Indiana

What Medicare pays in Indiana

Billed charges against Medicare allowed amounts in Indiana, across the 248 procedures Medicare covers most often.

248Procedures
23,179,438Services covered
2.9xBilled vs allowed
#41Rank of 61

Providers here billed the most above the national figure for removal of cataract with insertion of prosthetic lens. The average was $2,364.03 against a national $1,027.76. That is 2.3 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 Indiana

ProcedureBilled hereAllowedGapvs national billed
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$219.81$111.282.0x0.80x
Ground mileage, per statute mile$25.03$9.632.6x0.95x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$151.32$78.511.9x0.80x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$74.54$21.353.5x1.08x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$160.31$71.402.2x0.79x
Therapy procedure using functional activities$80.13$28.882.8x1.07x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$80.11$25.253.2x1.10x
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$36.32$14.892.4x0.84x
Insertion of needle into vein for collection of blood sample$14.81$8.551.7x0.68x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$259.19$108.352.4x0.80x
Therapy procedure using manual technique, each 15 minutes$69.36$19.353.6x1.02x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$186.33$87.812.1x0.88x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$40.18$7.545.3x0.90x
Destruction of precancer skin growth, 2-14 growths$30.48$5.625.4x1.39x
Pathology examination of tissue using a microscope, intermediate complexity$183.29$42.834.3x0.99x
Chiropractic manipulative treatment, 3-4 spinal regions$50.59$36.471.4x0.83x
Administration of influenza virus vaccine$34.20$27.651.2x0.84x
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more$130.85$61.522.1x0.85x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$316.35$147.642.1x0.77x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$234.63$116.772.0x0.84x
X-ray of chest, 1 view$41.19$8.025.1x0.79x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$454.43$156.702.9x0.80x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$294.89$152.261.9x0.72x
Emergency department visit with high level of medical decision making$1,123.42$160.767.0x0.91x
Detection test by nucleic acid for organism, amplified probe technique$39.51$34.391.1x0.62x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$31.24$7.594.1x0.84x
Hemoglobin a1c level$39.10$9.464.1x0.67x
Blood test, comprehensive group of blood chemicals$46.83$10.324.5x0.76x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$210.97$97.152.2x0.79x
Admn sarscov2 vacc 1 dose$41.99$35.171.2x0.83x
Injection, bupivacaine liposome, 1 mg$6.17$1.394.5x1.26x
Imaging of retina$108.75$37.612.9x0.88x
Automated urinalysis test$12.30$2.195.6x0.81x
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$95.11$48.362.0x0.81x
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes$283.00$117.442.4x0.77x
Test for allergy using allergenic extract$13.11$3.144.2x0.99x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report$66.36$12.825.2x0.96x
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function$291.84$73.184.0x0.61x
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month$108.18$55.841.9x0.96x
Screening mammography$172.45$47.293.6x0.70x

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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