93000

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

Medicare pricing data for 163,314 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 10.3 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS code 93000) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.51, but hospitals typically charge $67.91 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.90

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.51, your out-of-pocket cost would be approximately $2.90. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.51
Average Hospital Charge
$67.91
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$67.91
Medicare Allowed$14.51
Medicare Payment$10.43

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $10.43 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$17$15246512,100+17.5%
New York$16$9112,1271,236,204+13.0%
District of Columbia$16$6147734,559+9.7%
New Jersey$16$705,865640,087+8.6%
California$16$7014,142939,348+8.0%
Maryland$15$604,033433,853+4.6%
Connecticut$15$782,659182,762+4.3%
Massachusetts$15$744,287315,804+4.0%
Hawaii$15$6349218,095+3.0%
Illinois$15$845,028279,073+0.8%
Virginia$15$584,718302,077-0.1%
Pennsylvania$14$808,086487,413-0.9%
Florida$14$5012,813910,561-1.5%
Rhode Island$14$5476031,622-1.6%
Washington$14$502,90578,461-1.7%
Puerto Rico$14$2649217,498-1.7%
Delaware$14$5062484,392-1.8%
Colorado$14$502,94885,531-1.9%
New Hampshire$14$7965618,365-2.3%
Michigan$14$484,788201,760-2.4%
Nevada$14$621,56466,116-2.7%
Wyoming$14$16028910,282-3.8%
Oregon$14$551,40335,221-4.0%
Minnesota$14$1272,60369,424-4.6%
Texas$14$6012,268804,573-4.8%
Montana$14$4333811,281-5.2%
Arizona$14$444,042323,108-5.3%
North Dakota$14$551392,677-5.7%
Utah$14$5187523,649-6.1%
Georgia$14$705,457347,894-6.4%
Wisconsin$13$1772,09964,212-7.4%
Missouri$13$622,464105,513-7.6%
Maine$13$543757,350-7.6%
Ohio$13$536,268253,648-7.6%
Vermont$13$752394,319-7.6%
North Carolina$13$805,998246,988-7.9%
Louisiana$13$552,006161,083-8.8%
South Dakota$13$782445,099-9.0%
South Carolina$13$803,034232,004-9.2%
Kansas$13$671,25572,784-9.3%
West Virginia$13$5469326,888-9.8%
Indiana$13$663,264138,018-9.9%
Oklahoma$13$501,78167,151-10.1%
New Mexico$13$5584923,924-10.8%
Alabama$13$552,740182,708-11.0%
Iowa$13$661,24845,082-11.5%
Tennessee$13$534,378281,221-11.5%
Nebraska$13$541,19049,281-11.7%
Idaho$13$785278,615-12.1%
Mississippi$13$731,375108,426-12.7%
Kentucky$13$482,294114,051-13.0%
Arkansas$12$841,50762,925-14.3%

⚠️ 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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