93000

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

Code 93000. Medicare covered 10,144,071 of these. Here is what providers billed and what Medicare allowed, state by state.

$69.02Billed, national avg
$14.20Medicare allowed
4.9xBilled vs allowed
7.7xHighest vs lowest state

Providers in Wisconsin billed the most for this, at $176.65. In Puerto Rico the average was $22.93. 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
Wisconsin$176.65$13.1813.4x62,884
Alaska$157.26$16.629.5x12,922
Wyoming$150.29$13.7910.9x10,983
Minnesota$134.81$13.689.9x67,737
New York$97.35$15.876.1x1,227,152
Arkansas$88.25$12.187.2x67,235
South Carolina$86.48$12.986.7x231,413
South Dakota$84.08$13.166.4x4,625
Illinois$83.97$14.375.8x265,779
Idaho$82.37$12.626.5x8,570
Connecticut$81.39$14.945.4x175,993
North Carolina$80.44$12.936.2x225,347
Pennsylvania$80.10$14.035.7x482,445
Vermont$76.31$13.085.8x3,967
Massachusetts$73.86$14.775.0x307,196
Kansas$72.67$12.835.7x71,053
Mississippi$72.14$12.515.8x111,262
Armed Forces Europe$72.06$14.435.0x34
Foreign Country$71.48$11.766.1x42
California$70.73$15.344.6x960,958
New Jersey$70.11$15.424.5x658,569
New Hampshire$70.00$14.035.0x20,840
Georgia$69.08$13.425.1x345,095
Indiana$66.36$12.825.2x134,141
Iowa$65.66$12.545.2x43,308
Hawaii$64.81$14.584.4x16,679
Maine$64.48$13.884.6x6,427
North Dakota$63.88$13.864.6x1,670
Missouri$63.41$12.994.9x101,076
West Virginia$62.30$12.794.9x21,446
District of Columbia$61.36$15.583.9x31,855
Maryland$60.79$14.724.1x434,922
Texas$59.73$13.564.4x791,571
Nevada$59.69$13.644.4x65,677
Armed Forces Pacific$58.67$13.654.3x67
Virginia$57.10$14.084.1x299,634
Nebraska$55.80$12.564.4x48,194
Alabama$55.61$12.434.5x170,706
Louisiana$55.05$12.874.3x155,206
Oregon$54.99$13.674.0x33,732
Colorado$54.78$13.923.9x87,318
New Mexico$54.37$12.754.3x24,236
Tennessee$52.65$12.624.2x277,192
Rhode Island$51.58$14.123.7x27,771
Ohio$51.25$13.093.9x237,501
Washington$50.65$14.083.6x72,095
Oklahoma$50.57$12.813.9x61,774
Kentucky$50.36$12.534.0x113,411
Delaware$50.19$13.693.7x84,567
Utah$50.04$13.463.7x24,345
Florida$48.48$14.013.5x910,957
Michigan$47.06$13.933.4x185,199
Arizona$43.41$13.543.2x327,933
Montana$40.43$13.683.0x10,691
Unknown$30.05$15.471.9x459
Virgin Islands$29.40$13.312.2x3,362
Guam$24.14$14.191.7x590
Northern Mariana Islands$23.52$14.461.6x38
Puerto Rico$22.93$13.921.6x16,176

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

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