Pull your territory's Medicare data yourself

Every provider who bills traditional Medicare shows up in public data: who they are, what codes they bill, how often, and what Medicare pays them. This guide shows you how to get at it with nothing but a browser and a spreadsheet.

By Bill Thompson · Six years in medical device sales · Updated July 2026

Why this data exists, and why almost no rep uses it

CMS publishes yearly summaries of everything providers bill to traditional Medicare. It's aggregate billing data with no patient information in it, which is why it's legal, public, and free. Compliance teams at the big data companies build entire products on top of these exact files.

Here's the part that matters to you: the companies that resell this data price it for the home office, not for you. So the rep doing the actual driving either gets a quarterly spreadsheet from an analyst, or gets nothing and runs on Google and gut feel.

You don't need anyone's permission. The raw files are a browser tab away.

The three datasets that matter

All three live at data.cms.gov. Search each one by its exact name.

One row in these files is one provider, one code (or drug), one year. That's exactly the shape a call list wants.

The walkthrough: from a code to a ranked call list

Say your product rides on HCPCS 20610 (major joint injection) and your territory is Montana. Same steps work for any code and state.

1. Go to data.cms.gov and search "Medicare Physician & Other Practitioners, by Provider and Service." Open the latest year.
2. Open the data viewer. Look for the "View data" or "Filter" option on the dataset page. Don't download the full file, it's gigabytes. The viewer lets you filter first and export only what you need.
3. Add two filters: HCPCS_Cd equals your code, and Rndrng_Prvdr_State_Abrvtn equals your state.
4. Sort by Tot_Srvcs descending. You are now looking at every provider in your state who billed that code to Medicare that year, ranked by volume. Read that sentence again.
5. Export the filtered rows as CSV and open it in Excel or Google Sheets.

The columns worth your attention

Two upgrades once the basics work

• Trend. Pull the same filter from the prior year's dataset and match on NPI. Who's growing? Who just billed your code for the first time? A new biller is a door that just opened.
• Contact info. Drop any NPI into the official registry at npiregistry.cms.hhs.gov and you get the practice address and phone number on file.

The honest limits

I'd rather you hear this from me than from a physician mid-call:

• Traditional Medicare only. No Medicare Advantage, no commercial insurance, no cash. If a provider skews heavily MA or commercial, their real volume is bigger than these numbers show.
• Small counts are hidden. Any provider-code combination with fewer than 11 Medicare patients in a year is suppressed entirely. Low-volume billers won't appear at all.
• It lags. Figures show up roughly a year and a half after the care happens. You're reading a very detailed map, not a live feed.
• DME runs a year behind the other two datasets.

Why it's still the best prospecting data most reps will ever touch: new and Medicare-heavy products live exactly here. Private payors rarely cover a brand-new device; Medicare typically does once it's cleared and meets payment criteria. The slice of the market this data covers is the slice you prospect first.

The honest pitch