77427

Radiation treatment management, 5 treatment sessions

Code 77427. Medicare covered 858,263 of these. Here is what providers billed and what Medicare allowed, state by state.

$754.22Billed, national avg
$188.35Medicare allowed
4.0xBilled vs allowed
13.0xHighest vs lowest state

Providers in Alaska billed the most for this, at $3,069.82. In Puerto Rico the average was $235.87. 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$3,069.82$231.6313.3x2,518
Wisconsin$1,563.71$180.638.7x14,181
New Hampshire$1,350.41$181.617.4x5,409
Vermont$1,272.78$190.306.7x1,860
Wyoming$1,112.28$191.725.8x1,268
Connecticut$1,068.02$197.515.4x7,737
Illinois$1,054.72$192.555.5x33,835
Minnesota$942.05$184.385.1x11,233
Texas$885.76$184.824.8x62,327
California$847.17$200.954.2x77,720
New York$835.29$205.114.1x42,583
New Jersey$781.02$202.333.9x27,613
West Virginia$770.76$183.054.2x4,254
South Carolina$764.13$180.314.2x15,940
North Dakota$762.41$188.604.0x2,878
Massachusetts$756.32$196.073.9x25,409
Nevada$747.41$184.284.1x6,042
Ohio$736.72$183.084.0x28,238
Missouri$735.77$180.624.1x15,718
New Mexico$729.18$183.934.0x2,760
Georgia$721.89$183.153.9x22,246
Virginia$718.32$186.833.8x22,255
Iowa$716.41$176.674.1x9,162
Oregon$707.98$186.763.8x8,584
North Carolina$691.96$180.453.8x27,601
Montana$677.63$186.743.6x3,724
Rhode Island$670.02$191.143.5x3,137
District of Columbia$668.65$201.803.3x2,619
Washington$660.02$191.183.5x18,425
Louisiana$658.43$179.983.7x11,817
Michigan$641.61$186.063.4x21,819
Arkansas$639.75$175.523.6x8,580
Florida$638.52$191.293.3x87,610
Nebraska$636.78$174.663.6x6,094
Mississippi$636.00$175.643.6x8,622
Colorado$634.85$188.133.4x12,452
Pennsylvania$630.93$188.043.4x40,101
Indiana$624.70$175.863.6x18,931
Delaware$624.45$185.863.4x4,191
Oklahoma$618.52$178.053.5x9,621
Alabama$612.06$178.763.4x13,034
Hawaii$611.31$190.603.2x2,322
Kansas$607.18$179.033.4x11,246
Maryland$600.58$194.213.1x20,464
Arizona$595.81$183.073.3x23,131
Utah$594.69$184.133.2x3,803
Idaho$574.42$176.113.3x5,146
Kentucky$554.09$180.063.1x9,209
Maine$527.18$180.052.9x3,039
Tennessee$522.89$174.773.0x25,330
South Dakota$455.75$180.672.5x3,645
Guam$446.13$191.572.3x215
Puerto Rico$235.87$185.841.3x565

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

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