77080

Dxa bone density measurement of hip, pelvis, spine

Code 77080. Medicare covered 2,872,254 of these. Here is what providers billed and what Medicare allowed, state by state.

$156.44Billed, national avg
$21.38Medicare allowed
7.3xBilled vs allowed
6.6xHighest vs lowest state

Providers in Alaska billed the most for this, at $314.17. In Guam the average was $47.45. 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
Alaska$314.17$23.1913.5x8,614
Armed Forces Pacific$271.77$40.996.6x310
Wyoming$258.90$23.2311.1x4,902
New York$250.26$28.308.8x165,622
New Jersey$250.01$30.608.2x90,628
Maryland$217.55$33.816.4x91,926
Wisconsin$216.60$16.0413.5x51,412
District of Columbia$213.92$27.467.8x10,328
Connecticut$198.74$24.638.1x27,177
California$196.28$28.227.0x283,217
Arizona$192.00$28.676.7x60,675
Florida$187.76$27.546.8x192,410
Nevada$184.21$28.626.4x22,493
Foreign Country$173.97$20.458.5x39
Texas$171.48$21.647.9x191,238
Mississippi$170.51$16.9710.0x23,775
New Mexico$170.20$21.158.0x15,454
North Carolina$168.32$21.717.8x104,476
Hawaii$162.87$28.005.8x8,234
South Carolina$157.65$16.679.5x49,831
Colorado$149.21$25.755.8x43,977
Virginia$146.33$19.737.4x94,881
Illinois$144.10$15.769.1x117,956
Rhode Island$138.76$20.336.8x11,946
Missouri$137.76$17.827.7x73,207
Delaware$134.12$19.267.0x19,534
Georgia$132.55$17.717.5x76,769
Washington$131.52$23.165.7x62,748
Tennessee$129.96$18.986.8x71,038
Kansas$124.64$19.296.5x36,619
Arkansas$122.19$17.027.2x32,413
New Hampshire$121.84$13.848.8x16,716
Massachusetts$120.81$17.476.9x76,570
Montana$118.76$14.648.1x9,707
Alabama$117.01$19.755.9x36,647
Iowa$112.39$17.316.5x39,682
Indiana$105.28$13.567.8x58,583
Minnesota$103.26$17.166.0x52,721
Louisiana$100.54$15.586.5x33,507
Michigan$99.24$15.236.5x64,762
Oklahoma$93.69$16.105.8x35,240
Idaho$92.66$13.686.8x15,075
Pennsylvania$91.60$13.306.9x123,085
Utah$90.30$17.405.2x18,116
Nebraska$89.67$18.654.8x25,420
Kentucky$89.59$15.046.0x31,823
South Dakota$88.98$14.926.0x13,177
North Dakota$87.23$13.936.3x12,829
Ohio$84.92$12.187.0x101,158
Oregon$77.26$16.974.6x30,103
Virgin Islands$73.92$33.292.2x288
West Virginia$71.95$12.685.7x12,278
Vermont$62.83$10.765.8x6,731
Unknown$60.00$9.426.4x284
Maine$57.65$12.694.5x9,385
Puerto Rico$52.26$32.001.6x2,811
Armed Forces Central/South America$52.00$9.115.7x193
Guam$47.45$41.781.1x1,510

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

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