Florida

What Medicare pays in Florida

Billed charges against Medicare allowed amounts in Florida, across the 250 procedures Medicare covers most often.

250Procedures
135,343,972Services covered
3.0xBilled vs allowed
#33Rank of 61

Providers here billed the most above the national figure for removal of cataract with insertion of prosthetic lens. The average was $2,720.54 against a national $1,027.76. That is 2.6 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 Florida

ProcedureBilled hereAllowedGapvs national billed
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$2.14$1.082.0x1.23x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$275.22$121.172.3x1.00x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$189.86$85.722.2x1.01x
Ground mileage, per statute mile$15.70$9.021.7x0.59x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$71.97$22.043.3x1.04x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$192.08$77.012.5x0.94x
Insertion of needle into vein for collection of blood sample$22.47$8.472.7x1.03x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$35.70$7.604.7x0.96x
Blood test, comprehensive group of blood chemicals$70.61$10.346.8x1.15x
Therapy procedure using functional activities$76.15$29.722.6x1.02x
Destruction of precancer skin growth, 2-14 growths$16.57$6.052.7x0.75x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$309.07$116.202.7x0.95x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$72.33$25.952.8x1.00x
Pathology examination of tissue using a microscope, intermediate complexity$158.46$53.313.0x0.85x
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$42.64$16.022.7x0.98x
Blood test, lipids (cholesterol and triglycerides)$112.39$13.118.6x1.17x
Therapy procedure using manual technique, each 15 minutes$66.48$19.913.3x0.98x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$211.21$95.882.2x1.00x
Blood test, thyroid stimulating hormone (tsh)$103.85$16.456.3x1.08x
Hemoglobin a1c level$65.39$9.516.9x1.13x
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more$156.24$68.172.3x1.01x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$418.47$160.812.6x1.02x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$532.98$168.413.2x0.94x
Injection, bupivacaine liposome, 1 mg$5.29$1.403.8x1.08x
Detection test by nucleic acid for organism, amplified probe technique$78.37$34.342.3x1.24x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$45.66$7.955.7x1.02x
Administration of influenza virus vaccine$49.42$28.171.8x1.21x
Injection, fosaprepitant (focinvez), 1 mg$8.99$2.853.1x1.02x
X-ray of chest, 1 view$61.13$8.667.1x1.17x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report$48.48$14.013.5x0.70x
Test for allergy using allergenic extract$11.83$3.673.2x0.89x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$276.19$121.072.3x0.99x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$389.74$168.852.3x0.96x
Destruction of precancer skin growth, 1 growth$132.95$47.142.8x0.86x
Cyanocobalamin (vitamin b-12) level$91.47$14.776.2x1.04x
Chiropractic manipulative treatment, 3-4 spinal regions$72.03$37.871.9x1.19x
Manual urinalysis test with examination using microscope, automated$37.98$3.1112.2x1.19x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$273.73$105.172.6x1.03x
Established patient complete exam of visual system$214.37$122.071.8x0.94x
Vitamin d-3 level$201.81$28.987.0x1.10x

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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