80180

Mycophenolate (mycophenolic acid) level

Medicare pricing data for 131 providers across 22 states

🤖AI Overview

This procedure has a 10.8x markup — hospitals charge $190.98 but Medicare allows only $17.63. Uninsured patients may face bills 10.8 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Mycophenolate (mycophenolic acid) level (HCPCS code 80180) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $17.63, but hospitals typically charge $190.98 — a 10.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $17.63, your out-of-pocket cost would be approximately $3.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$17.63
Average Hospital Charge
$190.98
Markup Ratio
10.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$190.98
Medicare Allowed$17.63
Medicare Payment$17.63

Hospitals charge 10.8x more than what Medicare allows for this procedure. Medicare actually pays $17.63 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$18$215156+0.3%
Kansas$18$214251+0.3%
Massachusetts$18$224230+0.3%
Nevada$18$219184+0.3%
New Jersey$18$2025708+0.3%
New Mexico$18$102120+0.3%
New York$18$1554152+0.3%
North Carolina$18$1564451+0.3%
Ohio$18$165549+0.3%
Oregon$18$92415+0.3%
Utah$18$41228+0.3%
Virginia$18$216332+0.3%
Washington$18$108286+0.3%
Alabama$18$1644258+0.3%
Illinois$18$21942,070+0.3%
California$18$121111,382+0.3%
Texas$18$2177324+0.1%
Wisconsin$18$1004134-0.3%
Minnesota$18$227291,926-0.5%
Florida$18$2554352-0.6%
Arizona$17$1694390-1.4%
South Dakota$17$109238-3.1%

⚠️ 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