G2211

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

Code G2211. Medicare covered 24,966,114 of these. Here is what providers billed and what Medicare allowed, state by state.

$43.48Billed, national avg
$15.87Medicare allowed
2.7xBilled vs allowed
2.3xHighest vs lowest state

Providers in Ohio billed the most for this, at $59.62. In Guam the average was $26.31. 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
Ohio$59.62$15.303.9x773,756
New York$56.35$17.293.3x1,601,384
California$54.47$17.063.2x2,131,468
Foreign Country$53.73$15.323.5x126
Massachusetts$53.63$16.323.3x651,400
Minnesota$53.07$15.253.5x348,081
Wisconsin$50.78$14.953.4x370,239
New Hampshire$50.11$15.763.2x129,615
Alaska$48.69$20.602.4x33,219
Illinois$48.34$16.273.0x1,129,846
Tennessee$47.89$14.793.2x573,067
North Dakota$47.35$15.183.1x62,068
Washington$45.57$16.232.8x556,418
Oregon$45.47$15.642.9x366,896
Connecticut$44.35$16.842.6x214,416
Armed Forces Central/South America$44.21$17.432.5x78
New Jersey$43.99$17.212.6x836,845
Kansas$42.99$15.032.9x287,507
Florida$42.64$16.022.7x1,936,211
Virginia$41.23$15.812.6x922,360
Georgia$40.13$15.542.6x640,447
West Virginia$39.87$15.282.6x78,627
North Carolina$39.81$15.002.7x1,007,069
Utah$39.78$14.932.7x227,999
Rhode Island$39.65$16.062.5x52,789
Missouri$39.63$15.302.6x393,773
Hawaii$39.52$16.202.4x47,507
Nevada$39.21$15.192.6x135,899
New Mexico$39.04$15.392.5x71,891
Pennsylvania$38.57$15.832.4x1,310,024
South Carolina$38.54$15.132.5x787,257
Maryland$38.46$16.552.3x794,791
Colorado$38.41$15.722.4x328,995
District of Columbia$38.33$17.552.2x62,190
Armed Forces Europe$38.27$17.982.1x522
Texas$38.15$15.582.4x1,597,484
Arizona$38.04$15.332.5x529,389
Vermont$37.29$15.382.4x28,302
Nebraska$36.96$14.902.5x141,181
Indiana$36.32$14.892.4x504,036
Louisiana$35.78$15.272.3x329,693
Unknown$35.75$16.572.2x365
Maine$35.64$15.562.3x56,366
Virgin Islands$35.31$15.602.3x689
Armed Forces Pacific$35.18$15.702.2x554
Kentucky$34.90$15.112.3x302,480
Mississippi$34.75$14.762.4x311,715
Iowa$34.57$14.812.3x306,983
Montana$33.77$15.402.2x103,492
Arkansas$33.50$14.632.3x264,368
Delaware$33.19$15.732.1x150,864
Oklahoma$32.70$14.822.2x378,445
Michigan$31.74$15.912.0x542,846
Idaho$30.96$14.692.1x86,716
Wyoming$30.37$15.392.0x12,092
Puerto Rico$30.29$16.001.9x2,459
Alabama$27.98$14.851.9x346,603
South Dakota$27.68$15.001.8x101,091
Guam$26.31$16.131.6x3,120

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

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