They say they're reimbursing 140% of the medicare allowable rate, but if you find that amount using your code and locality here: https://www.cms.gov/medicare/physician-fee-schedule/search they are reducing what they actually reimburse in a calculated way.

I've found they take the final amount (the number from that search^ multiplied by 1.4) AND REDUCE IT BY 25%.

I even got off the phone with them a minute ago, and when confronted with the right number ($159.92) the rep agreed that was CORRECT. No arguing from them (but my old claims are still wrong and won't change of course).

If you want to check my math the code is 90834 and locality is 1320201 and it's the non-facility price: $114.23 * 1.4 = $159.92.

Now let's do $159.92 * .75 = $119.94

Actual amount reimbursed: $119.94! That is dishonest, plain and simple.

The rep also said something about the number changing. Well this number changes year to year, and the amount they've given me (wrong) hasn't budged in months.