South Carolina

What Medicare pays in South Carolina

Billed charges against Medicare allowed amounts in South Carolina, across the 246 procedures Medicare covers most often.

246Procedures
27,802,109Services covered
2.9xBilled vs allowed
#39Rank of 61

Providers here billed the most above the national figure for phosphate level. The average was $44.18 against a national $26.52. That is 1.7 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 South Carolina

ProcedureBilled hereAllowedGapvs national billed
Ground mileage, per statute mile$16.47$8.981.8x0.62x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$227.37$113.682.0x0.83x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$60.38$21.412.8x0.87x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$160.99$80.102.0x0.85x
Therapy procedure using functional activities$65.38$28.832.3x0.88x
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$38.54$15.132.5x0.89x
Insertion of needle into vein for collection of blood sample$17.81$8.502.1x0.82x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$186.08$73.232.5x0.91x
Therapy procedure using manual technique, each 15 minutes$58.03$19.443.0x0.86x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$65.04$25.072.6x0.90x
Destruction of precancer skin growth, 2-14 growths$23.71$5.794.1x1.08x
Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month$80.92$62.781.3x0.79x
Pathology examination of tissue using a microscope, intermediate complexity$186.71$43.094.3x1.00x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$41.52$7.575.5x1.12x
Chiropractic manipulative treatment, 3-4 spinal regions$52.97$36.721.4x0.87x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$333.39$149.412.2x0.82x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$51.38$7.656.7x1.15x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$307.11$110.732.8x0.94x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$250.44$119.732.1x0.90x
Administration of influenza virus vaccine$33.24$27.121.2x0.82x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report$86.48$12.986.7x1.25x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$158.51$89.761.8x0.75x
Hemoglobin a1c level$50.60$9.445.4x0.87x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$319.85$157.882.0x0.79x
Removal of cataract with insertion of prosthetic lens$1,049.67$232.014.5x1.02x
Blood test, comprehensive group of blood chemicals$66.11$10.276.4x1.08x
Professional service for preparation and provision of 1 or more antigens$26.27$12.912.0x0.89x
X-ray of chest, 1 view$51.92$8.066.4x0.99x
Test for allergy using allergenic extract$13.47$3.244.2x1.02x
Emergency department visit with high level of medical decision making$1,336.25$163.588.2x1.08x
Blood test, lipids (cholesterol and triglycerides)$68.89$13.015.3x0.72x
Injection of drug or substance under skin or into muscle$50.96$12.634.0x0.92x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$219.27$98.142.2x0.82x
Automated urinalysis test$16.41$2.197.5x1.08x
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month$92.97$57.701.6x0.82x
Established patient complete exam of visual system$200.31$117.511.7x0.88x
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes$164.83$103.491.6x0.73x
Ambulance service, basic life support, non-emergency transport, (bls)$632.01$221.442.9x0.56x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$527.39$160.833.3x0.93x
Imaging of retina$90.23$37.882.4x0.73x

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.

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