Virgin Islands

What Medicare pays in Virgin Islands

Billed charges against Medicare allowed amounts in Virgin Islands, across the 188 procedures Medicare covers most often.

188Procedures
293,062Services covered
2.7xBilled vs allowed
#55Rank of 61

Providers here billed the most above the national figure for removal of cataract with insertion of prosthetic lens. The average was $9,097.61 against a national $1,027.76. That is 8.9 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 Virgin Islands

ProcedureBilled hereAllowedGapvs national billed
Fixed wing air mileage, per statute mile$22.39$15.501.4x0.16x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$71.86$23.063.1x1.04x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$262.59$120.762.2x0.96x
Insertion of needle into vein for collection of blood sample$16.23$7.772.1x0.74x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$172.43$85.432.0x0.92x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$18.57$7.592.4x0.50x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$54.28$26.482.1x0.75x
Blood test, comprehensive group of blood chemicals$13.56$10.351.3x0.22x
Therapy procedure using functional activities$61.95$31.592.0x0.83x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$341.90$168.702.0x0.84x
Blood test, lipids (cholesterol and triglycerides)$14.45$13.091.1x0.15x
Therapy procedure using manual technique, each 15 minutes$62.65$20.473.1x0.92x
Manual urinalysis test with examination using microscope, automated$7.40$3.112.4x0.23x
Ground mileage, per statute mile$10.58$9.171.2x0.40x
Hemoglobin a1c level$11.48$9.511.2x0.20x
Blood test, thyroid stimulating hormone (tsh)$18.71$16.421.1x0.20x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report$29.40$13.312.2x0.43x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$135.09$73.701.8x0.66x
Urine microalbumin (protein) level$13.06$5.662.3x0.23x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$220.80$103.342.1x0.83x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$359.94$158.392.3x0.88x
Thyroxine (thyroid chemical), free$9.39$8.841.1x0.11x
Injection of drug or substance under skin or into muscle$85.22$13.696.2x1.54x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$249.62$120.032.1x0.90x
Chiropractic manipulative treatment, 3-4 spinal regions$60.54$37.731.6x1.00x
Psa (prostate specific antigen) measurement, total$18.69$17.921.0x0.18x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$9.05$7.351.2x0.20x
Established patient complete exam of visual system$346.43$122.952.8x1.52x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$186.28$111.481.7x0.57x
Bacterial urine culture$12.00$7.931.5x0.38x
Dialysis services, 4 or more physician visits per month (20 years or older)$537.85$342.491.6x0.70x
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$93.35$53.281.8x0.79x
Vitamin d-3 level$29.65$28.951.0x0.16x
Therapy procedure for walking training, each 15 minutes$63.98$21.972.9x1.13x
Measurement of antibody (ige) to allergic substance, crude allergen extract, each$6.74$5.121.3x0.22x
Creatinine level to test for kidney function or muscle injury$5.37$5.081.1x0.12x
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function$305.81$166.911.8x0.64x
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes$42.52$38.561.1x0.48x
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more$413.63$207.752.0x0.74x
Administration of influenza virus vaccine$45.93$26.761.7x1.13x

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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