17311

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks

Code 17311. Medicare covered 934,948 of these. Here is what providers billed and what Medicare allowed, state by state.

$1,528.79Billed, national avg
$569.09Medicare allowed
2.7xBilled vs allowed
5.0xHighest vs lowest state

Providers in Wisconsin billed the most for this, at $2,853.02. In North Dakota the average was $568.31. 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$2,853.02$444.816.4x13,452
Alaska$2,326.49$718.343.2x772
Minnesota$2,117.15$532.134.0x13,355
Massachusetts$2,034.59$571.163.6x24,814
Iowa$1,990.59$517.843.8x8,409
New Hampshire$1,972.29$460.974.3x6,065
Wyoming$1,927.30$605.993.2x1,156
Oregon$1,923.41$593.053.2x8,549
Illinois$1,865.14$571.233.3x28,233
Connecticut$1,857.94$627.603.0x8,542
New York$1,796.98$644.692.8x40,941
Rhode Island$1,725.07$552.803.1x3,143
Nebraska$1,712.80$525.743.3x4,269
Georgia$1,655.46$565.042.9x30,558
New Jersey$1,630.02$597.472.7x20,752
New Mexico$1,602.71$506.423.2x3,808
Colorado$1,587.15$614.842.6x18,726
California$1,586.69$625.772.5x96,014
Kentucky$1,553.44$498.753.1x12,777
Arizona$1,502.53$590.042.5x34,636
Missouri$1,498.74$501.093.0x20,000
Michigan$1,494.67$560.362.7x14,930
Indiana$1,491.68$539.002.8x16,356
Texas$1,481.75$563.462.6x61,570
South Carolina$1,460.90$553.552.6x19,176
Kansas$1,446.61$536.312.7x12,829
Washington$1,423.44$570.682.5x19,534
Oklahoma$1,412.58$509.812.8x8,879
North Carolina$1,406.61$551.192.6x36,975
Virginia$1,403.39$595.152.4x30,105
Utah$1,394.00$529.732.6x9,892
Mississippi$1,391.31$539.792.6x6,110
West Virginia$1,389.32$515.412.7x4,135
Maryland$1,376.39$654.582.1x15,718
Hawaii$1,372.83$624.072.2x1,614
Montana$1,366.86$465.412.9x4,868
District of Columbia$1,363.91$714.641.9x725
Ohio$1,354.36$536.782.5x26,640
Florida$1,346.44$598.222.3x118,260
Pennsylvania$1,331.88$528.142.5x37,684
Maine$1,310.86$519.732.5x2,271
Nevada$1,309.34$576.262.3x8,231
Alabama$1,300.86$513.472.5x15,440
Tennessee$1,286.20$531.282.4x23,338
Idaho$1,246.69$516.052.4x5,495
Louisiana$1,240.25$524.022.4x8,125
Arkansas$1,190.03$515.952.3x14,313
Delaware$1,105.38$589.801.9x3,568
South Dakota$999.06$403.292.5x5,371
Vermont$738.56$392.431.9x1,517
Puerto Rico$669.02$587.321.1x280
North Dakota$568.31$322.121.8x2,021

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

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