88363

Examination of archival tissue for genetic analysis

Medicare pricing data for 3,397 providers across 45 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

Examination of archival tissue for genetic analysis (HCPCS code 88363) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.90, but hospitals typically charge $94.40 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.98

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.90, your out-of-pocket cost would be approximately $3.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.90
Average Hospital Charge
$94.40
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$94.40
Medicare Allowed$19.90
Medicare Payment$15.72

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $15.72 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$26$2557159+28.3%
New York$22$1041461,178+10.6%
Nevada$22$7620530+9.0%
Washington$22$721221,149+8.7%
California$21$1233394,683+7.8%
New Jersey$21$8544321+3.7%
Florida$21$962263,615+3.5%
Maryland$20$72901,392+2.9%
Oregon$20$8927234+2.8%
Massachusetts$20$7976709+2.7%
Connecticut$20$7742194+2.5%
West Virginia$20$6712273+1.7%
District of Columbia$20$60873+1.5%
Tennessee$20$8250577+1.4%
Illinois$20$1051693,284+0.8%
Arkansas$20$6227565+0.7%
Minnesota$20$10152425-0.3%
Pennsylvania$20$892122,055-0.3%
North Carolina$20$66711,147-0.3%
Kansas$20$8643340-0.6%
Colorado$20$7548295-0.9%
Delaware$19$73454-2.2%
New Mexico$19$1079211-2.7%
Arizona$19$83631,265-2.8%
Michigan$19$751281,205-3.1%
Texas$19$1222463,935-3.1%
Louisiana$19$8826472-3.2%
Utah$19$5943420-3.3%
North Dakota$19$126472-3.6%
Missouri$19$991381,947-3.7%
Oklahoma$19$8916526-3.8%
Mississippi$19$7440505-4.0%
Virginia$19$117841,610-4.3%
Indiana$19$7644771-4.4%
Georgia$19$781162,214-4.5%
Montana$19$58661-4.5%
Idaho$19$6718165-4.7%
Alabama$19$5752827-5.4%
Ohio$19$841962,016-5.5%
New Hampshire$19$69454-5.6%
Nebraska$19$5849746-5.9%
Wisconsin$19$122141898-6.2%
South Carolina$19$8954669-6.8%
Iowa$19$7840483-7.0%
Kentucky$18$8932388-7.2%

⚠️ 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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