87900

Infectious agent drug susceptibility analysis

Medicare pricing data for 193 providers across 26 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

Infectious agent drug susceptibility analysis (HCPCS code 87900) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $126.36, but hospitals typically charge $244.68 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$25.27

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $126.36, your out-of-pocket cost would be approximately $25.27. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$126.36
Average Hospital Charge
$244.68
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$244.68
Medicare Allowed$126.36
Medicare Payment$126.36

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $126.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$128$3282154+1.1%
Kansas$128$303241+1.1%
Louisiana$128$310228+1.1%
Maryland$128$20346,999+1.1%
Massachusetts$128$310379+1.1%
Mississippi$128$3263490+1.1%
Nevada$128$303124+1.1%
Ohio$128$268483+1.1%
Pennsylvania$128$340520+1.1%
West Virginia$128$3911113+1.1%
Wisconsin$128$298212+1.1%
Arizona$128$249253+1.1%
Colorado$128$287215+1.1%
Florida$128$3055386+1.1%
New York$128$523457+1.1%
Illinois$128$38831,438+1.0%
Washington$128$2125371+1.0%
California$128$284131,133+0.9%
Texas$127$22695,253+0.9%
New Jersey$127$2704368+0.8%
North Carolina$127$2675529+0.8%
Tennessee$127$325211,481+0.5%
Arkansas$127$325311,455+0.5%
Alabama$124$17232379-1.7%
Oklahoma$112$117101,585-11.1%
Virginia$83$151424-33.9%

⚠️ 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