95886

Needle measurement of electrical activity in arm or leg muscles, complete study

Code 95886. Medicare covered 842,347 of these. Here is what providers billed and what Medicare allowed, state by state.

$295.65Billed, national avg
$86.64Medicare allowed
3.4xBilled vs allowed
8.9xHighest vs lowest state

Providers in Alaska billed the most for this, at $964.63. In Guam the average was $107.86. 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
Alaska$964.63$103.799.3x1,657
Wisconsin$552.80$70.057.9x9,459
Nevada$506.04$87.465.8x15,799
New Jersey$454.79$100.594.5x29,767
Utah$414.09$82.605.0x5,916
Connecticut$393.10$94.954.1x6,344
Minnesota$374.79$82.614.5x11,757
Texas$373.30$84.564.4x61,281
Wyoming$373.00$91.184.1x1,956
Louisiana$347.69$82.004.2x12,630
Illinois$327.07$76.874.3x31,797
Arizona$324.35$87.863.7x25,044
Georgia$317.66$83.533.8x17,347
Delaware$316.68$86.503.7x4,823
New York$316.34$101.373.1x82,913
Florida$314.70$94.003.3x62,451
New Hampshire$308.07$75.204.1x2,884
Massachusetts$292.22$80.973.6x18,458
Virgin Islands$286.44$92.213.1x65
Colorado$282.65$91.113.1x10,617
Rhode Island$281.40$96.632.9x1,827
Iowa$276.86$80.813.4x5,927
California$273.20$101.082.7x89,781
Oregon$270.32$87.993.1x8,197
South Carolina$266.41$82.953.2x14,265
Virginia$251.74$86.042.9x23,204
New Mexico$249.83$78.933.2x3,406
Washington$249.12$84.013.0x13,130
Maryland$248.47$97.962.5x22,410
Indiana$246.29$77.253.2x15,519
Nebraska$244.82$72.643.4x5,149
Arkansas$241.37$72.553.3x8,068
Vermont$235.28$57.154.1x755
North Carolina$234.05$84.482.8x19,837
Pennsylvania$231.08$77.763.0x36,176
District of Columbia$229.62$105.202.2x1,364
Michigan$228.53$81.452.8x26,370
Oklahoma$222.13$75.243.0x9,117
Tennessee$221.88$79.072.8x19,392
Kentucky$216.17$69.773.1x10,389
Missouri$215.99$65.553.3x12,918
Kansas$214.16$83.782.6x8,441
West Virginia$209.33$70.863.0x4,621
Mississippi$205.14$73.482.8x7,908
Ohio$204.90$69.732.9x31,522
Montana$204.14$69.342.9x3,099
South Dakota$200.40$63.163.2x4,977
Maine$197.79$54.483.6x2,454
Alabama$195.37$75.292.6x10,548
Hawaii$187.78$86.312.2x1,610
Idaho$165.28$56.852.9x3,338
North Dakota$159.33$46.393.4x1,616
Puerto Rico$149.35$94.481.6x1,795
Guam$107.86$109.681.0x248

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

← All procedures