87150

Identification of organisms by genetic analysis, amplified probe technique

Medicare pricing data for 362 providers across 31 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.5 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

Identification of organisms by genetic analysis, amplified probe technique (HCPCS code 87150) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.32, but hospitals typically charge $62.63 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.86

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.32, your out-of-pocket cost would be approximately $6.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.32
Average Hospital Charge
$62.63
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$62.63
Medicare Allowed$34.32
Medicare Payment$34.32

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $34.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$34$54491+0.2%
Indiana$34$393139,639+0.2%
Kansas$34$115535+0.2%
Kentucky$34$3941,498+0.2%
Louisiana$34$5063,772+0.2%
Maryland$34$14845,320+0.2%
Minnesota$34$17713230+0.2%
Mississippi$34$53514,510+0.2%
Missouri$34$655149+0.2%
New Mexico$34$5321,051+0.2%
North Dakota$34$1763110+0.2%
Ohio$34$77116,194+0.2%
Oklahoma$34$41578,254+0.2%
Tennessee$34$5110500+0.2%
Washington$34$10578,025+0.2%
Arizona$34$504137,508+0.2%
Arkansas$34$49122+0.2%
California$34$5443181,356+0.2%
Colorado$34$405758+0.2%
Connecticut$34$742119+0.2%
Florida$34$7353196,804+0.2%
Illinois$34$531436,940+0.2%
Virginia$34$76959,115+0.2%
Pennsylvania$34$579149,483+0.1%
North Carolina$34$5396,010+0.0%
Texas$34$7546388,947+0.0%
Iowa$34$486275-0.1%
Idaho$34$55112,284-0.2%
Alabama$34$5344,168-0.2%
New York$34$991952,785-1.5%
New Jersey$34$541662,758-2.3%

⚠️ 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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