17003

Destruction of precancer skin growth, 2-14 growths

Code 17003. Medicare covered 19,857,687 of these. Here is what providers billed and what Medicare allowed, state by state.

$21.97Billed, national avg
$6.15Medicare allowed
3.6xBilled vs allowed
8.4xHighest vs lowest state

Providers in Virgin Islands billed the most for this, at $79.16. In Puerto Rico the average was $9.47. Same procedure code, same programme.

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.

By state

StateBilledMedicare allowedGapServices
Virgin Islands$79.16$6.3612.4x207
Wisconsin$52.51$5.2110.1x204,196
New York$37.79$6.815.6x822,931
Iowa$35.55$5.386.6x219,859
Mississippi$34.85$5.506.3x177,185
New Hampshire$33.79$5.616.0x121,689
Wyoming$31.19$6.085.1x42,054
Illinois$31.00$5.975.2x567,659
Massachusetts$30.89$6.604.7x495,128
Indiana$30.48$5.625.4x338,988
Alabama$29.42$5.485.4x293,411
Alaska$28.09$7.123.9x19,999
Maine$25.98$5.904.4x49,256
Pennsylvania$25.75$6.014.3x584,911
New Jersey$24.50$6.923.5x457,982
Connecticut$24.33$6.643.7x156,005
Hawaii$24.16$6.733.6x61,179
Kansas$24.16$5.554.4x224,969
Kentucky$24.07$5.524.4x237,204
South Carolina$23.71$5.794.1x481,920
Minnesota$23.71$5.644.2x188,712
Missouri$23.62$5.624.2x357,486
Armed Forces Pacific$23.19$6.233.7x87
Guam$23.17$6.793.4x1,451
Virginia$22.65$6.313.6x602,611
West Virginia$22.12$5.054.4x80,478
North Carolina$22.02$5.833.8x696,359
Maryland$21.99$6.783.2x411,416
Georgia$21.74$5.783.8x590,351
Delaware$20.99$6.203.4x87,788
Rhode Island$19.95$6.203.2x68,311
Louisiana$19.90$5.743.5x254,653
South Dakota$19.89$4.404.5x83,582
Michigan$19.86$5.903.4x369,504
Montana$19.84$5.893.4x94,271
Nebraska$19.80$5.623.5x144,603
North Dakota$19.72$3.975.0x39,609
Oklahoma$19.27$5.533.5x239,220
California$19.15$7.302.6x2,497,074
Texas$18.77$6.053.1x1,322,540
Oregon$18.53$6.093.0x237,336
Colorado$17.92$6.502.8x375,376
Arizona$17.72$6.082.9x705,151
District of Columbia$17.51$7.102.5x33,148
New Mexico$16.63$5.613.0x122,709
Florida$16.57$6.052.7x2,543,742
Ohio$16.36$5.592.9x503,084
Utah$16.29$5.812.8x210,094
Tennessee$15.39$5.562.8x453,827
Nevada$15.18$6.052.5x197,337
Arkansas$15.13$5.302.9x240,244
Washington$14.68$6.092.4x387,445
Idaho$14.62$5.392.7x132,656
Vermont$13.00$5.072.6x25,123
Puerto Rico$9.47$6.411.5x3,540

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

← All procedures