80165

Valproic acid level, free

Medicare pricing data for 221 providers across 33 states

🤖AI Overview

This procedure has a 7.8x markup — hospitals charge $103.61 but Medicare allows only $13.26. Uninsured patients may face bills 7.8 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

Valproic acid level, free (HCPCS code 80165) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.26, but hospitals typically charge $103.61 — a 7.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.65

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $13.26, your out-of-pocket cost would be approximately $2.65. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$13.26
Average Hospital Charge
$103.61
Markup Ratio
7.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$103.61
Medicare Allowed$13.26
Medicare Payment$13.26

Hospitals charge 7.8x more than what Medicare allows for this procedure. Medicare actually pays $13.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$13$1113213+0.1%
Illinois$13$1058304+0.1%
Indiana$13$74231+0.1%
Kansas$13$1224140+0.1%
Kentucky$13$173172+0.1%
Maryland$13$1104123+0.1%
Massachusetts$13$1123563+0.1%
Michigan$13$31580+0.1%
Mississippi$13$183214+0.1%
New Hampshire$13$135230+0.1%
New Jersey$13$13481,373+0.1%
New Mexico$13$63144+0.1%
New York$13$9793,704+0.1%
Ohio$13$1169635+0.1%
Oregon$13$51527+0.1%
Pennsylvania$13$1057354+0.1%
Rhode Island$13$30113+0.1%
South Carolina$13$38455+0.1%
Tennessee$13$101265+0.1%
Texas$13$10711700+0.1%
Utah$13$60395+0.1%
Virginia$13$877168+0.1%
Washington$13$1324202+0.1%
Wisconsin$13$946206+0.1%
Alabama$13$1206359+0.1%
Arizona$13$1164100+0.1%
Colorado$13$1313140+0.1%
Florida$13$92129900.0%
Oklahoma$13$633960.0%
California$13$79151,1530.0%
North Carolina$13$13641,430-0.2%
Minnesota$13$11440363-0.4%
Nevada$13$522110-1.6%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber