88313

Special stained specimen slides to examine tissue including interpretation and report

Code 88313. Medicare covered 1,445,845 of these. Here is what providers billed and what Medicare allowed, state by state.

$128.71Billed, national avg
$42.79Medicare allowed
3.0xBilled vs allowed
4.9xHighest vs lowest state

Providers in New York billed the most for this, at $192.89. In Maine the average was $39.10. 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 York$192.89$50.683.8x138,844
Connecticut$175.45$58.853.0x24,467
New Jersey$172.64$64.852.7x104,828
New Hampshire$161.84$16.889.6x3,078
Illinois$158.17$37.474.2x41,028
Maryland$152.03$68.942.2x78,476
California$149.31$46.413.2x159,063
Rhode Island$145.99$39.033.7x2,591
Texas$141.78$43.493.3x109,248
Wisconsin$135.62$23.415.8x13,752
Florida$130.33$49.512.6x125,143
Louisiana$120.90$35.713.4x14,735
Pennsylvania$117.12$37.083.2x58,483
Kansas$117.09$22.145.3x8,221
Tennessee$113.07$40.422.8x44,273
Mississippi$112.57$33.573.4x7,410
Arizona$111.47$46.762.4x43,463
Oregon$104.51$29.293.6x4,871
Virginia$103.71$26.423.9x32,307
Georgia$101.97$47.022.2x54,017
Delaware$101.57$31.603.2x6,012
Iowa$99.62$22.394.4x6,376
South Carolina$98.71$45.052.2x26,305
Colorado$98.45$33.422.9x10,848
Massachusetts$98.01$29.033.4x37,217
Alaska$94.64$15.955.9x860
Ohio$94.36$27.453.4x31,574
New Mexico$93.00$38.692.4x3,212
West Virginia$92.40$26.203.5x2,911
Missouri$90.79$23.683.8x19,292
Oklahoma$90.78$28.183.2x12,780
Washington$90.44$27.893.2x14,699
North Carolina$88.92$30.412.9x19,518
Indiana$87.84$22.054.0x13,799
Utah$83.94$35.932.3x6,596
Minnesota$83.58$23.043.6x18,206
Kentucky$79.68$20.783.8x5,789
Nevada$79.38$29.152.7x3,415
Alabama$77.56$30.312.6x11,872
Michigan$76.41$14.855.1x11,591
District of Columbia$75.73$22.973.3x3,890
Hawaii$75.45$26.452.9x1,414
North Dakota$73.27$13.855.3x1,852
Wyoming$71.39$12.075.9x386
Vermont$69.39$11.276.2x1,326
Nebraska$63.33$17.783.6x3,773
Arkansas$56.60$25.602.2x93,630
Idaho$54.61$19.422.8x1,538
Puerto Rico$48.17$37.781.3x473
South Dakota$44.38$12.703.5x2,100
Montana$42.74$16.682.6x1,499
Armed Forces Pacific$40.57$11.653.5x28
Foreign Country$39.95$11.573.5x38
Maine$39.10$15.952.5x2,703

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

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