The Medical Cost tool now includes outpatient and treatment costs. This expansion can help case managers, actuaries, and evaluators compare costs to national benchmarks.
Now you can use CPT codes to explore procedure expenses, determine price drivers, and make cost-informed decisions.
The MDGuidelines Medical Cost Tool provides cost information for inpatient and outpatient healthcare services. Users can explore costs by diagnosis codes (ICD-10) or procedure codes (CPT) to understand typical expenses and compare them to national benchmarks. The tool can help you identify high-cost diagnoses and procedures, benchmark costs against national averages, understand cost variation across medical services, support claim reviews and healthcare decision-making, and inform reserve-setting and financial planning activities. Check out the resources below for more information.

Review Frequently Asked Questions about the Medical Costs tool.

Watch a short training video showcasing the inpatient and outpatient cost sections of the Medical Costs tool.

Access the Medical Costs User Guidebook for feature descriptions and best practices for using the tool effectively.