93005

Routine electrocardiogram (ecg) using at least 12 leads with tracing

Medicare pricing data for 34,439 providers across 52 states

🤖AI Overview

This procedure has a 8.5x markup — hospitals charge $52.93 but Medicare allows only $6.22. Uninsured patients may face bills 8.5 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

Routine electrocardiogram (ecg) using at least 12 leads with tracing (HCPCS code 93005) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6.22, but hospitals typically charge $52.93 — a 8.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.24

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $6.22, your out-of-pocket cost would be approximately $1.24. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$6.22
Average Hospital Charge
$52.93
Markup Ratio
8.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$52.93
Medicare Allowed$6.22
Medicare Payment$4.39

Hospitals charge 8.5x more than what Medicare allows for this procedure. Medicare actually pays $4.39 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$7$7489217,491+17.8%
District of Columbia$7$47115662+16.6%
New Jersey$7$502633,323+14.6%
California$7$473,78847,604+13.5%
Hawaii$7$6459333+12.1%
Connecticut$7$331591,154+11.9%
Massachusetts$7$501,01512,322+11.4%
Rhode Island$7$3570242+9.5%
Washington$7$582,84825,261+8.0%
Alaska$7$96166925+7.4%
Colorado$7$266825,785+5.0%
New Hampshire$7$643303,271+4.8%
Delaware$6$4145269+2.4%
Maryland$6$1829823,017+2.3%
Montana$6$613171,853+1.6%
Nevada$6$413713,323+1.6%
Illinois$6$861,67925,157+1.4%
Puerto Rico$6$1021188+1.4%
Wyoming$6$821331,023+1.0%
Florida$6$4093011,439+0.3%
Minnesota$6$448917,4470.0%
Oregon$6$711,24211,956-0.2%
Virginia$6$374033,787-0.2%
Vermont$6$351441,796-0.3%
North Dakota$6$612812,748-0.5%
Ohio$6$426697,199-1.6%
South Dakota$6$492432,539-1.6%
New Mexico$6$3786636-1.9%
Arizona$6$294833,667-2.4%
Texas$6$401,65825,079-3.1%
Georgia$6$365666,956-4.5%
Pennsylvania$6$521,14812,089-4.7%
Michigan$6$371,0338,033-5.3%
North Carolina$6$381,44024,549-6.1%
Wisconsin$6$1071,49114,864-6.8%
Utah$6$226476,226-6.9%
Maine$6$45240915-7.2%
Louisiana$6$702694,215-8.5%
Indiana$6$6487610,734-8.7%
Missouri$6$446017,758-8.7%
South Carolina$6$434286,159-9.0%
Iowa$6$477347,439-9.3%
Kansas$6$5368112,464-9.5%
Oklahoma$6$303312,338-10.0%
Idaho$6$294142,179-10.5%
Tennessee$6$307069,667-10.5%
Kentucky$6$348415,731-10.6%
West Virginia$6$1073632,510-10.6%
Alabama$6$322392,453-11.3%
Nebraska$6$231562,337-11.4%
Arkansas$5$15757010,165-13.8%
Mississippi$5$523349,257-14.3%

⚠️ 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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