95851

Measurement of range of motion in arm, leg or each spine section

Medicare pricing data for 420 providers across 30 states

🤖AI Overview

This procedure has a 6.4x markup — hospitals charge $130.76 but Medicare allows only $20.42. Uninsured patients may face bills 6.4 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

Measurement of range of motion in arm, leg or each spine section (HCPCS code 95851) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $20.42, but hospitals typically charge $130.76 — a 6.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.08

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $20.42, your out-of-pocket cost would be approximately $4.08. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$20.42
Average Hospital Charge
$130.76
Markup Ratio
6.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$130.76
Medicare Allowed$20.42
Medicare Payment$15.91

Hospitals charge 6.4x more than what Medicare allows for this procedure. Medicare actually pays $15.91 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$24$84681,295+19.6%
New Jersey$23$231374,894+11.3%
New York$21$181253,423+4.2%
Minnesota$21$176432+2.3%
Nevada$21$40970+2.2%
Michigan$21$65517+1.7%
Maryland$20$46181,022-1.0%
North Carolina$20$6713233-2.9%
Ohio$20$59971-3.3%
Georgia$19$31756-5.2%
Pennsylvania$19$8320492-5.4%
Oklahoma$19$26341-6.0%
Oregon$19$416179-6.8%
Alabama$19$3871,259-7.1%
Kentucky$19$506280-7.6%
South Carolina$18$476219-10.5%
Texas$18$10422246-10.7%
Illinois$18$26426546-13.1%
Nebraska$18$488661-13.8%
Colorado$18$485643-13.9%
Arizona$18$699124-14.2%
Florida$17$6422492-16.2%
Utah$17$58223-17.2%
Wisconsin$17$579388-17.2%
West Virginia$17$30474-17.3%
Missouri$17$307499-17.9%
Iowa$17$107154-19.0%
Kansas$17$331154-19.2%
Tennessee$16$2216720-19.4%
Louisiana$16$3612118-22.0%

⚠️ 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