Northern Mariana Islands

What Medicare pays in Northern Mariana Islands

Billed charges against Medicare allowed amounts in Northern Mariana Islands, across the 52 procedures Medicare covers most often.

52Procedures
13,684Services covered
2.4xBilled vs allowed
#58Rank of 61

Providers here billed the most above the national figure for removal of cataract with insertion of prosthetic lens. The average was $4,646.76 against a national $1,027.76. That is 4.5 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 Northern Mariana Islands

ProcedureBilled hereAllowedGapvs national billed
Ground mileage, per statute mile$15.00$13.101.1x0.57x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$139.54$109.751.3x0.51x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$102.99$69.851.5x0.55x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$254.08$71.013.6x1.25x
Established patient problem focused exam of visual system$159.96$94.871.7x0.96x
Removal of skin and tissue, 20.0 sq cm or less$336.75$80.374.2x1.22x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$44.97$24.601.8x0.65x
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more$175.58$70.482.5x1.14x
Established patient complete exam of visual system$194.14$133.981.4x0.85x
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional$26.34$21.751.2x0.44x
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$53.98$39.811.4x0.46x
Photography of the retina$67.50$37.751.8x0.57x
Imaging of retina$137.06$42.393.2x1.11x
Ambulance service, basic life support, emergency transport (bls-emergency)$500.00$488.251.0x0.40x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$49.70$33.851.5x0.68x
Emergency department visit with low level of medical decision making$493.61$59.688.3x1.21x
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes$94.74$38.082.5x1.01x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$253.66$101.862.5x1.20x
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes$139.07$44.993.1x1.16x
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes$313.40$126.492.5x1.08x
Exam of visual field with extended testing$93.87$68.531.4x0.63x
Injection of drug into eye$1,529.03$113.5213.5x2.62x
New patient complete exam of visual system$228.77$158.161.4x0.90x
Imaging of optic nerve$66.08$36.181.8x0.60x
Ambulance service, basic life support, non-emergency transport, (bls)$325.00$285.541.1x0.29x
Dialysis services, 4 or more physician visits per month (20 years or older)$298.11$280.721.1x0.39x
Administration of influenza virus vaccine$31.26$30.631.0x0.77x
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes$482.78$121.044.0x1.31x
Emergency department visit with moderate level of medical decision making$770.08$101.577.6x0.98x
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care$13.93$9.001.5x0.36x
Hospital discharge day management, 30 minutes or less$261.58$72.133.6x1.18x
Application of ultrasound, each 15 minutes$21.82$10.822.0x0.57x
Hospital discharge day management, more than 30 minutes$371.31$110.783.4x1.05x
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more$103.85$66.761.6x0.61x
Removal of cataract with insertion of prosthetic lens$4,646.76$543.818.5x4.52x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$203.59$167.801.2x0.50x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$134.32$130.011.0x0.48x
Comprehensive hearing and speech recognition test$37.41$36.811.0x0.30x
Test to assess middle ear function$17.54$17.101.0x0.34x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report$23.52$14.461.6x0.34x

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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