83880

Natriuretic peptide (heart and blood vessel protein) level

Code 83880. Medicare covered 904,431 of these. Here is what providers billed and what Medicare allowed, state by state.

$170.54Billed, national avg
$38.41Medicare allowed
4.4xBilled vs allowed
5.0xHighest vs lowest state

Providers in New Hampshire billed the most for this, at $219.41. In Puerto Rico the average was $43.99. 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 Hampshire$219.41$38.325.7x269
New Jersey$206.69$38.455.4x117,090
North Carolina$205.34$38.445.3x55,343
Connecticut$196.02$38.465.1x854
Kansas$194.77$38.455.1x28,426
Colorado$191.47$38.375.0x8,212
Alaska$187.53$38.184.9x263
New York$185.66$38.454.8x55,942
Arkansas$182.90$38.244.8x4,505
Georgia$182.54$38.374.8x12,884
Arizona$181.32$38.444.7x19,736
Alabama$179.85$38.364.7x19,361
Wisconsin$178.05$38.214.7x17,744
Wyoming$174.24$38.474.5x264
Massachusetts$173.50$38.464.5x23,217
Texas$170.04$38.414.4x110,298
Pennsylvania$169.21$38.444.4x15,260
Washington$168.91$38.394.4x18,487
Minnesota$166.55$38.384.3x15,037
California$166.37$38.444.3x108,822
Florida$166.32$38.434.3x58,365
Maryland$163.22$38.404.3x8,836
South Dakota$162.23$38.454.2x2,204
Illinois$156.51$38.404.1x29,638
Nevada$154.12$38.424.0x4,260
North Dakota$153.91$38.434.0x1,907
Guam$149.31$38.313.9x119
Ohio$147.89$38.423.8x29,515
Oklahoma$143.38$38.403.7x25,137
Louisiana$143.32$38.383.7x6,603
Iowa$140.74$38.373.7x5,264
Oregon$134.15$38.383.5x6,772
Tennessee$132.12$38.313.4x25,935
South Carolina$131.89$38.163.5x4,369
Montana$129.85$38.413.4x304
West Virginia$123.27$37.903.3x68
Mississippi$122.80$38.153.2x7,078
Virginia$120.91$38.383.2x13,613
New Mexico$118.23$38.333.1x1,955
Maine$115.00$38.473.0x1,024
Missouri$114.06$38.393.0x3,169
Rhode Island$100.55$38.452.6x1,709
Kentucky$99.39$38.412.6x4,516
Indiana$98.16$38.402.6x4,473
Michigan$97.55$38.402.5x10,888
Hawaii$96.79$38.372.5x3,303
Idaho$92.26$38.412.4x999
Nebraska$90.10$38.442.3x5,262
Utah$88.78$38.442.3x3,693
Delaware$69.55$38.471.8x371
Virgin Islands$53.99$38.471.4x85
Puerto Rico$43.99$37.661.2x915

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

← All procedures