87220

Tissue fungi or parasites

Medicare pricing data for 3,316 providers across 47 states

🤖AI Overview

This procedure has a 8.6x markup — hospitals charge $35.78 but Medicare allows only $4.16. Uninsured patients may face bills 8.6 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

Tissue fungi or parasites (HCPCS code 87220) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.16, but hospitals typically charge $35.78 — a 8.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.16, your out-of-pocket cost would be approximately $0.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.16
Average Hospital Charge
$35.78
Markup Ratio
8.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$35.78
Medicare Allowed$4.16
Medicare Payment$4.16

Hospitals charge 8.6x more than what Medicare allows for this procedure. Medicare actually pays $4.16 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Iowa$4$2259156+2.4%
Delaware$4$32617+0.5%
Hawaii$4$17715+0.5%
Illinois$4$5157716+0.5%
Indiana$4$3129121+0.5%
Montana$4$22967+0.5%
Nevada$4$1910284+0.5%
New Jersey$4$60391,588+0.5%
New Mexico$4$46717+0.5%
New York$4$1237843+0.5%
Vermont$4$28819+0.5%
Wyoming$4$411744+0.5%
Alaska$4$441124+0.5%
California$4$422512,510+0.5%
Colorado$4$1754185+0.5%
Kansas$4$2692720+0.2%
Massachusetts$4$431071,151+0.2%
Pennsylvania$4$39111750+0.2%
South Carolina$4$2497387+0.2%
Texas$4$46108814+0.2%
Wisconsin$4$49215564+0.2%
Florida$4$451382,2590.0%
Georgia$4$401231,0140.0%
Missouri$4$51345050.0%
North Carolina$4$141288790.0%
Maryland$4$44168928-0.2%
Minnesota$4$21283485-0.2%
Nebraska$4$2535142-0.2%
North Dakota$4$252963-0.2%
South Dakota$4$2843116-0.2%
Ohio$4$2533165-0.7%
Oklahoma$4$3824132-1.0%
Oregon$4$2375266-1.0%
Tennessee$4$2076307-1.0%
Virginia$4$26271845-1.0%
Washington$4$2294352-1.0%
Arizona$4$3530139-1.0%
Arkansas$4$18110485-1.0%
Utah$4$1845169-1.2%
Kentucky$4$2047148-1.4%
Michigan$4$1655119-1.4%
Louisiana$4$191142-1.9%
Mississippi$4$1529545-2.2%
Alabama$4$832108-2.4%
Idaho$4$143180-2.9%
West Virginia$4$281548-3.6%
Connecticut$4$32719-3.8%

⚠️ 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