How we source, verify, and update every data point on this site
Medical billing is a YMYL (Your Money or Your Life) topic where data accuracy is not optional. This page documents the primary sources we use, the review process behind curated content, and the cadence on which the underlying data refreshes.
Where the data comes from
Every data point on the code, denial, fee, and specialty pages traces to one of these primary sources. Click through to verify any value.
CMS Medicare Physician Fee Schedule (PFS)
RVU values, conversion factor, payment rates, status indicators, and global periods are sourced from the current CMS PFS Final Rule. Updated annually with each calendar year rule release plus quarterly modifier updates.
National Correct Coding Initiative (NCCI) Edits
Procedure-to-Procedure (PTP) bundling edits and Medically Unlikely Edits (MUE) are sourced from the CMS NCCI quarterly file. Refreshed each quarter on the publication date.
American Medical Association (AMA) CPT Code Set
CPT codes and short descriptors are sourced from the AMA CPT code set. Long descriptors are AMA-copyrighted and not redistributed; we link to the AMA CPT manual for full definitions.
X12 Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC)
CARC and RARC code descriptions are sourced from the X12 N standards. These are the standard adjustment reason codes used by payers across all electronic remittance advice.
ICD-10-CM (Public Domain)
ICD-10-CM diagnosis code descriptions are public domain via the CDC and CMS. Updates are applied annually on October 1.
MGMA Benchmarks and Reports
Industry benchmarks for denial rates, claim rework costs, and revenue cycle KPIs are referenced from MGMA published reports where applicable.
OIG Work Plan and CMS CERT Reports
Audit risk patterns and compliance focus areas are referenced from the HHS OIG Work Plan and CMS Comprehensive Error Rate Testing program reports.
How we verify and refresh content
Source Verification
Every data point published on this site traces to a primary source listed above. We do not aggregate from secondary sources or scrape competitor sites.
AAPC-Certified Review
Curated content (the 35+ enriched CPT codes, the top 6 CARC codes, the 40 specialty billing guides, the cornerstone blog articles) is reviewed by AAPC-certified medical coders before publication and on each refresh.
Quarterly NCCI Updates
Bundling edits and MUE values refresh on the CMS NCCI quarterly publication schedule. Our database mirrors the current quarter file.
Annual PFS Refresh
RVU values, conversion factor, and payment rates refresh with each CMS PFS Final Rule. The 2026 Conversion Factor is $33.4009.
Editorial Independence
Our editorial content is independent of payer relationships. We do not accept payment from CMS, MACs, commercial payers, or industry vendors in exchange for content placement.
Who reviews this content
Curated content on this site is reviewed by AAPC-certified medical coders with active credentials. The Editorial Team is part of the Go Medical Billing operations team that handles billing for hundreds of physician practices across all 50 states.
Active Credentials Held by the Editorial Team
- AAPC CPC (Certified Professional Coder)— the primary credential for outpatient medical coding accuracy.
- AAPC specialty credentials across cardiology (CCC), orthopedic surgery (COSC), gastroenterology (CGSC), and other specialty-specific certifications.
- HIPAA compliance training with annual refresh.
- Continuing Education Units (CEUs) on annual AAPC and CMS updates, including the annual PFS Final Rule and quarterly NCCI changes.
Corrections Policy
If you find a factual error on any page of this site, please report it. We acknowledge correction requests within 5 business days and publish corrections with a visible note on the affected page.
Email corrections to editorial@gomedicalbilling.com with the page URL, the specific text in question, and the source supporting the correction.
Important Disclaimers
CPT codes and descriptors are copyright of the American Medical Association. We display short descriptors that are legally redistributable; full long descriptors are available in the current AMA CPT manual.
Medicare payment values displayed on this site are calculated from the current published CMS Physician Fee Schedule and Geographic Practice Cost Index. Actual payment varies by Medicare locality and is subject to sequestration and other adjustments not reflected in our displayed values.
Commercial payer rates vary by contract and are not displayed on this site. Practices should refer to their individual payer contracts for actual commercial reimbursement amounts.
Coding and billing guidanceon this site reflects our interpretation of CMS, NCCI, and AMA published guidance as of the page’s last update. Coding decisions are clinical judgments that require chart documentation specific to each encounter. Nothing on this site constitutes legal, compliance, or audit-defense advice.
Industry statistics referenced in our content (denial rates, rework costs, recovery percentages) are sourced from MGMA, Change Healthcare, OIG, and CERT published reports where attributed. Practice-specific results vary based on payer mix, specialty, workflow maturity, and other factors.
Have a question about our data or methodology?
Email editorial@gomedicalbilling.com or use our contact form. We respond to methodology questions within 5 business days.