1. Go to https://www.cms.gov/Medicare/MedicareFeeforServicePayment/PhysicianFeeSched/PFSRelativeValueFiles.html. 
2. Select a time period. The latest data will have the most recent year and highest letter: for example, the first fee schedule for any calendar year is "A," with subsequent fee schedules for the same year being marked "B," "C," and so on. 

3. Click to download the file (e.g. RVU18D.zip) 

4. In the zip file, there are several Excel files. First open the LOCCO Excel file (e.g. 18LOCCO.xls.) 

5. Find the carrier code and location code that correspond to your state and city/county region. In this example, let's look for Knoxville, Tennessee. Tennessee has a single carrier/location code pair: 10312 and 35. 

6. Next, open the GPCI Excel file (e.g. GPCI2018.xls) in the zip file. 

7. In the GPCI file, find your carrier and location code. Then make a note of the three Geographic Practice Cost Indicators for your location: physician work (PW GPCI), practice expense (PE GPCI), and malpractice (MP GPCI). In our example, the indicators for Tennessee’s sole locality are 1.000, 0.901, and 0.526, respectively.
You may close the GPCI file. 

8. Now, open the RVU file (e.g. PPRRVU18_OCT.xls.) I recommend that you make a Save As copy, e.g. “My Medicare Fee Schedule 2018 – D.xlsx.” 

9. Add two new columns to the file. Hover over the Column F column header, rightclick, and choose Insert. A new column will appear. Repeat for a second new column. 

10. Label your two new columns Payment (nonfacility) and Payment (facility). 

11. Optional: Hide rows that will not be valued on by this fee schedule. There are over 16,000 rows on this spreadsheet, many of which are zerovalued on this particular spreadsheet (indicating they are priced elsewhere.) The more useful data may get lost, so you can temporarily filter out the rows you don't think you need. For example, you can hide everything that has a practice expense factor of zero. To do this, first type CtrlA to select all rows. Then in the Data tab, under Sort & Filter, click Filter. Click the filtering arrow under the Column I header. In the dropdown, remove the check box next to 0.00, then click OK. You can always remove this filter later if you want to see everything again. 

12. Now, create the nonfacility formula. First find the row index for the first row of data. In this example, the first medical service listed is G0101, located in row 1366. 

13. In that row, find the Excel coordinates of four cells: the first row's Work RVU, the first row's NonFacility PE RVU, the first row's Malpractice (MP) RVU, and the first row's Conversion (Conv) Factor. In this example, these are found in cells H1366, I1366, M1366, and AA1366, respectively. 

14. In the first Payment (nonfacility) cell (here, F1366), enter a formula based on the following construction:
=ROUND(((row's Work RVU cell * PW GPCI)+(row's Non Facility PE RVU cell * PE GPCI)+( row's Malpractice RVU cell * MP GPCI)) * row's Conversion Factor),2)
Or in this example:
=ROUND(((H1366*1)+(I1366*0.901)+(M1366*0.526))*AA1366,2) 

15. Press Enter, and a value should appear in F1366. 

16. Now you can copy/paste this formula down all of column F. Click in cell F1366. Then type CtrlC to copy the formula in F1366. Then click and drag to the bottom of the column, and type CtrlV. You should now see the formula's result in every row. 

17. Create the Payment (facility) formula in a similar manner. In the first Payment (facility) cell (here, G1366), enter a formula based on the following construction:
=ROUND(((row's Work RVU cell * PW GPCI)+(row's Facility PE RVU cell * PE GPCI)+( row's Malpractice RVU cell * MP GPCI)) * row's Conversion Factor),2)
Or in this example:
=ROUND(((H1366*1)+(K1366*0.901)+(M1366*0.526))*AA1366,2) 

18. Copy/paste the formula down through column G. 

19. Be sure to save your work! 