Armed Forces Pacific

What Medicare pays in Armed Forces Pacific

Billed charges against Medicare allowed amounts in Armed Forces Pacific, across the 117 procedures Medicare covers most often.

117Procedures
32,552Services covered
3.8xBilled vs allowed
#8Rank of 61

Providers here billed the most above the national figure for blood test, comprehensive group of blood chemicals. The average was $241.38 against a national $61.44. That is 3.9 times as much.

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.

The 40 most common procedures in Armed Forces Pacific

ProcedureBilled hereAllowedGapvs national billed
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$249.80$114.442.2x0.91x
X-ray of chest, 1 view$53.51$8.646.2x1.02x
X-ray of chest, 2 views$84.07$14.265.9x1.17x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$241.29$78.793.1x1.19x
Therapy procedure using functional activities$103.24$30.933.3x1.38x
Emergency department visit with high level of medical decision making$1,217.62$175.956.9x0.99x
Screening 3d breast mammography$165.51$41.064.0x1.20x
Screening mammography$329.38$81.984.0x1.33x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$194.38$87.612.2x0.92x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$170.62$79.752.1x0.91x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$65.83$7.818.4x1.47x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$76.38$21.233.6x1.10x
Ct scan head or brain without contrast$183.21$41.364.4x0.74x
Pathology examination of tissue using a microscope, intermediate complexity$202.04$51.743.9x1.09x
Ct scan of abdomen and pelvis with contrast$446.07$110.504.0x0.72x
Emergency department visit with moderate level of medical decision making$788.94$123.436.4x1.00x
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's$35.18$15.702.2x0.81x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$319.56$125.172.6x0.98x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$210.35$115.391.8x0.76x
Critical care, first 30-74 minutes$1,315.07$217.806.0x1.25x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$75.25$26.682.8x1.04x
Ct scan of chest without contrast$362.41$78.674.6x0.87x
Therapy procedure using manual technique, each 15 minutes$74.91$20.333.7x1.10x
Detection test by immunoassay with direct visual observation for influenza virus$42.98$16.222.6x0.98x
Psychotherapy, 1 hour$167.22$110.431.5x0.80x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$735.53$171.584.3x1.29x
Ultrasound scan of head and neck soft tissue$390.30$60.566.4x1.62x
Dxa bone density measurement of hip, pelvis, spine$271.77$40.996.6x1.74x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$239.42$96.862.5x0.90x
X-ray of abdomen, 1 view$39.18$11.633.4x0.71x
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)$168.83$38.914.3x1.10x
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more$137.49$60.332.3x0.89x
Ct scan of abdomen and pelvis without contrast$494.97$97.255.1x0.89x
X-ray of hip, 2-3 views$71.72$20.673.5x0.71x
X-ray of shoulder, minimum of 2 views$56.21$16.313.4x0.62x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$400.87$151.972.6x0.98x
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes$280.85$128.322.2x0.96x
Insertion of needle into vein for collection of blood sample$15.76$8.511.9x0.72x
Ct scan of blood vessels of chest with contrast$416.77$96.454.3x0.78x
Psychotherapy, 30 minutes$131.95$58.832.2x1.01x

The last column compares this state against the national average for the same code. Above 1.00 means providers here billed more.

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

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