64483

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

Code 64483. Medicare covered 898,002 of these. Here is what providers billed and what Medicare allowed, state by state.

$1,875.36Billed, national avg
$261.12Medicare allowed
7.2xBilled vs allowed
18.4xHighest vs lowest state

Providers in New Jersey billed the most for this, at $4,605.30. In Puerto Rico the average was $250.43. 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$4,605.30$293.1415.7x30,343
Alaska$3,288.99$310.8310.6x1,428
Nevada$3,059.33$294.0410.4x8,520
California$2,920.07$324.319.0x98,916
Colorado$2,480.72$263.499.4x20,911
Wisconsin$2,380.20$210.4911.3x10,990
Indiana$2,170.77$245.638.8x18,536
Georgia$2,101.73$269.677.8x42,766
New York$2,065.73$274.707.5x35,568
Texas$1,903.24$248.457.7x69,019
Illinois$1,864.10$243.957.6x32,040
Arizona$1,814.54$277.646.5x36,543
Delaware$1,779.69$287.956.2x9,565
Louisiana$1,744.43$221.987.9x16,919
New Mexico$1,729.08$232.477.4x2,944
Florida$1,652.86$270.536.1x68,742
Connecticut$1,632.73$283.395.8x6,325
New Hampshire$1,628.15$236.886.9x3,953
Maryland$1,619.84$284.975.7x35,345
Kansas$1,607.39$224.307.2x14,038
Minnesota$1,595.76$253.706.3x13,634
Pennsylvania$1,561.29$244.716.4x34,077
Massachusetts$1,501.48$229.056.6x13,899
Arkansas$1,470.99$243.046.1x10,806
Virginia$1,438.48$268.265.4x26,036
Rhode Island$1,433.28$260.875.5x1,835
Missouri$1,432.95$193.967.4x11,610
Tennessee$1,353.60$253.885.3x21,686
Wyoming$1,350.24$266.795.1x3,346
Iowa$1,337.44$218.516.1x4,343
Virgin Islands$1,335.76$248.415.4x110
Hawaii$1,308.70$249.855.2x360
Oregon$1,263.39$289.524.4x9,064
Mississippi$1,251.75$230.645.4x14,006
Ohio$1,209.92$218.255.5x28,947
Michigan$1,208.54$239.945.0x13,337
North Carolina$1,192.43$243.124.9x26,737
Kentucky$1,157.20$238.564.9x8,360
Idaho$1,156.54$219.905.3x4,386
Nebraska$1,152.16$230.985.0x6,497
South Carolina$1,142.79$252.234.5x21,188
Vermont$1,095.11$141.477.7x582
Washington$1,060.18$259.884.1x16,289
Alabama$973.52$213.784.6x13,864
Oklahoma$972.85$211.074.6x10,264
Utah$915.29$252.383.6x8,523
North Dakota$893.03$180.874.9x987
District of Columbia$890.57$207.444.3x784
Montana$816.51$225.513.6x2,882
South Dakota$643.94$150.614.3x3,211
West Virginia$601.45$163.553.7x1,554
Maine$493.80$142.513.5x863
Guam$362.02$255.711.4x19
Puerto Rico$250.43$225.661.1x504

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

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