77300

Calculation of radiation therapy dose

Code 77300. Medicare covered 1,215,396 of these. Here is what providers billed and what Medicare allowed, state by state.

$188.60Billed, national avg
$41.76Medicare allowed
4.5xBilled vs allowed
9.1xHighest vs lowest state

Providers in Alaska billed the most for this, at $739.80. In South Dakota the average was $81.42. 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$739.80$43.7616.9x5,585
Vermont$309.03$36.398.5x1,721
Wisconsin$294.46$34.168.6x19,426
New Hampshire$262.03$32.098.2x6,799
Texas$254.82$47.025.4x90,506
Minnesota$237.60$39.686.0x18,670
Illinois$237.16$40.585.8x44,378
California$223.47$47.574.7x130,386
Nevada$219.49$46.754.7x8,308
Connecticut$214.44$34.286.3x10,883
New York$202.46$42.474.8x67,725
Wyoming$191.21$38.874.9x2,614
Florida$185.55$49.133.8x122,271
North Dakota$182.22$45.224.0x2,397
Ohio$181.72$38.054.8x41,741
New Mexico$181.49$39.334.6x3,908
Arizona$180.40$52.353.4x27,374
Alabama$179.21$44.804.0x19,520
Michigan$179.10$39.764.5x28,252
Missouri$172.74$33.865.1x23,362
New Jersey$171.81$44.363.9x36,313
Delaware$170.64$35.204.8x5,417
Nebraska$170.64$39.444.3x6,532
Louisiana$167.88$45.203.7x17,522
South Carolina$167.58$41.194.1x19,011
Tennessee$165.60$36.884.5x26,095
Guam$164.18$69.172.4x206
Maryland$164.07$48.123.4x33,266
Georgia$164.06$38.634.2x32,980
West Virginia$161.77$38.304.2x5,543
Hawaii$160.88$37.394.3x3,427
Arkansas$159.53$36.984.3x16,290
North Carolina$157.52$36.934.3x36,606
Virginia$157.01$38.694.1x25,352
Indiana$153.85$37.614.1x23,455
Rhode Island$152.98$44.763.4x3,907
Iowa$152.32$31.794.8x14,829
Idaho$150.45$34.424.4x6,199
Washington$149.48$40.843.7x24,680
Massachusetts$148.34$35.564.2x40,448
Oregon$147.00$37.953.9x9,992
Kansas$143.51$39.703.6x14,230
District of Columbia$143.23$39.333.6x4,812
Colorado$140.70$36.783.8x18,289
Montana$140.55$34.614.1x4,917
Pennsylvania$138.79$35.413.9x57,016
Mississippi$138.73$33.124.2x10,960
Kentucky$138.66$34.744.0x14,918
Oklahoma$130.87$35.353.7x14,786
Utah$120.49$35.273.4x4,743
Puerto Rico$96.15$64.771.5x335
Maine$95.53$32.672.9x2,783
South Dakota$81.42$32.632.5x3,711

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

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