17004

Destruction of precancer skin growth, 15 or more growths

Code 17004. Medicare covered 852,763 of these. Here is what providers billed and what Medicare allowed, state by state.

$367.95Billed, national avg
$159.36Medicare allowed
2.3xBilled vs allowed
3.7xHighest vs lowest state

Providers in Wisconsin billed the most for this, at $739.65. In Puerto Rico the average was $201.65. 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
Wisconsin$739.65$142.235.2x4,713
Alaska$603.38$178.713.4x359
Guam$568.59$167.023.4x40
New Hampshire$523.04$150.153.5x2,941
Massachusetts$495.22$170.962.9x16,207
Iowa$478.47$132.753.6x8,761
Illinois$476.26$152.943.1x19,401
New York$463.17$178.072.6x45,493
Minnesota$457.58$156.352.9x5,973
Wyoming$446.57$151.982.9x936
Indiana$429.07$144.293.0x12,999
Mississippi$419.69$140.213.0x7,897
Rhode Island$417.51$158.682.6x2,350
Oregon$415.87$153.542.7x6,627
North Dakota$404.07$118.243.4x896
Maryland$401.76$171.952.3x15,902
Virginia$401.47$160.482.5x20,357
Maine$388.25$156.192.5x1,240
Kansas$386.98$140.172.8x5,921
New Mexico$385.13$143.282.7x5,535
Nebraska$382.68$142.182.7x5,147
Colorado$378.67$163.122.3x12,719
Oklahoma$376.93$142.682.6x8,464
Hawaii$375.01$169.492.2x5,339
Alabama$366.49$139.032.6x12,232
Idaho$363.36$136.282.7x4,926
California$360.88$179.892.0x157,582
Ohio$359.89$146.602.5x15,338
Texas$354.98$154.312.3x60,425
District of Columbia$350.64$179.712.0x1,323
North Carolina$350.10$147.492.4x22,260
Connecticut$349.19$171.312.0x5,942
Nevada$348.42$155.822.2x16,528
New Jersey$343.05$174.932.0x21,355
West Virginia$342.98$134.192.6x1,380
Georgia$342.31$145.702.3x24,540
Washington$340.40$153.772.2x12,937
Michigan$339.95$152.702.2x13,561
Missouri$338.77$148.672.3x11,806
Arizona$336.64$154.032.2x28,233
Pennsylvania$335.51$158.752.1x17,798
South Carolina$332.77$147.472.3x21,445
Florida$332.29$155.882.1x117,534
Kentucky$327.89$142.612.3x9,548
Delaware$321.14$156.472.1x2,803
Montana$317.20$153.922.1x3,176
Vermont$310.72$142.352.2x294
South Dakota$309.78$127.062.4x2,461
Tennessee$309.44$140.122.2x18,612
Louisiana$303.71$150.112.0x12,921
Arkansas$298.93$137.782.2x7,823
Utah$294.08$150.792.0x10,935
Puerto Rico$201.65$162.921.2x736

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

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