The Cost Map Foreign Country

What Medicare pays in Foreign Country

Billed charges against Medicare allowed amounts in Foreign Country, across the 109 procedures Medicare covers most often.

109Procedures

26,117Services covered

5.1xBilled vs allowed

#3Rank of 61

Providers here billed the most above the national figure for physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and. The average was $516.42 against a national $130.48. That is 4.0 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 Foreign Country

Procedure	Billed here	Allowed	Gap	vs national billed
Therapy procedure using functional activities	$72.64	$28.78	2.5x	0.97x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$296.63	$107.19	2.8x	1.08x
Pathology examination of tissue using a microscope, intermediate complexity	$169.58	$36.12	4.7x	0.91x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	$387.10	$73.53	5.3x	1.90x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	$608.27	$112.41	5.4x	1.87x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$232.46	$76.74	3.0x	1.23x
Emergency department visit with high level of medical decision making	$1,627.15	$168.03	9.7x	1.32x
Injection of drug or substance under skin or into muscle	$59.42	$11.46	5.2x	1.07x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	$67.92	$22.18	3.1x	0.98x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	$65.77	$25.86	2.5x	0.91x
Hospital discharge day management, more than 30 minutes	$814.79	$110.55	7.4x	2.31x
Special stained specimen slides to examine tissue, each additional procedure	$117.39	$28.71	4.1x	0.80x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	$317.82	$138.43	2.3x	0.78x
Psychotherapy, 1 hour	$196.89	$128.77	1.5x	0.94x
Emergency department visit with moderate level of medical decision making	$998.72	$114.85	8.7x	1.27x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	$888.89	$160.31	5.5x	1.56x
Pathology examination of tissue using a microscope, moderately high complexity	$427.01	$80.09	5.3x	1.17x
Critical care, first 30-74 minutes	$1,718.64	$203.80	8.4x	1.64x
Therapy procedure using manual technique, each 15 minutes	$65.66	$20.22	3.2x	0.97x
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	$123.53	$44.78	2.8x	1.03x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	$462.33	$139.60	3.3x	1.13x
Ct scan of abdomen and pelvis with contrast	$411.22	$82.38	5.0x	0.67x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	$78.61	$7.80	10.1x	1.76x
Ct scan head or brain without contrast	$250.64	$38.24	6.6x	1.01x
X-ray of abdomen, 1 view	$39.96	$8.51	4.7x	0.72x
Established patient problem focused exam of visual system	$165.16	$83.67	2.0x	0.99x
Special stained specimen slides to examine tissue, initial procedure	$160.13	$35.37	4.5x	0.83x
X-ray of chest, 2 views	$120.87	$22.65	5.3x	1.68x
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	$353.94	$125.30	2.8x	0.96x
Complete ultrasound scan behind abdominal cavity	$259.26	$33.91	7.6x	1.05x
X-ray of chest, 1 view	$103.49	$8.28	12.5x	1.98x
Limited ultrasound scan of abdomen	$333.38	$27.23	12.2x	1.81x
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$1,111.12	$92.01	12.1x	0.76x
Protein measurement, serum	$75.00	$17.35	4.3x	1.07x
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	$468.99	$173.68	2.7x	0.84x
Imaging of retina	$88.52	$37.85	2.3x	0.71x
Automated urinalysis test	$16.63	$2.19	7.6x	1.10x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	$251.83	$88.39	2.8x	0.95x
Established patient complete exam of visual system	$229.40	$118.52	1.9x	1.01x
Anesthesia for lens surgery	$1,536.60	$104.31	14.7x	1.73x

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.

← All states · All procedures