87625

Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only

Medicare pricing data for 505 providers across 38 states

🤖AI Overview

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

Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only (HCPCS code 87625) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $39.70, but hospitals typically charge $86.27 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.94

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $39.70, your out-of-pocket cost would be approximately $7.94. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$39.70
Average Hospital Charge
$86.27
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$86.27
Medicare Allowed$39.70
Medicare Payment$39.70

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $39.70 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$40$135196+0.1%
Indiana$40$106422+0.1%
Iowa$40$120220+0.1%
Kansas$40$1329257+0.1%
Kentucky$40$116355+0.1%
Massachusetts$40$13332384+0.1%
Michigan$40$89417+0.1%
Minnesota$40$85737+0.1%
Mississippi$40$139229+0.1%
Missouri$40$547390+0.1%
Montana$40$73221+0.1%
Nebraska$40$111430+0.1%
Nevada$40$154262+0.1%
New Mexico$40$193134+0.1%
New York$40$25830835+0.1%
North Carolina$40$12210537+0.1%
North Dakota$40$141112+0.1%
Ohio$40$115577+0.1%
Oregon$40$8728152+0.1%
Pennsylvania$40$50513,510+0.1%
Virginia$40$66630+0.1%
West Virginia$40$1341273+0.1%
Wisconsin$40$156653+0.1%
Arizona$40$2283263+0.1%
Arkansas$40$62339+0.1%
Colorado$40$1267249+0.1%
Illinois$40$80121,168+0.1%
California$40$122881,382+0.0%
New Jersey$40$136111,3520.0%
Louisiana$40$1129175-0.0%
Oklahoma$40$134593-0.1%
Tennessee$40$11130452-0.1%
Maryland$40$1248210-0.3%
Texas$40$124601,353-0.4%
Florida$40$107311,391-0.4%
Washington$40$8235282-0.5%
Alabama$39$1327160-0.7%
Connecticut$39$1446109-2.6%

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

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