87205

Special gram or giemsa stain for microorganism

Medicare pricing data for 2,625 providers across 48 states

🤖AI Overview

This procedure has a 8.6x markup — hospitals charge $35.88 but Medicare allows only $4.17. Uninsured patients may face bills 8.6 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Special gram or giemsa stain for microorganism (HCPCS code 87205) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.17, but hospitals typically charge $35.88 — a 8.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.17, your out-of-pocket cost would be approximately $0.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.17
Average Hospital Charge
$35.88
Markup Ratio
8.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$35.88
Medicare Allowed$4.17
Medicare Payment$4.17

Hospitals charge 8.6x more than what Medicare allows for this procedure. Medicare actually pays $4.17 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Mississippi$4$41102,496+0.5%
Florida$4$455132,901+0.2%
Georgia$4$192819,090+0.2%
Kansas$4$46187,619+0.2%
Louisiana$4$3823709+0.2%
Massachusetts$4$412607,050+0.2%
Missouri$4$47141,752+0.2%
Nebraska$4$135728+0.2%
Nevada$4$4371,549+0.2%
New Hampshire$4$29422+0.2%
New Jersey$4$4524822,107+0.2%
New Mexico$4$2351,091+0.2%
New York$4$341626,181+0.2%
Pennsylvania$4$37164,706+0.2%
Rhode Island$4$201151+0.2%
Tennessee$4$34554,075+0.2%
Texas$4$4611013,212+0.2%
Utah$4$2334244+0.2%
Vermont$4$232762+0.2%
Puerto Rico$4$563418+0.2%
California$4$3210732,755+0.2%
Colorado$4$47141,462+0.2%
Illinois$4$46255,7450.0%
Iowa$4$221371,9300.0%
Maine$4$10226460.0%
Maryland$4$38123,0420.0%
Michigan$4$24231,2190.0%
Minnesota$4$234442,8700.0%
North Carolina$4$385513,9510.0%
North Dakota$4$37178140.0%
Ohio$4$29225,4880.0%
Oklahoma$4$35124,0360.0%
Virginia$4$18535,4780.0%
Alabama$4$42193,6320.0%
Arizona$4$32808,8700.0%
Hawaii$4$1732,800-0.2%
Oregon$4$19592,673-0.2%
South Dakota$4$2710412-0.2%
Washington$4$312347,117-0.2%
Indiana$4$32111,217-0.5%
Kentucky$4$2724664-1.0%
Connecticut$4$324201-1.0%
Idaho$4$148254-1.2%
Wyoming$4$55415-1.2%
Wisconsin$4$39295,451-1.4%
South Carolina$4$1822102-4.1%
West Virginia$4$67718-4.6%
Arkansas$4$13628-9.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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