82248

Bilirubin level, direct

Code 82248. Medicare covered 928,106 of these. Here is what providers billed and what Medicare allowed, state by state.

$24.42Billed, national avg
$4.88Medicare allowed
5.0xBilled vs allowed
8.7xHighest vs lowest state

Providers in Alaska billed the most for this, at $43.54. In Virgin Islands the average was $5.02. 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$43.54$4.928.8x50
Wisconsin$35.61$4.857.3x2,855
Florida$31.37$4.916.4x79,029
Georgia$30.43$4.926.2x17,682
South Carolina$29.55$4.916.0x3,511
Illinois$29.23$4.886.0x13,730
Kansas$28.64$4.915.8x9,508
Minnesota$27.45$4.895.6x20,892
Maryland$27.41$4.915.6x9,749
California$27.25$4.905.6x99,501
Idaho$27.18$4.925.5x96
Massachusetts$26.74$4.925.4x34,554
Mississippi$26.50$4.905.4x921
Louisiana$25.97$4.895.3x8,626
North Carolina$25.83$4.895.3x81,792
New York$25.67$4.895.2x51,154
Connecticut$25.55$4.635.5x712
Pennsylvania$25.51$4.895.2x13,835
New Jersey$25.11$4.895.1x190,572
West Virginia$24.41$4.885.0x110
South Dakota$24.06$4.874.9x364
Nevada$24.00$4.914.9x12,087
Indiana$22.72$4.864.7x915
Arkansas$22.22$4.904.5x27,993
Colorado$21.34$4.904.4x5,043
New Hampshire$21.13$4.924.3x204
Alabama$20.97$4.724.4x28,942
Washington$20.42$4.864.2x7,145
New Mexico$20.26$4.754.3x3,839
Texas$20.14$4.864.1x72,662
Arizona$18.99$4.774.0x28,628
Ohio$18.97$4.893.9x33,620
Tennessee$18.84$4.913.8x16,538
Montana$18.74$4.923.8x292
Oregon$17.76$4.873.6x1,969
Wyoming$16.68$4.923.4x157
Virginia$16.59$4.743.5x3,852
Iowa$16.45$4.893.4x1,737
North Dakota$15.72$4.923.2x1,108
Missouri$15.71$4.913.2x9,347
Kentucky$15.50$4.833.2x1,370
Utah$15.27$4.913.1x2,007
Delaware$13.45$4.922.7x59
Michigan$12.39$4.832.6x5,867
Nebraska$10.98$4.922.2x1,445
Oklahoma$10.94$4.882.2x5,822
Maine$9.88$4.162.4x494
Rhode Island$8.31$4.911.7x4,979
Hawaii$6.10$4.881.2x9,918
Puerto Rico$5.36$4.911.1x693
Virgin Islands$5.02$4.921.0x68

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

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