them. This can be used to get MPFS data
      operationId: getCarriers
      parameters:
      - name: codetype
        in: path
        description: The codetype needed to identify the type of code
        required: true
        schema:
          type: string
          enum:
          - cpt
          - hcpcs
      - name: code
        in: path
        description: The code value for the respective codetype
        required: true
        schema:
          type: string
        example: 13100
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
              - href: /ws/codetype/cpt/13100/mpfs/global-info
                value: Medicare Global Information
              - href: /ws/codetype/cpt/13100/mpfs/00000-00
                value: NATIONAL
        '400':
          description: Wrong codetype
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error:
                - The code provided ('250.02') in this web service request is not a valid 'cpt' code.
                warning: []
                info: []
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: Modifiers not found for the code entered
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error:
                - Code '13104' does not exist
                warning: []
                info: []
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
  /codetype/{codetype}/{code}/mpfs/{carrier-locality}/non-facility:
    get:
      tags:
      - Code Fee
      summary: Return all Medicare Physician non facility Fees
      operationId: getFee
      parameters:
      - name: code
        in: path
        description: The code value for the respective codetype
        required: true
        schema:
          type: string
        example: 13100
      - name: codetype
        in: path
        description: The codetype needed to identify the type of code
        required: true
        schema:
          type: string
          enum:
          - cpt
          - hcpcs
      - name: carrier-locality
        in: path
        description: The carrier-localty value
        required: true
        schema:
          type: string
        example: 00000-00
      - name: types
        in: query
        description: 'Comma seperated list of<UL> <LI>fee : Medicare Physican fees (default)</LI><LI>rvu : Medicare Physician RVUs</LI></UL>'
        schema:
          type: string
          default: fee
        example: fee,rvu
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                mpfsFee:
                  global: '352.98'
                mpfsRvu:
                  global:
                    totalRvu: '10.2000'
                    workRvu: '3.0000'
                    peRvu: '6.8500'
                    mpRvu: '0.3500'
        '400':
          description: Wrong codetype
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error:
                - The code provided ('250.02') in this web service request is not a valid 'cpt' code.
                warning: []
                info: []
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: Carrier/Locality length is incorrect
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error: []
                warning: []
                info:
                - Carrier/Locality length is incorrect. Please use the Carriers web service to check your entry.
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
  /codetype/{codetype}/{code}/mpfs/global-info:
    get:
      tags:
      - Code Fee
      summary: Return all Medicare Global information for the supplied {code}
      operationId: getGlobal
      parameters:
      - name: code
        in: path
        description: The code value for the respective codetype
        required: true
        schema:
          type: string
        example: G0168
      - name: codetype
        in: path
        description: The codetype needed to identify the type of code
        required: true
        schema:
          type: string
          enum:
          - hcpcs
          - cpt
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                preoperative: '0.10'
                intraoperative: '0.80'
                postoperative: '0.10'
                global: '010'
        '400':
          description: Wrong codetype
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error:
                - The code provided ('250.02') in this web service request is not a valid 'cpt' code.
                warning: []
                info: []
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: The requested resource does not exist
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error:
                - The requested resource does not exist.
                warning: []
                info: []
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
  /codetype/{codetype}/{code}/mpfs/{locality}:
    get:
      tags:
      - Code Fee
      summary: Links to data available for the locality
      operationId: getMpfsLinks
      parameters:
      - name: codetype
        in: path
        description: The codetype needed to identify the type of code
        required: true
        schema:
          type: string
          enum:
          - cpt
          - hcpcs
      - name: code
        in: path
        description: The code value for the respective codetype
        required: true
        schema:
          type: string
        example: 13100
      - name: locality
        in: path
        description: The value for locality
        required: true
        schema:
          pattern: '[0-9][0-9][0-9][0-9][0-9]-[0-9][0-9]'
          type: string
        example: 10102-00
      responses:
        '200':
          description: Successful Response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
              - href: /ws/codetype/cpt/13100/mpfs/10102-00/non-facility
                value: Medicare Physician Fees/RVUs
        '400':
          description: Wrong codetype
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error:
                - The code provided ('250.02') in this web service request is not a valid 'cpt' code.
                warning: []
                info: []
        '401':
          description: Not Authorized
          content:
            application/json:
              example:
                timestamp: '2022-07-06T16:34:39.385Z'
                error: Unauthorized
                status: 401
        '404':
          description: Code {code} does not exist
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Modifiers'
              example:
                error:
                - Code '13104' does not exist
                warning: []
                info: []
        '405':
          description: Method Not Allowed - Request method not supported
          content:
            application/json:
              example:
                timestamp: '2022-07-07T15:28:34.152Z'
                status: 405
                error: Method Not Allowed
        '503':
          description: Service Unavailable
components:
  schemas:
    Links:
      type: object
      properties:
        link:
          type: array
          xml:
            name: Link
          items:
            $ref: '#/components/schemas/Link'
    Link:
      type: object
      properties:
        href:
          type: string
          xml:
            attribute: true
        value:
          type: string
    Modifiers:
      type: object
      properties:
        physician:
          $ref: '#/components/schemas/Links'
        facility:
          $ref: '#/components/schemas/Links'
        opps:
          $ref: '#/components/schemas/Links'
        mpfs:
          $ref: '#/components/schemas/Links'
        asc:
          $ref: '#/components/schemas/Links'
        ambulance:
          $ref: '#/components/schemas/Links'
        dme:
          $ref: '#/components/schemas/Links'
      xml:
        name: modifiers
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
    ws_auth:
      type: oauth2
      flows:
        authorizationCode:
          authorizationUrl: https://idx.linkhealth.com/auth
          tokenUrl: https://idx.linkhealth.com/auth/token
          scopes:
            scope-1: required scope for API access
x-readme:
  explorer-enabled: true
  proxy-enabled: true