99315

Nursing facility discharge day management, 30 minutes or less

Medicare pricing data for 14,334 providers across 52 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

Nursing facility discharge day management, 30 minutes or less (HCPCS code 99315) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $76.27, but hospitals typically charge $159.62 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.25

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $76.27, your out-of-pocket cost would be approximately $15.25. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$76.27
Average Hospital Charge
$159.62
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$159.62
Medicare Allowed$76.27
Medicare Payment$59.31

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $59.31 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$101$35258370+32.4%
New York$87$18593514,131+13.8%
California$84$17082316,391+9.6%
New Jersey$83$1605397,427+8.4%
Maryland$81$1423245,104+5.9%
Connecticut$78$1471971,874+2.4%
Montana$77$190113372+0.9%
Rhode Island$77$13662771+0.6%
Illinois$77$1565725,974+0.4%
Nevada$77$221911,140+0.4%
Florida$76$15475212,413+0.2%
Pennsylvania$76$1448309,562-0.5%
Massachusetts$76$1624116,609-0.6%
District of Columbia$75$13316119-2.1%
Hawaii$75$15440231-2.1%
Washington$75$1882491,831-2.3%
Colorado$74$1483213,366-2.3%
Texas$74$1567385,952-2.4%
Wyoming$74$17668663-2.8%
Oregon$74$191120681-3.0%
Georgia$74$1352772,684-3.2%
North Dakota$73$202112573-4.1%
Maine$73$18787253-4.2%
Michigan$73$1514146,155-4.2%
Utah$73$21596614-4.6%
West Virginia$73$1561551,300-4.6%
Delaware$73$18736251-4.7%
Arizona$73$1651651,952-4.9%
New Hampshire$72$1751191,183-5.1%
Ohio$72$1426905,950-5.4%
South Carolina$72$1451751,339-5.4%
Vermont$72$14951353-5.6%
Louisiana$72$1671961,079-5.8%
Missouri$72$1282822,235-5.8%
Minnesota$72$1973301,472-5.8%
New Mexico$72$16361304-6.0%
Arkansas$72$144117800-6.1%
Kansas$72$1392281,375-6.2%
Puerto Rico$71$74530-6.7%
Virginia$71$1474404,481-6.8%
South Dakota$71$143117853-7.1%
Wisconsin$71$2272451,614-7.2%
Kentucky$71$1462692,214-7.4%
Alabama$70$1271992,043-7.8%
Iowa$70$1733752,157-8.0%
Nebraska$69$1631561,113-9.1%
Mississippi$69$1411491,725-9.2%
Tennessee$69$1513663,638-9.3%
North Carolina$69$1635345,647-9.3%
Oklahoma$69$1721482,288-9.8%
Idaho$69$15197533-10.0%
Indiana$68$1303803,820-11.3%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber