Procedures

What Medicare pays, and what you get billed

The 250 procedures Medicare pays for most often. What providers billed. What Medicare allowed. How far apart they sit.

8,704Procedures tracked
240,266State-level rows
11.2xWidest billed vs allowed
Whose price this is

These are Medicare figures. The billed column is what providers asked for. The allowed column is what Medicare agreed to pay. Neither is what an uninsured patient gets charged, and neither is what a private insurer negotiates.

The gap between the two columns is the point. A hospital billing three times what Medicare allows tells you the billed number was never a price. It was an opening position.

Most billed procedures

ProcedureCodeBilledMedicare allowedGapServices
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more99214$274.90$117.362.3x103,737,268
Ground mileage, per statute mileA0425$26.41$9.462.8x98,923,627
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more99213$188.37$83.792.2x69,283,490
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes97110$69.14$22.793.0x64,224,019
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelledP9603$1.74$1.081.6x49,488,257
Therapy procedure using functional activities97530$74.55$31.542.4x44,653,830
Insertion of needle into vein for collection of blood sample36415$21.81$8.492.6x40,280,537
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes97112$72.64$27.072.7x34,770,833
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes99232$203.39$76.042.7x34,684,276
Therapy procedure using manual technique, each 15 minutes97140$67.80$20.623.3x29,275,217
Blood test, comprehensive group of blood chemicals80053$61.44$10.335.9x27,220,202
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count85025$37.12$7.594.9x26,199,882
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient'sG2211$43.48$15.872.7x24,966,114
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes99233$325.44$115.502.8x22,973,090
Destruction of precancer skin growth, 2-14 growths17003$21.97$6.153.6x19,857,687
Pathology examination of tissue using a microscope, intermediate complexity88305$186.06$50.743.7x18,377,033
Blood test, lipids (cholesterol and triglycerides)80061$96.05$13.097.3x17,334,040
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only93010$44.77$7.955.6x15,486,654
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes99309$210.73$96.782.2x14,872,513
Hemoglobin a1c level83036$58.04$9.496.1x14,591,380
Blood test, thyroid stimulating hormone (tsh)84443$95.89$16.445.8x13,899,335
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more99215$406.90$163.052.5x12,922,225
Chiropractic manipulative treatment, 3-4 spinal regions98941$60.72$38.131.6x12,843,003
Detection test by nucleic acid for organism, amplified probe technique87798$63.45$34.351.8x12,744,756
X-ray of chest, 1 view71045$52.28$8.666.0x12,688,062
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more99204$408.44$156.982.6x12,663,680
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more99308$154.13$68.902.2x11,795,272
Administration of influenza virus vaccineG0008$40.77$29.101.4x11,616,610
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visitG0439$278.53$117.902.4x10,304,868
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report93000$69.02$14.204.9x10,144,071
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes99223$568.30$167.523.4x10,127,121
Established patient complete exam of visual system92014$227.20$124.081.8x9,207,151
Emergency department visit with high level of medical decision making99285$1,232.17$169.607.3x9,078,142
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more99203$265.96$103.442.6x8,656,567
Test for allergy using allergenic extract95004$13.22$3.623.6x8,632,592
Admn sarscov2 vacc 1 dose90480$50.47$38.041.3x8,441,109
Removal of cataract with insertion of prosthetic lens66984$1,027.76$245.774.2x8,319,156
Imaging of retina92134$123.94$39.393.1x8,171,858
Injection of drug or substance under skin or into muscle96372$55.32$13.424.1x6,927,967
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month99490$112.91$59.571.9x6,919,114
Injection, bupivacaine liposome, 1 mgC9290$4.88$1.393.5x6,884,666
Psychotherapy, 1 hour90837$209.11$124.731.7x6,863,646
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function93306$475.05$113.004.2x6,792,070
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more99212$117.55$51.972.3x6,770,558
X-ray of chest, 2 views71046$71.87$16.494.4x6,714,671
Vitamin d-3 level82306$184.26$28.966.4x6,420,195
Manual urinalysis test with examination using microscope, automated81001$31.94$3.1010.3x6,352,561
Destruction of precancer skin growth, 1 growth17000$155.48$49.833.1x6,300,981
Screening mammography77067$247.97$65.203.8x6,050,448
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes99222$368.00$126.032.9x6,018,660
Professional service for preparation and provision of 1 or more antigens95165$29.45$13.842.1x5,866,952
Screening 3d breast mammography77063$138.33$34.094.1x5,805,552
Critical care, first 30-74 minutes99291$1,050.22$208.015.0x5,801,848
Automated urinalysis test81003$15.18$2.196.9x5,688,971
Creatinine level to test for kidney function or muscle injury82570$45.67$5.069.0x5,536,830
Thyroxine (thyroid chemical), free84439$87.19$8.829.9x5,454,734
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careG0283$38.88$8.764.4x5,441,343
Hospital discharge day management, more than 30 minutes99239$353.47$110.403.2x5,422,288
Removal of fingernails or toenails, 6 or more nails11721$85.46$42.802.0x5,354,601
Blood test, basic group of blood chemicals (calcium, total)80048$47.96$8.275.8x5,135,813
Therapy procedure for walking training, each 15 minutes97116$56.50$21.902.6x4,996,954
Ct scan head or brain without contrast70450$247.20$40.416.1x4,945,922
Aspiration and/or injection of fluid from large joint20610$291.33$64.524.5x4,837,670
Cyanocobalamin (vitamin b-12) level82607$88.01$14.756.0x4,691,340
Emergency department visit with moderate level of medical decision making99284$787.96$114.816.9x4,532,507
Urine microalbumin (protein) level82043$57.23$5.6410.1x4,470,806
Bacterial colony count, urine87086$51.07$7.906.5x4,434,773
Rotary wing air mileage, per statute mileA0436$357.05$38.439.3x4,293,489
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes99231$120.09$46.972.6x4,092,932
Training for self-care or home management, each 15 minutes97535$62.98$25.392.5x3,946,851
Special stained specimen slides to examine tissue, each additional procedure88341$147.10$40.403.6x3,781,054
Chiropractic manipulative treatment, 1-2 spinal regions98940$48.93$26.741.8x3,705,639
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)A0427$1,636.95$522.513.1x3,697,421
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes99349$224.64$111.362.0x3,651,486
Ct scan of abdomen and pelvis with contrast74177$617.25$106.575.8x3,649,661
Injection of drug into eye67028$582.86$122.044.8x3,585,910
Iron level83540$32.90$6.335.2x3,576,974
Magnesium level83735$38.22$6.555.8x3,498,127
Biopsy of related skin growth, first growth11102$225.32$83.052.7x3,491,138
Photography of the retina92250$119.30$35.863.3x3,485,020
Ferritin (blood protein) level82728$78.74$13.335.9x3,450,457
Psychotherapy, 45 minutes90834$177.45$87.062.0x3,373,356
Complete blood cell count (red cells, white blood cell, platelets), automated test85027$31.98$6.335.1x3,331,509
Psa (prostate specific antigen) measurement, total84153$102.68$17.985.7x3,278,858
Blood test, clotting time85610$27.42$4.196.5x3,265,833
Destruction of skin growth, 1-14 growths17110$243.36$103.012.4x3,195,867
Established patient problem focused exam of visual system92012$167.46$90.451.9x3,155,982
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month99439$96.88$45.982.1x3,107,166
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more99205$557.40$204.932.7x3,052,360
Ambulance service, basic life support, non-emergency transport, (bls)A0428$1,121.33$260.654.3x2,956,154
Detection test for candida species (yeast), amplified probe technique87481$60.27$34.051.8x2,949,353
Iron binding capacity83550$45.31$8.555.3x2,918,577
Dxa bone density measurement of hip, pelvis, spine77080$156.44$21.387.3x2,872,254
Fixed wing air mileage, per statute mileA0435$138.72$14.649.5x2,831,236
X-ray of shoulder, minimum of 2 views73030$90.17$22.144.1x2,817,362
Ct guidance for insertion of radiation therapy fields77014$303.28$70.384.3x2,789,240
Imaging of optic nerve92133$110.94$34.163.2x2,771,233
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution87186$55.03$8.476.5x2,748,294
Exam of visual field with extended testing92083$149.44$61.212.4x2,722,253
Therapy procedure in a group setting97150$51.42$13.613.8x2,707,451
Advance care planning, first 30 minutes99497$187.36$73.842.5x2,700,155
Uric acid level, blood84550$30.57$4.426.9x2,683,561
X-ray of hip, 2-3 views73502$101.26$26.783.8x2,640,504
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes99457$113.75$48.482.3x2,639,411
X-ray of foot, minimum of 3 views73630$82.57$24.073.4x2,630,753
Ambulance service, basic life support, emergency transport (bls-emergency)A0429$1,250.95$446.942.8x2,608,184
Folic acid level, serum82746$85.17$14.395.9x2,597,305
Annual depression screening, 5 to 15 minutesG0444$40.85$17.762.3x2,586,676
Ct scan of chest without contrast71250$418.90$66.566.3x2,528,435
Measurement of antibody (ige) to allergic substance, crude allergen extract, each86003$30.44$5.116.0x2,515,723
Special stained specimen slides to examine tissue, initial procedure88342$192.62$58.583.3x2,439,385
Measurement c-reactive protein for detection of infection or inflammation86140$55.53$5.0711.0x2,378,846
Professional service for multiple injections of allergen95117$36.33$11.633.1x2,344,043
X-ray of knee, 3 views73562$102.81$27.323.8x2,338,418
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes99310$292.83$136.422.1x2,232,111
Bacterial urine culture87088$31.20$7.923.9x2,217,560
Urinalysis, manual test81002$15.04$3.394.4x2,205,818
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes99458$88.47$38.992.3x2,191,295
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days99454$130.08$47.802.7x2,172,131
Red blood cell sedimentation rate, to detect inflammation, automated85652$29.54$2.6411.2x2,160,659
Gammaglobulin (immune system protein) measurement82784$58.20$9.096.4x2,154,299
Psychotherapy, 30 minutes90832$130.26$65.292.0x2,145,307
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)G0471$19.23$10.561.8x2,124,397
Flow cytometry technique for dna or cell analysis, each additional marker88185$111.06$24.354.6x2,080,803
Removal of skin and tissue, 20.0 sq cm or less11042$276.08$85.263.2x2,042,234
Ct scan of abdomen and pelvis without contrast74176$558.96$90.666.2x1,992,585
X-ray of abdomen, 1 view74018$55.15$11.444.8x1,991,691
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days93296$92.82$21.594.3x1,982,430
Bacterial culture for aerobic isolates87077$32.76$7.914.1x1,941,666
Ultrasound measurement of bladder capacity after voiding51798$70.89$11.326.3x1,918,942
Testing for presence of drug, by chemistry analyzers80307$211.28$60.303.5x1,905,331
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days93294$105.62$28.573.7x1,898,791
Ct scan of chest with contrast71260$434.77$62.457.0x1,846,940
Removal of fingernails or toenails, 1-5 nails11720$59.35$31.651.9x1,838,644
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes99348$150.91$69.542.2x1,831,073
Removal of noncancer thickened skin growth, 2-4 growths11056$134.27$79.641.7x1,824,860
X-ray of knee, 4 or more views73564$128.99$33.803.8x1,800,995
Phosphate level84100$26.52$4.635.7x1,797,226
Parathormone (parathyroid hormone) level83970$185.36$40.364.6x1,785,418
Administration of pneumococcal vaccineG0009$49.09$29.961.6x1,730,774
Evaluation for physical therapy, typically 20 minutes97161$192.76$99.461.9x1,714,184
Administration of chemotherapy into vein, 1 hour or less96413$481.33$125.213.8x1,706,956
Anesthesia for lens surgery00142$887.34$94.939.3x1,702,334
Measurement of corneal curvature and depth of eye92136$155.89$35.524.4x1,692,632
Ultrasound of both sides of head and neck blood flow93880$414.04$123.223.4x1,671,936
Measurement of antibody for assessment of autoimmune disorder, any method86235$104.75$17.496.0x1,660,751
X-ray of lower and sacral spine, 2-3 views72100$99.88$23.924.2x1,655,257
Hospital discharge day management, 30 minutes or less99238$222.39$77.742.9x1,651,210
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope43239$1,454.87$166.718.7x1,630,320
New patient complete exam of visual system92004$255.35$145.211.8x1,591,405
Therapy procedure using water pool to exercises, each 15 minutes97113$73.17$27.652.6x1,570,017
Removal of polyps or growths of large bowel using an endoscope with mechanical snare45385$1,838.87$360.175.1x1,564,543
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes99307$94.25$38.152.5x1,556,786
Ct scan of blood vessels of chest with contrast71275$532.72$90.075.9x1,555,203
Instillation, bupivacaine and meloxicam, 1 mg/0.03 mgC9088$2.36$0.733.2x1,552,138
Ct scan of upper spine without contrast72125$296.72$47.636.2x1,546,919
Evaluation of cardiac rhythm monitor system, remote up to 30 days93298$197.77$75.902.6x1,545,091
Psychotherapy with evaluation and management visit, 30 minutes90833$142.11$64.702.2x1,539,816
Thyroid hormone, t3 measurement, free84481$145.94$16.568.8x1,529,939
Evaluation for physical therapy, typically 30 minutes97162$185.49$99.211.9x1,505,150
Ultrasound study of one arm or leg veins with compression and maneuvers93971$225.84$52.144.3x1,504,508
Removal of impacted ear wax69210$136.96$42.003.3x1,499,606
Detection test by immunoassay with direct visual observation for influenza virus87804$43.91$16.072.7x1,486,307
Biopsy of related skin growth, each additional growth11103$116.43$46.552.5x1,465,983
Identification of organisms by genetic analysis, amplified probe technique87150$64.75$34.301.9x1,457,908
Special stained specimen slides to examine tissue including interpretation and report88313$128.71$42.793.0x1,445,845
Mri scan of lower spinal canal without contrast72148$914.85$116.327.9x1,438,739
Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month99489$101.84$66.881.5x1,438,630
Special stained specimen slides to identify organisms including interpretation and report88312$183.05$74.422.5x1,436,390
Ultrasound study of arm or leg veins with compression and maneuvers93970$351.16$96.103.7x1,435,694
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes99152$112.43$15.767.1x1,412,693
Prostate cancer screening; prostate specific antigen test (psa)G0103$103.30$18.885.5x1,406,946
Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope00731$1,108.59$103.2310.7x1,393,598
Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less96365$222.72$60.453.7x1,390,306
Injection of additional new drug or substance into vein96375$81.45$14.945.5x1,386,426
Anesthesia for other procedure on large bowel using an endoscope00811$1,030.27$98.8310.4x1,377,188
Total protein level, urine84156$34.15$3.599.5x1,375,147
Protein measurement, serum84165$69.97$13.505.2x1,369,974
X-ray of knee, 1-2 views73560$73.62$18.853.9x1,364,130
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more99306$353.87$173.692.0x1,343,885
Test for allergy using allergenic extract injected into skin95024$19.11$7.532.5x1,338,236
Removal of recurring cataract in lens capsule using a laser66821$645.84$193.283.3x1,333,141
X-ray of hand, minimum of 3 views73130$87.66$23.023.8x1,312,279
Test for allergy using skin patch95044$17.71$4.953.6x1,311,924
Set-up portable x-ray equipmentQ0092$50.82$25.532.0x1,305,623
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional99211$60.19$22.272.7x1,302,454
Lactate dehydrogenase (enzyme) level83615$32.31$5.895.5x1,301,854
Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes99350$331.49$162.442.0x1,299,284
Telephone medical discussion with physician, 11-20 minutes99442$183.09$83.062.2x1,294,240
Testosterone (hormone) level, total84403$148.21$25.195.9x1,288,334
Biopsy of large bowel using a flexible endoscope45380$1,789.26$240.457.4x1,287,849
Creatine kinase (cardiac enzyme) level, total82550$37.83$6.375.9x1,283,205
Anticoagulant management of patient taking warfarin93793$40.16$10.703.8x1,282,550
Complete ultrasound scan behind abdominal cavity76770$246.73$58.694.2x1,280,211
Comprehensive hearing and speech recognition test92557$122.78$35.973.4x1,263,075
Nuclear medicine studies of heart muscle at rest and with stress and spect78452$826.68$231.553.6x1,244,326
Calculation of radiation therapy dose77300$188.60$41.764.5x1,215,396
Trimming of dystrophic nails, any numberG0127$46.82$17.802.6x1,190,124
Liver function blood test panel80076$44.28$7.995.5x1,178,776
X-ray of ankle, minimum of 3 views73610$84.06$22.123.8x1,168,699
Mri scan of brain without contrast70551$666.15$94.417.1x1,162,275
Blood creatinine level82565$22.73$4.894.6x1,160,145
Liver enzyme (sgpt), level84460$48.05$5.159.3x1,154,341
Injection, fosaprepitant (focinvez), 1 mgJ1434$8.85$2.973.0x1,130,029
Dialysis services, 4 or more physician visits per month (20 years or older)90960$773.20$347.572.2x1,124,753
Kidney function blood test panel80069$56.14$8.486.6x1,098,129
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip chargeP9604$15.78$11.131.4x1,086,793
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes99305$290.31$126.192.3x1,083,909
Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment sessionG6015$1,749.75$350.355.0x1,078,295
Mri scan of brain before and after contrast70553$1,114.93$153.967.2x1,071,592
Aspiration and/or injection of fluid large joint using ultrasound guidance20611$449.33$101.174.4x1,068,754
Application of ultrasound, each 15 minutes97035$37.95$10.513.6x1,064,193
X-ray of wrist, minimum of 3 views73110$93.40$24.623.8x1,047,664
Limited ultrasound scan of abdomen76705$184.24$36.625.0x1,044,421
Annual alcohol misuse screening, 5 to 15 minutesG0442$40.70$17.932.3x1,010,813
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)G0279$153.19$33.194.6x1,000,625
Ultrasound scan of head and neck soft tissue76536$240.52$66.453.6x991,676
Test to assess middle ear function92567$51.44$15.963.2x990,670
Application of blood vessel compression device97016$45.24$8.555.3x988,655
Chiropractic manipulative treatment, 5 spinal regions98942$73.95$49.811.5x982,994
Emergency department visit with low level of medical decision making99283$408.98$66.926.1x981,836
Test to examine how well the lungs exchange gases94729$112.18$34.303.3x976,142
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician orG2212$98.93$30.623.2x959,448
Assessment of emotional or behavioral problems96127$22.83$4.465.1x955,986
Measurement of immunoglobulin light chains83521$121.78$16.907.2x952,706
Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle96401$196.47$70.672.8x937,494
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks17311$1,528.79$569.092.7x934,948
Immunologic analysis technique on serum (immunofixation)86334$124.33$19.866.3x934,844
Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less96367$120.33$27.644.4x930,254
Bilirubin level, direct82248$24.42$4.885.0x928,106
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians andG0180$130.48$51.952.5x921,546
Natriuretic peptide (heart and blood vessel protein) level83880$170.54$38.414.4x904,431
Pathology examination of tissue using a microscope, moderately high complexity88307$366.05$85.944.3x903,970
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level64483$1,875.36$261.127.2x898,002
Thyroxine (thyroid chemical), total84436$42.74$6.736.4x892,669
Telephone medical discussion with physician, 21-30 minutes99443$282.17$118.852.4x883,996
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician93018$78.53$13.445.8x883,429
Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique87640$58.61$34.351.7x876,008
Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen87635$126.58$50.062.5x872,784
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatmG2067$274.83$224.781.2x868,503
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes99221$278.60$78.733.5x864,473
Radiation treatment management, 5 treatment sessions77427$754.22$188.354.0x858,263
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)87811$145.03$40.123.6x856,116
Destruction of precancer skin growth, 15 or more growths17004$367.95$159.362.3x852,763
Needle measurement of electrical activity in arm or leg muscles, complete study95886$295.65$86.643.4x842,347
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report95251$107.04$32.363.3x841,748
Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days93297$153.00$45.453.4x839,353
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more99202$171.47$66.242.6x832,888
Nuclear medicine study from skull base to mid-thigh with ct scan78815$2,125.52$612.773.5x831,041
Diagnostic exam of bladder and urethra using an endoscope52000$804.76$197.914.1x826,866

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. National figures, weighted by service volume, non-drug codes.

How to read this

Two columns matter. Billed is the ask. Allowed is the settlement.

A 10x gap does not mean anyone paid 10x. It means the billed figure was never real. Medicare set the price and the provider took it.

Anyone without Medicare negotiates from that first column instead. That is the whole problem with it.