Is your hospital bill actually fair?

Your patient-responsibility amount is compared against the Medicare reimbursement rate for the same CPT code (or service category if you don't have a code). A score of 95–100 means your bill is at or near a fair benchmark (~1.2× Medicare). 60–94 means above-average but within commercial-insurance norms. 30–59 means overcharged (2.5×–4× Medicare). Below 30 means severely overcharged (>4× Medicare).

From the CMS Physician Fee Schedule and Hospital Outpatient Prospective Payment System, both publicly available federal data. The rates baked into this calculator are 2026 national averages for the most common CPT codes. Your local rate may vary 10–25% by region; the calculator uses national averages as the benchmark.

No. This is an educational orientation tool. The Fairness Score is a directional indicator, not a definitive valuation. For a personalized statute-cited dispute letter, use the Medical Bill Dispute Tool. For complex bills referred to collections or in active litigation, consult a licensed attorney.

No. The calculation runs entirely in your browser. Your bill amount, ZIP code, and CPT code are never sent to any server. The only data we receive is your email, and only if you choose to subscribe to the free checklist after seeing your results.

The calculator uses category-level Medicare averages as a fallback (ER visit, imaging, lab, primary care, specialist, outpatient surgery). Category fallbacks are less precise than CPT-specific lookups but still give a reasonable orientation. The full Medicare Physician Fee Schedule has 10,000+ codes; the most common 40 or so are baked in here, which covers the majority of consumer-billed services.