Oregon

What Medicare pays in Oregon

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

248Procedures
12,050,395Services covered
3.4xBilled vs allowed
#15Rank of 61

Providers here billed the most above the national figure for injection, bupivacaine liposome, 1 mg. The average was $13.41 against a national $4.88. That is 2.7 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 Oregon

ProcedureBilled hereAllowedGapvs national billed
Ground mileage, per statute mile$28.63$10.132.8x1.08x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$335.63$111.853.0x1.22x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$227.45$81.452.8x1.21x
Therapy procedure using functional activities$77.90$30.692.5x1.04x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$70.37$22.723.1x1.02x
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$45.47$15.642.9x1.05x
Insertion of needle into vein for collection of blood sample$18.23$8.572.1x0.84x
Rotary wing air mileage, per statute mile$305.56$39.467.7x0.86x
Therapy procedure using manual technique, each 15 minutes$65.63$20.283.2x0.97x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$73.54$26.192.8x1.01x
Fixed wing air mileage, per statute mile$224.06$13.6816.4x1.62x
Destruction of precancer skin growth, 2-14 growths$18.53$6.093.0x0.84x
Blood test, comprehensive group of blood chemicals$40.78$10.324.0x0.66x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$25.89$7.583.4x0.70x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$240.44$75.463.2x1.18x
Pathology examination of tissue using a microscope, intermediate complexity$157.86$44.333.6x0.85x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$463.24$152.173.0x1.14x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$35.91$7.914.5x0.80x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$372.56$114.923.2x1.14x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$458.65$152.773.0x1.12x
Blood test, lipids (cholesterol and triglycerides)$50.92$13.063.9x0.53x
Chiropractic manipulative treatment, 3-4 spinal regions$67.82$37.851.8x1.12x
Injection, bupivacaine liposome, 1 mg$13.41$1.389.7x2.74x
Hemoglobin a1c level$39.93$9.454.2x0.69x
Imaging of retina$115.66$39.212.9x0.93x
Blood test, thyroid stimulating hormone (tsh)$63.20$16.423.8x0.66x
Administration of influenza virus vaccine$34.48$26.581.3x0.85x
Established patient complete exam of visual system$247.13$124.532.0x1.09x
Admn sarscov2 vacc 1 dose$43.94$35.531.2x0.87x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$296.77$100.922.9x1.12x
Psychotherapy, 1 hour$239.58$121.722.0x1.15x
X-ray of chest, 1 view$40.51$8.394.8x0.77x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$342.54$102.453.3x1.23x
Emergency department visit with high level of medical decision making$972.70$167.085.8x0.79x
Destruction of precancer skin growth, 1 growth$175.67$49.663.5x1.13x
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$138.41$49.022.8x1.18x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$609.30$166.943.6x1.07x
Screening mammography$197.76$59.193.3x0.80x
Screening 3d breast mammography$108.74$30.533.6x0.79x
X-ray of chest, 2 views$51.59$14.413.6x0.72x

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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