93298

Evaluation of cardiac rhythm monitor system, remote up to 30 days

Code 93298. Medicare covered 1,545,091 of these. Here is what providers billed and what Medicare allowed, state by state.

$197.77Billed, national avg
$75.90Medicare allowed
2.6xBilled vs allowed
7.0xHighest vs lowest state

Providers in New York billed the most for this, at $371.58. In North Dakota the average was $53.06. 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$371.58$94.443.9x297,504
Wyoming$367.48$69.785.3x504
Alaska$273.16$94.752.9x1,922
Wisconsin$269.10$55.764.8x9,055
Hawaii$253.14$35.527.1x682
Minnesota$217.85$68.633.2x13,546
Colorado$216.44$68.473.2x30,133
New Hampshire$208.66$38.255.5x5,007
Massachusetts$202.59$65.733.1x32,892
Connecticut$193.34$88.482.2x16,023
California$191.08$81.642.3x143,449
Tennessee$183.33$66.832.7x25,419
New Jersey$182.64$94.351.9x66,427
Nebraska$175.40$72.862.4x4,595
Nevada$175.00$65.812.7x5,518
Washington$172.55$65.232.6x11,251
Illinois$166.84$77.492.2x43,213
Florida$164.47$80.442.0x177,765
Vermont$163.01$28.125.8x2,079
Delaware$160.53$79.322.0x7,804
Pennsylvania$158.72$70.562.2x63,054
Rhode Island$152.29$43.873.5x2,295
Texas$152.28$74.642.0x106,039
Kansas$148.00$69.632.1x39,270
North Carolina$147.94$74.022.0x33,927
Montana$146.62$45.333.2x2,843
Virginia$142.24$65.452.2x36,351
Georgia$142.03$71.472.0x21,795
Missouri$141.52$62.632.3x19,768
Maryland$136.67$85.171.6x24,747
Arizona$133.29$63.582.1x47,301
Oregon$132.28$49.782.7x5,309
Mississippi$127.45$75.361.7x15,652
Ohio$123.63$57.042.2x39,353
Louisiana$121.48$60.252.0x18,557
Maine$119.56$45.772.6x2,260
Alabama$109.54$67.221.6x11,245
South Carolina$108.93$61.551.8x40,447
Michigan$108.49$54.742.0x33,476
Indiana$107.32$58.461.8x12,842
Iowa$106.94$42.952.5x6,012
District of Columbia$101.98$86.531.2x1,590
West Virginia$100.92$57.291.8x6,795
New Mexico$98.43$40.222.4x3,300
Kentucky$95.93$55.961.7x10,198
Idaho$91.19$35.952.5x3,989
Utah$84.59$60.961.4x3,848
South Dakota$79.86$35.742.2x2,065
Oklahoma$77.48$42.921.8x22,761
Arkansas$71.64$42.891.7x6,682
North Dakota$53.06$24.982.1x6,524

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

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