Every one of 5,000 synthetic Medicare inpatient claims, built on 60 real hospitals' provider records, priced within $1.00 of the CMS Web Pricer, with the largest gap 22 cents, and every claim is published for anyone to check. Health plans can sign in free at cmswebpricer.com, or book a 15-minute call and get up to 50,000 of their own scenario claims priced through a contract model at no charge.

SUGAR LAND, Texas, Nov. 2, 2026 /PRNewswire-PRWeb/ -- Most claim-pricing software asks payers to trust its numbers. PayerParity published all of its numbers.

PayerParity today released a claim-by-claim accuracy test of cmswebpricer.com, its independent Medicare and Medicaid claim pricer, against the CMS Web Pricer, the federal government's own pricing program. All 5,000 inpatient test claims came back within $1.00 of CMS. The largest difference on any claim was 22 cents. The average absolute difference was 2.8 cents.

The test covered $88,981,916 in Medicare inpatient payments. Across all 5,000 claims, the differences from CMS netted to minus $9.64, about one cent for every $92,000 paid.

The test used synthetic claims at 60 real hospitals, half with fiscal year 2026 discharges and half with fiscal year 2027 discharges. Each claim was priced twice, once by cmswebpricer.com and once by the CMS Web Pricer, on the hospital's provider record in force on the discharge date. The set deliberately included the claims pricers most often get wrong: 298 transfers paid at a per diem and 165 cost outliers. Every one matched within $1.00. Each claim, each difference and the full results file are public at cmswebpricer.com/accuracy.

"Health plans should not have to take a pricer's accuracy on faith," said Sanju Chand, chief technology officer of PayerParity. "Every claim and every difference from CMS is public, so anyone can check our work. And we would rather show you on your own scenario than tell you: tell us which claims your current pricer gets wrong, and we will build them and price them."

Why a matching number matters to a health plan

A few dollars of drift per claim becomes real money across a year of inpatient volume, and an overpayment is far harder to recover when no one can show how the price was reached. A price that matches CMS, with the math shown, is one a payer can pay, defend in a provider dispute and audit later.

One claim, priced every way a payer needs

cmswebpricer.com is built for health plan pricing, provider contracting and payment-integrity teams. On a single inpatient claim it shows, side by side:

• Original Medicare: the full CMS calculation, including DRG, wage index, add-ons, transfer rules and outlier
• Medicare Advantage: what the plan owes the same hospital out of network
• The contract: percent-of-Medicare, case-rate, stop-loss and outlier terms, compared dollar for dollar with Medicare on the same claim
• Medicaid: inpatient pricing in six states (New York, Texas, Colorado, Virginia, Washington and Maryland)

Beyond inpatient, the same tool prices Medicare skilled nursing, home health, outpatient, professional and anesthesia claims, and includes a DRG grouper and a side-by-side check against CMS, on current fiscal year 2027 rates. The published accuracy test covers inpatient claims.

Every price comes with its worksheet: each factor, each step and each dollar, so a reviewer, an auditor or a provider can see exactly how the payment was reached. No black box.

The offer: your scenario, up to 50,000 claims, free

Health plan teams can sign in free at cmswebpricer.com with a work email and start pricing.

Teams that want proof on their own volume can book a 15-minute call. PayerParity will then build a realistic test set of up to 50,000 claims matched to the plan's hospitals and scenario, adjust charges as the plan specifies, run every claim through the plan's contract terms and return detailed pricing for each claim, at no charge and with no contract required. No PHI, claims data or business associate agreement is needed to start.

Book a call or sign in at cmswebpricer.com, or email info@payerparity.com.

cmswebpricer.com is an independent tool. It is not affiliated with, endorsed by or operated by CMS or any government agency, and its estimates are not a claims determination.

About PayerParity

PayerParity builds transparent claim pricing, grouping and payment-integrity tools for health plans and the teams that review hospital payments, including cmswebpricer.com, drgcalculator.com and drgpricer.com. Every price shows its math. The company is based in Sugar Land, Texas.

Media Contact

Media Relations, PayerParity, 1 2816257695, info@payerparity.com, https://cmswebpricer.com

View original content to download multimedia:https://www.prweb.com/releases/payerparity-publishes-5-000-claim-test-against-the-cms-web-pricer-every-inpatient-claim-within-1-00--largest-gap-22-cents-302926032.html

SOURCE PayerParity