99341

Residence visit for new patient with straightforward medical decision making, per day, if using time, at least 15 minutes

Medicare pricing data for 3,216 providers across 51 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

Residence visit for new patient with straightforward medical decision making, per day, if using time, at least 15 minutes (HCPCS code 99341) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $47.05, but hospitals typically charge $115.25 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.41

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $47.05, your out-of-pocket cost would be approximately $9.41. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$47.05
Average Hospital Charge
$115.25
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$115.25
Medicare Allowed$47.05
Medicare Payment$34.71

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $34.71 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$50$216943+6.1%
Connecticut$50$11838435+5.9%
New Jersey$50$1091712,841+5.6%
New York$50$1042023,426+5.6%
California$49$1182193,915+5.0%
Maryland$49$98661,240+4.9%
Massachusetts$49$122661,104+3.8%
Washington$48$121961,734+2.1%
Puerto Rico$48$53719+1.8%
Pennsylvania$48$891854,377+1.3%
Vermont$48$80332+1.2%
Michigan$48$951592,567+1.1%
Maine$47$8411194+0.8%
Minnesota$47$106431,617+0.1%
Illinois$47$1121574,707+0.1%
North Dakota$47$68555-0.0%
Louisiana$47$20615106-0.3%
South Dakota$47$954109-0.5%
Texas$47$1232163,759-0.6%
Wyoming$47$117652-0.6%
Wisconsin$47$92472,359-0.7%
Missouri$47$99611,611-0.7%
Montana$47$166976-1.0%
New Hampshire$46$7311411-1.2%
Ohio$46$1001682,905-1.5%
Oregon$46$13721239-1.6%
Virginia$46$144871,284-1.7%
Rhode Island$46$1841049-1.8%
Florida$46$1203156,473-1.8%
South Carolina$46$7739945-1.8%
Indiana$46$123511,320-2.1%
Georgia$46$15355946-2.3%
Alabama$46$12421430-2.3%
Kentucky$46$8930748-2.4%
Hawaii$46$88520-2.5%
Utah$46$8342655-2.8%
Arkansas$46$979161-2.8%
Idaho$45$10532841-3.4%
Delaware$45$100727-3.6%
North Carolina$45$10661986-3.6%
Nevada$45$214431,197-3.9%
Kansas$45$10130614-5.3%
Colorado$45$21186932-5.4%
West Virginia$44$1721051-5.8%
Iowa$44$9738319-6.0%
Arizona$44$170811,162-6.8%
Oklahoma$44$17236217-7.0%
Nebraska$43$8721435-8.4%
Tennessee$43$18163884-9.5%
New Mexico$43$260530-9.7%
Mississippi$41$1221932-13.5%

⚠️ 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