20610

Aspiration and/or injection of fluid from large joint

Code 20610. Medicare covered 4,837,670 of these. Here is what providers billed and what Medicare allowed, state by state.

$291.33Billed, national avg
$64.52Medicare allowed
4.5xBilled vs allowed
4.1xHighest vs lowest state

Providers in New Jersey billed the most for this, at $555.78. In Puerto Rico the average was $136.88. 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
New Jersey$555.78$76.847.2x191,131
Wisconsin$547.56$58.149.4x64,387
New York$456.57$73.036.3x243,663
Alaska$438.79$69.986.3x9,739
Nevada$432.90$62.147.0x32,699
Illinois$334.70$69.544.8x238,783
New Hampshire$325.98$59.195.5x27,072
Georgia$324.20$63.125.1x166,653
Connecticut$321.14$69.594.6x43,739
California$317.67$69.024.6x345,545
Massachusetts$308.57$65.454.7x121,122
Wyoming$299.93$62.244.8x10,346
Minnesota$299.49$59.275.1x61,685
Delaware$296.76$67.244.4x30,120
Missouri$291.87$59.144.9x93,393
Kansas$289.98$59.084.9x62,166
Mississippi$287.98$57.305.0x60,868
Iowa$281.70$56.815.0x56,155
Indiana$276.12$60.424.6x109,748
Nebraska$274.59$57.254.8x40,682
Rhode Island$273.54$63.174.3x10,983
Texas$270.52$64.424.2x303,582
Colorado$267.92$66.424.0x64,883
Armed Forces Europe$261.47$68.493.8x17
North Dakota$261.31$52.725.0x14,791
District of Columbia$260.51$75.253.5x6,367
Pennsylvania$259.53$67.533.8x272,888
Florida$256.15$65.413.9x404,876
Louisiana$254.63$60.044.2x62,498
Maryland$253.44$70.403.6x121,517
Virginia$250.91$64.513.9x147,410
Oregon$247.49$62.114.0x36,355
Tennessee$246.65$59.414.2x130,476
Ohio$244.48$60.184.1x184,658
North Carolina$242.81$60.674.0x185,271
Arizona$238.40$63.513.8x116,156
New Mexico$227.62$61.673.7x24,290
Washington$227.36$63.553.6x58,886
West Virginia$226.28$56.054.0x29,308
Kentucky$222.46$61.603.6x99,993
South Carolina$218.06$62.743.5x136,918
South Dakota$216.07$53.744.0x20,302
Idaho$210.02$52.054.0x17,856
Virgin Islands$209.90$57.873.6x650
Alabama$204.96$59.143.5x67,083
Michigan$202.57$63.033.2x103,819
Arkansas$187.11$60.083.1x55,322
Oklahoma$186.81$57.633.2x63,804
Vermont$184.93$43.534.2x8,626
Utah$183.88$59.353.1x35,437
Montana$181.21$58.503.1x17,586
Hawaii$179.27$63.952.8x5,172
Foreign Country$178.00$68.582.6x15
Maine$161.59$53.053.0x14,627
Guam$157.14$63.632.5x501
Puerto Rico$136.88$72.901.9x5,022

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

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