99233

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes

Code 99233. Medicare covered 22,973,090 of these. Here is what providers billed and what Medicare allowed, state by state.

$325.44Billed, national avg
$115.50Medicare allowed
2.8xBilled vs allowed
3.8xHighest vs lowest state

Providers in Armed Forces Central/South America billed the most for this, at $710.64. In Virgin Islands the average was $186.28. 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 Central/South America$710.64$113.836.2x408
Foreign Country$608.27$112.415.4x1,046
Alaska$571.70$148.643.8x31,148
New Hampshire$461.34$113.624.1x78,814
Minnesota$432.35$109.883.9x257,129
Wyoming$415.91$111.983.7x14,773
New York$415.60$125.283.3x1,368,332
Wisconsin$414.08$108.113.8x227,202
Oregon$372.56$114.923.2x147,640
Washington$368.61$117.023.2x293,377
New Jersey$365.62$121.973.0x1,024,276
Massachusetts$364.53$118.463.1x600,290
Maryland$360.99$118.493.0x525,252
Northern Mariana Islands$358.63$109.893.3x32
Ohio$356.89$110.483.2x755,984
Idaho$354.35$108.133.3x49,861
California$350.90$120.812.9x3,282,653
North Dakota$348.31$111.063.1x35,559
Montana$348.25$112.863.1x41,988
District of Columbia$331.13$125.162.6x118,004
New Mexico$323.35$109.942.9x71,236
Georgia$323.04$112.602.9x618,503
Vermont$322.01$111.822.9x24,242
West Virginia$319.85$112.362.8x94,353
Armed Forces Pacific$319.56$125.172.6x533
Virginia$319.09$115.142.8x524,705
Oklahoma$317.92$108.572.9x281,924
Nevada$317.90$111.532.9x372,444
Iowa$317.67$108.522.9x117,082
Tennessee$316.99$107.952.9x422,536
Colorado$315.61$114.342.8x240,970
Utah$315.22$110.412.9x73,374
Connecticut$315.12$119.702.6x184,440
North Carolina$314.97$109.492.9x534,525
Texas$313.84$112.432.8x1,995,804
Rhode Island$311.40$116.212.7x52,738
Florida$309.07$116.202.7x2,204,073
South Carolina$307.11$110.732.8x250,268
Kansas$304.86$109.162.8x223,812
Louisiana$301.40$109.782.7x285,746
Guam$300.32$113.142.7x6,104
Maine$297.15$113.332.6x55,317
Illinois$291.67$118.602.5x1,226,378
Missouri$287.78$111.312.6x365,456
Armed Forces Europe$284.18$112.262.5x92
Kentucky$281.86$110.922.5x306,274
Michigan$279.53$115.532.4x572,633
Nebraska$279.04$106.712.6x113,180
Pennsylvania$272.80$113.692.4x915,905
Hawaii$267.32$115.522.3x60,715
Delaware$259.39$114.302.3x85,357
Indiana$259.19$108.352.4x420,976
Arizona$256.76$112.032.3x629,747
South Dakota$244.50$110.262.2x38,043
Mississippi$242.24$107.862.2x234,856
$240.00$118.752.0x238
Alabama$233.86$107.322.2x288,649
Arkansas$220.85$106.762.1x201,574
Puerto Rico$190.31$110.171.7x23,232
Virgin Islands$186.28$111.481.7x1,238

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

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