82540

Creatine measurement

Medicare pricing data for 322 providers across 29 states

🤖AI Overview

This procedure has a 12.0x markup — hospitals charge $54.61 but Medicare allows only $4.56. Uninsured patients may face bills 12.0 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

Creatine measurement (HCPCS code 82540) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.56, but hospitals typically charge $54.61 — a 12.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.91

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.56, your out-of-pocket cost would be approximately $0.91. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.56
Average Hospital Charge
$54.61
Markup Ratio
12.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$54.61
Medicare Allowed$4.56
Medicare Payment$4.56

Hospitals charge 12.0x more than what Medicare allows for this procedure. Medicare actually pays $4.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$5$71191,289+1.5%
Florida$5$5423575-0.2%
Indiana$5$14285-0.2%
Kansas$5$82241-0.2%
Kentucky$5$11226-0.2%
Massachusetts$5$364585-0.2%
Mississippi$5$23329-0.2%
Nevada$5$682140-0.2%
Ohio$5$657137-0.2%
Oklahoma$5$84313-0.2%
Pennsylvania$5$67658-0.2%
Tennessee$5$238223-0.2%
Texas$5$7612209-0.2%
Utah$5$47213-0.2%
Virginia$5$48599-0.2%
Washington$5$70373-0.2%
Puerto Rico$5$6741-0.2%
Alabama$5$4110101-0.2%
California$5$531262,133-0.2%
Colorado$5$64558-0.2%
Connecticut$5$12572-0.2%
Illinois$5$3012509-0.4%
New Jersey$5$6012531-0.4%
North Carolina$5$559656-0.4%
Georgia$5$466179-0.7%
Arizona$5$1032187-0.7%
Michigan$4$24432-1.8%
Missouri$4$83106-2.0%
Maryland$4$65654-2.4%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber