G6015

Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session

Medicare pricing data for 2,011 providers across 50 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.1 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

Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session (HCPCS code G6015) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $358.13, but hospitals typically charge $1,763 — a 4.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$71.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $358.13, your out-of-pocket cost would be approximately $71.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$358.13
Average Hospital Charge
$1,763
Markup Ratio
4.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,763.19
Medicare Allowed$358.13
Medicare Payment$285.29

Hospitals charge 4.9x more than what Medicare allows for this procedure. Medicare actually pays $285.29 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$419$1,612236115,174+16.9%
New Jersey$407$1,8302932,978+13.6%
New York$405$1,57614961,991+13.0%
Hawaii$397$1,56584,171+10.7%
Connecticut$396$1,81353,347+10.5%
Maryland$391$2,0935128,572+9.3%
Alaska$385$5,302115,501+7.6%
Delaware$380$5,2247812+6.2%
Massachusetts$377$2,2602110,102+5.2%
Colorado$374$2,2511811,394+4.5%
New Hampshire$372$1,36511,733+3.8%
Rhode Island$369$1,438134,906+3.0%
Virginia$366$2,9642015,422+2.2%
North Dakota$365$1,63044,291+1.9%
Wyoming$365$3,24541,700+1.9%
Washington$365$1,3713522,017+1.9%
Minnesota$364$3,2074216,131+1.8%
Oregon$362$1,896236,560+1.0%
Puerto Rico$360$463182,097+0.5%
Utah$359$2,807155,444+0.4%
Illinois$358$2,0644127,783-0.1%
Nevada$357$2,0223016,971-0.4%
Pennsylvania$354$1,5216523,153-1.2%
Texas$349$1,871335134,848-2.6%
Florida$346$1,431237188,099-3.3%
Arizona$346$1,6887257,888-3.4%
Wisconsin$345$3,223305,036-3.8%
Montana$340$2,58211,173-4.9%
District of Columbia$336$1,24542,855-6.1%
Ohio$336$2,5026925,376-6.1%
Michigan$333$1,6113622,988-6.9%
North Carolina$333$1,6084020,843-7.0%
Kansas$333$1,1051120,088-7.1%
Indiana$332$1,6712721,315-7.3%
South Carolina$332$1,3291423,205-7.3%
Nebraska$332$1,134116,239-7.3%
Missouri$331$1,732108,549-7.6%
New Mexico$329$2,333131,344-8.1%
Iowa$326$1,532121,912-8.9%
Kentucky$325$2,017209,802-9.3%
Tennessee$325$1,7662714,611-9.4%
Georgia$323$1,8433521,926-9.8%
Idaho$323$1,261246,883-9.9%
Maine$318$1,02311,257-11.3%
Alabama$317$1,5385826,416-11.4%
Louisiana$315$1,4232620,672-12.0%
Oklahoma$315$1,086166,884-12.1%
Mississippi$311$2,19443,631-13.2%
West Virginia$310$1,18855,394-13.4%
Arkansas$306$3,1152617,615-14.5%

⚠️ 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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