Nevada

What Medicare pays in Nevada

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

249Procedures
13,489,395Services covered
3.5xBilled vs allowed
#13Rank of 61

Providers here billed the most above the national figure for instillation, bupivacaine and meloxicam, 1 mg/0.03 mg. The average was $10.98 against a national $2.36. That is 4.7 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 Nevada

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$1.13$1.101.0x0.65x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$293.18$116.752.5x1.07x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$67.99$22.803.0x0.98x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$207.51$82.932.5x1.10x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$206.26$72.322.9x1.01x
Ground mileage, per statute mile$34.58$9.523.6x1.31x
Therapy procedure using functional activities$84.62$30.392.8x1.14x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$317.90$111.532.9x0.98x
Insertion of needle into vein for collection of blood sample$27.46$8.583.2x1.26x
Therapy procedure using manual technique, each 15 minutes$70.47$20.143.5x1.04x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$73.48$26.542.8x1.01x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$34.20$7.594.5x0.92x
Blood test, comprehensive group of blood chemicals$68.05$10.326.6x1.11x
Destruction of precancer skin growth, 2-14 growths$15.18$6.052.5x0.69x
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more$172.77$64.752.7x1.12x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$564.87$162.643.5x0.99x
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$39.21$15.192.6x0.90x
Rotary wing air mileage, per statute mile$392.01$38.2810.2x1.10x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$246.55$93.642.6x1.17x
Blood test, lipids (cholesterol and triglycerides)$130.54$13.1010.0x1.36x
Pathology examination of tissue using a microscope, intermediate complexity$209.67$50.154.2x1.13x
X-ray of chest, 1 view$76.46$8.389.1x1.46x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$434.72$154.632.8x1.06x
Blood test, thyroid stimulating hormone (tsh)$110.83$16.456.7x1.16x
Hemoglobin a1c level$62.44$9.506.6x1.08x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$42.77$7.795.5x0.96x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$381.36$163.242.3x0.94x
Test for allergy using allergenic extract$14.38$3.384.3x1.09x
Chiropractic manipulative treatment, 3-4 spinal regions$66.27$38.171.7x1.09x
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)$26.83$10.612.5x1.40x
Emergency department visit with high level of medical decision making$1,542.66$165.929.3x1.25x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$300.98$102.312.9x1.13x
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month$121.78$59.552.0x1.08x
Manual urinalysis test with examination using microscope, automated$39.35$3.1012.7x1.23x
Administration of influenza virus vaccine$34.09$27.291.2x0.84x
Hospital discharge day management, more than 30 minutes$376.37$109.253.4x1.06x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report$59.69$13.644.4x0.86x
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month$117.90$46.132.6x1.22x
Imaging of retina$113.72$39.532.9x0.92x
Advance care planning, first 30 minutes$151.32$70.622.1x0.81x

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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