90480

Admn sarscov2 vacc 1 dose

Code 90480. Medicare covered 8,441,109 of these. Here is what providers billed and what Medicare allowed, state by state.

$50.47Billed, national avg
$38.04Medicare allowed
1.3xBilled vs allowed
2.9xHighest vs lowest state

Providers in Armed Forces Europe billed the most for this, at $96.84. In Mississippi the average was $32.93. Same procedure code, same programme.

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.

By state

StateBilledMedicare allowedGapServices
Armed Forces Europe$96.84$45.032.2x165
Idaho$87.02$42.792.0x661,844
Armed Forces Pacific$79.66$41.371.9x35
Foreign Country$73.63$43.151.7x19
District of Columbia$70.71$42.791.7x17,309
Virgin Islands$69.45$36.271.9x430
Alaska$55.71$41.461.3x17,803
Arkansas$55.69$30.341.8x63,010
North Dakota$55.50$36.021.5x23,296
New York$55.24$41.021.3x429,692
Pennsylvania$54.72$38.981.4x387,683
West Virginia$53.44$32.381.7x24,705
California$52.77$41.491.3x801,288
Maryland$51.67$41.091.3x232,688
Wisconsin$51.48$35.331.5x198,874
Washington$51.33$38.041.3x188,634
Massachusetts$50.94$40.871.2x350,463
Delaware$50.27$38.941.3x44,314
New Jersey$50.07$40.811.2x234,809
North Carolina$49.81$35.931.4x232,227
Nebraska$49.74$35.391.4x70,560
Montana$49.28$35.381.4x31,297
Connecticut$48.74$40.741.2x104,375
Maine$48.60$36.511.3x36,817
Virginia$47.98$37.511.3x279,480
Guam$47.44$44.001.1x412
Illinois$47.05$38.041.2x319,209
Florida$45.17$39.771.1x506,176
Ohio$44.53$35.221.3x265,730
Hawaii$44.51$40.431.1x45,892
Rhode Island$44.28$40.231.1x30,050
Tennessee$44.25$34.091.3x128,138
Michigan$44.09$36.471.2x180,381
South Dakota$44.06$33.311.3x30,346
Kentucky$44.03$32.831.3x84,864
Oregon$43.94$35.531.2x89,353
Minnesota$43.66$35.241.2x182,820
Puerto Rico$43.28$40.021.1x2,929
Iowa$42.82$36.121.2x157,611
Colorado$42.77$36.971.2x301,718
Missouri$42.69$34.451.2x142,644
South Carolina$42.56$35.601.2x139,324
New Hampshire$42.33$38.221.1x74,602
Indiana$41.99$35.171.2x172,345
Louisiana$41.93$33.231.3x41,348
Georgia$41.80$36.411.1x141,755
Texas$41.64$35.481.2x357,779
New Mexico$41.28$32.841.3x51,046
Utah$40.89$32.131.3x53,536
Vermont$40.37$35.411.1x34,996
Alabama$39.83$33.361.2x41,751
Arizona$39.21$35.551.1x142,043
Wyoming$38.90$32.031.2x15,354
Kansas$38.88$31.991.2x115,659
Nevada$36.27$34.361.1x48,970
Oklahoma$35.94$30.301.2x72,662
Mississippi$32.93$29.841.1x37,787

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

← All procedures