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Reasonable Charges Data Tables–Outpatient and Professional

Reasonable Charges are based on amounts that third parties pay for the same services furnished by private-sector health care providers in the same geographic area. In the past, VA used average cost-based, per diem rates for billing insurers. Reasonable charges are calculated for inpatient and outpatient facility charges, and for professional or clinician charges for inpatient and outpatient care.

2024 (v5.24)
Reasonable Charges Data Tables, Version 5.24 – Dated January 01, 2024
Table Table Name
C v5.24: Observation Care Facility Nationwide Base and Hourly Charges
D v5.24: Partial Hospitalization Facility Nationwide Per Diem Charge
E v5.24: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v5.24: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v5.24: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v5.24: Professional Anesthesia Nationwide Base Units by CPT Code
I v5.24: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v5.24: Pathology and Laboratory Services Relative Value Units (RVUs)
K v5.24: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v5.24: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v5.24: Charge Adjustment Factors for Professional Services Charge Modifiers
N v5.24: Acute Inpatient Facility Charges GAAFs by Zip Code
O v5.24: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v5.24: Outpatient Facility Charges GAAFs by Zip Code
Q v5.24: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v5.24: Outpatient Dental Professional Charges GAAFs by Zip Code
S v5.24: Professional Services Conversion Factors
2023 (v4.235)
Reasonable Charges Data Tables, Version 4.235 – Dated January 01, 2023
Table Table Name
C v4.235: Observation Care Facility Nationwide Base and Hourly Charges
D v4.235: Partial Hospitalization Facility Nationwide Per Diem Charge
E v4.235: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v4.235: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v4.235: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v4.235: Professional Anesthesia Nationwide Base Units by CPT Code
I v4.235: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v4.235: Pathology and Laboratory Services Relative Value Units (RVUs)
K v4.235: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v4.235: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v4.235: Charge Adjustment Factors for Professional Services Charge Modifiers
N v4.235: Acute Inpatient Facility Charges GAAFs by Zip Code
O v4.235: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v4.235: Outpatient Facility Charges GAAFs by Zip Code
Q v4.235: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v4.235: Outpatient Dental Professional Charges GAAFs by Zip Code
S v4.235: Professional Services Conversion Factors
2022 (v4.225)
Reasonable Charges Data Tables, Version 4.225 – Dated January 01, 2022
Table Table Name
C v4.225: Observation Care Facility Nationwide Base and Hourly Charges
D v4.225: Partial Hospitalization Facility Nationwide Per Diem Charge
E v4.225: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v4.225: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v4.225: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v4.225: Professional Anesthesia Nationwide Base Units by CPT Code
I v4.225: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v4.225: Pathology and Laboratory Services Relative Value Units (RVUs)
K v4.225: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v4.225: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v4.225: Charge Adjustment Factors for Professional Services Charge Modifiers
N v4.225: Acute Inpatient Facility Charges GAAFs by Zip Code
O v4.225: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v4.225: Outpatient Facility Charges GAAFs by Zip Code
Q v4.225: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v4.225: Outpatient Dental Professional Charges GAAFs by Zip Code
S v4.225: Professional Services Conversion Factors
2021 (v4.215)
Reasonable Charges Data Tables, Version 4.215 – Dated January 01, 2021
Table Table Name
C v4.215: Observation Care Facility Nationwide Base and Hourly Charges
D v4.215: Partial Hospitalization Facility Nationwide Per Diem Charge
E v4.215: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v4.215: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v4.215: Physician and Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v4.215: Professional Anesthesia Nationwide Base Units by CPT Code
I v4.215: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v4.215: Pathology and Laboratory Services Relative Value Units (RVUs)
K v4.215: Durable Medical Equipment and Supplies Nationwide Charges by HCPCS Code
L v4.215: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code
M v4.215: Charge Adjustment Factors for Professional Services Charge Modifiers
N v4.215: Acute Inpatient Facility Charges GAAFs by Zip Code
O v4.215: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges GAAFs by Zip Code
P v4.215: Outpatient Facility Charges GAAFs by Zip Code
Q v4.215: Durable Medical Equipment and Supplies GAAFs by Zip Code
R v4.215: Outpatient Dental Professional Charges GAAFs by Zip Code
S v4.215: Professional Services Conversion Factors
2020 (v3.27)
Reasonable Charges Data Tables, Version 3.27 – Dated January 01, 2020
Table Table Name
C v3.27: Observation Care Facility Nationwide Base and Hourly Charges
D v3.27: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.27: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.27: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.27: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.27: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.27: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.27: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.27: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.27: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.27: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.27: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.27: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.27: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.27: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.27: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.27: Professional Services Conversion Factors
2019 (v3.25)
Reasonable Charges Data Tables, Version 3.25 – Dated January 01, 2019
Table Table Name
C v3.25: Observation Care Facility Nationwide Base and Hourly Charges
D v3.25: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.25: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.25: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.25: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.25: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.25: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.25: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.25: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.25: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.25: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.25: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.25: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.25: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.25: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.25: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.25: Professional Services Conversion Factors
2018 (v3.23)
Reasonable Charges Data Tables, Version 3.23 – Dated January 01, 2018
Table Table Name
C v3.23: Observation Care Facility Nationwide Base and Hourly Charges
D v3.23: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.23: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.23: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.23: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.23: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.23: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.23: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.23: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.23: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.23: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.23: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.23: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.23: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.23: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.23: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.23: Professional Services Conversion Factors
2017 (v3.21)
Reasonable Charges Data Tables, Version 3.21 – Dated January 01, 2017
Table Table Name
C v3.21: Observation Care Facility Nationwide Base and Hourly Charges
D v3.21: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.21: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.21: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.21: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.21: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.21: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.21: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.21: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.21: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.21: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.21: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.21: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.21: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.21: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.21: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.21: Professional Services Conversion Factors
2016 (v3.18)
Reasonable Charges Data Tables, Version 3.18 – Dated January 01, 2016
Table Table Name
C v3.18: Observation Care Facility Nationwide Base and Hourly Charges
D v3.18: Partial Hospitalization Facility Nationwide Per Diem Charge
E v3.18: Ambulance and Other Emergency Transportation Charges by HCPCS Code
F v3.18: Outpatient Facility Nationwide Charges by CPT/HCPCS Code
G v3.18: Physician and Other Professional Services Relative Value Units (RVUs) by CPT/HCPCS Code
H v3.18: Professional Anesthesia Nationwide Base Units by CPT Code
I v3.18: Outpatient Dental Professional Nationwide Charges by HCPCS Code
J v3.18: Pathology and Laboratory Services Relative Value Units (RVUs)
K v3.18: Durable Medical Equipment, Supplies, Vision, and Hearing Hardware Nationwide Charges by HCPCS Code
L v3.18: Professional Services Relative Value Unit (RVU) And Conversion Factor Geographic Area Adjustment Factors (GAAFS) By Zip Code
M v3.18: Charge Adjustment Factors for Professional Services Charge Modifiers
N v3.18: Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
O v3.18: Skilled Nursing Facility/Sub-Acute Inpatient Facility Charges Geographic Area Adjustment Factors (GAAFS) By Zip Code
P v3.18: Outpatient Facility Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
Q v3.18: Durable Medical Equipment, Supplies, Vision and Hearing Hardware Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
R v3.18: Outpatient Dental Professional Charges Geographic Area Adjustment Factors (GAAFs) by Zip Code
S v3.18: Professional Services Conversion Factors
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