Colorado

What Medicare pays in Colorado

Billed charges against Medicare allowed amounts in Colorado, across the 249 procedures Medicare covers most often.

249Procedures
18,766,967Services covered
3.3xBilled vs allowed
#21Rank of 61

Providers here billed the most above the national figure for removal of cataract with insertion of prosthetic lens. The average was $2,538.82 against a national $1,027.76. That is 2.5 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 Colorado

ProcedureBilled hereAllowedGapvs national billed
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$285.72$113.682.5x1.04x
Ground mileage, per statute mile$30.93$9.513.3x1.17x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$68.52$23.173.0x0.99x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$199.39$83.452.4x1.06x
Therapy procedure using functional activities$76.08$31.812.4x1.02x
Therapy procedure using manual technique, each 15 minutes$67.41$20.663.3x0.99x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$71.97$27.262.6x0.99x
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled$2.99$1.112.7x1.72x
Destruction of precancer skin growth, 2-14 growths$17.92$6.502.8x0.82x
Insertion of needle into vein for collection of blood sample$21.08$8.402.5x0.97x
Detection test by nucleic acid for organism, amplified probe technique$60.14$34.381.7x0.95x
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$38.41$15.722.4x0.88x
Administration of influenza virus vaccine$33.37$28.161.2x0.82x
Admn sarscov2 vacc 1 dose$42.77$36.971.2x0.85x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$427.55$153.222.8x1.05x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$216.04$75.192.9x1.06x
Pathology examination of tissue using a microscope, intermediate complexity$154.58$47.653.2x0.83x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$315.61$114.342.8x0.97x
Blood test, comprehensive group of blood chemicals$50.42$10.324.9x0.82x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$31.29$7.594.1x0.84x
Rotary wing air mileage, per statute mile$289.54$40.467.2x0.81x
X-ray of chest, 1 view$61.66$8.477.3x1.18x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$409.14$157.652.6x1.00x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$40.16$7.955.1x0.90x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$202.58$96.222.1x0.96x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$286.39$91.213.1x1.03x
Chiropractic manipulative treatment, 3-4 spinal regions$62.30$38.991.6x1.03x
Injection, bupivacaine liposome, 1 mg$3.13$1.382.3x0.64x
Fixed wing air mileage, per statute mile$250.66$15.3516.3x1.81x
Psychotherapy, 1 hour$228.01$123.971.8x1.09x
Imaging of retina$108.59$39.822.7x0.88x
Blood test, lipids (cholesterol and triglycerides)$84.76$13.106.5x0.88x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$267.40$104.132.6x1.01x
Hemoglobin a1c level$51.76$9.485.5x0.89x
Established patient complete exam of visual system$236.75$123.031.9x1.04x
Test for allergy using allergenic extract$13.95$3.533.9x1.06x
Destruction of precancer skin growth, 1 growth$157.47$52.253.0x1.01x
Blood test, thyroid stimulating hormone (tsh)$97.29$16.435.9x1.01x
Emergency department visit with high level of medical decision making$1,133.43$168.796.7x0.92x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$572.60$166.473.4x1.01x

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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