93010

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

Code 93010. Medicare covered 15,486,654 of these. Here is what providers billed and what Medicare allowed, state by state.

$44.77Billed, national avg
$7.95Medicare allowed
5.6xBilled vs allowed
11.3xHighest vs lowest state

Providers in Armed Forces Europe billed the most for this, at $102.14. In Virgin Islands the average was $9.05. 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
Armed Forces Europe$102.14$7.6113.4x326
Wisconsin$98.92$7.5713.1x284,057
Alaska$91.92$10.518.7x29,536
Foreign Country$78.61$7.8010.1x394
Armed Forces Central/South America$77.63$8.569.1x234
New Hampshire$72.97$7.919.2x99,237
Wyoming$72.70$7.989.1x18,834
Armed Forces Pacific$65.83$7.818.4x769
Minnesota$65.62$7.768.5x216,720
Vermont$63.46$7.658.3x46,307
Arizona$58.69$7.737.6x155,557
Mississippi$53.39$7.497.1x156,456
Delaware$53.11$7.826.8x62,011
South Carolina$51.38$7.656.7x275,749
California$50.55$8.416.0x1,254,504
Texas$48.37$7.836.2x909,838
Louisiana$48.13$7.666.3x231,496
Illinois$47.91$8.115.9x780,783
Connecticut$47.86$8.275.8x207,278
Hawaii$47.76$7.906.0x25,595
Georgia$46.45$7.796.0x397,465
Maine$46.28$7.756.0x81,270
West Virginia$46.27$7.805.9x104,693
Florida$45.66$7.955.7x955,785
North Dakota$45.36$7.685.9x58,149
Pennsylvania$44.31$7.905.6x930,401
Iowa$43.43$7.465.8x178,613
Nevada$42.77$7.795.5x99,318
North Carolina$42.65$7.585.6x457,361
New Jersey$42.61$8.505.0x495,997
New York$42.21$8.594.9x1,135,347
Ohio$41.71$7.685.4x620,244
Virginia$41.42$7.895.2x450,420
Rhode Island$41.03$7.945.2x64,168
Michigan$40.70$7.915.1x505,476
Alabama$40.47$7.465.4x206,598
Guam$40.47$8.165.0x2,365
Indiana$40.18$7.545.3x361,278
Colorado$40.16$7.955.1x180,412
Utah$38.36$7.754.9x75,883
District of Columbia$37.85$8.544.4x36,937
Tennessee$37.24$7.534.9x320,052
Missouri$37.08$7.684.8x312,114
Kansas$36.82$7.524.9x163,353
Puerto Rico$36.72$7.754.7x8,009
Washington$36.06$8.074.5x271,284
Massachusetts$35.93$8.224.4x633,237
Oregon$35.91$7.914.5x152,191
Oklahoma$35.46$7.574.7x224,329
Maryland$34.66$8.164.2x390,436
Kentucky$34.63$7.714.5x275,383
New Mexico$33.13$7.724.3x75,253
Nebraska$32.69$7.514.4x103,264
South Dakota$32.09$7.574.2x60,117
Arkansas$31.08$7.384.2x223,505
Idaho$30.29$7.424.1x68,371
Montana$29.74$7.833.8x50,593
Virgin Islands$9.05$7.351.2x1,293

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

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