A0425

Ground mileage, per statute mile

Medicare pricing data for 9,978 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 99.5 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Ground mileage, per statute mile (HCPCS code A0425) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.23, but hospitals typically charge $24.62 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $9.23, your out-of-pocket cost would be approximately $1.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$9.23
Average Hospital Charge
$24.62
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$24.62
Medicare Allowed$9.23
Medicare Payment$7.35

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $7.35 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Vermont$11$2167441,139+16.1%
Maine$10$21150534,153+13.4%
Hawaii$10$353122,858+13.2%
Alaska$10$2340170,355+12.9%
New Hampshire$10$38122543,503+11.2%
Kentucky$10$171722,076,306+9.3%
Iowa$10$19291813,198+8.6%
Mississippi$10$25351,844,928+8.5%
Delaware$10$2561299,906+8.0%
Oregon$10$26118949,715+7.2%
Montana$10$2398329,761+7.0%
Wyoming$10$3227128,371+6.2%
Wisconsin$10$273371,688,406+5.9%
Idaho$10$1975368,946+5.5%
Oklahoma$10$211211,867,590+5.5%
Kansas$10$171291,035,046+5.4%
South Dakota$10$17108360,160+5.3%
North Dakota$10$2396382,188+5.0%
Minnesota$10$311611,339,156+4.9%
Arkansas$10$21631,862,506+4.9%
Missouri$10$171862,129,467+4.6%
Ohio$10$198893,841,274+3.5%
North Carolina$9$151863,472,629+2.5%
Washington$9$262161,608,456+2.2%
Alabama$9$171332,182,528+2.2%
New Mexico$9$1382489,971+2.1%
Indiana$9$232411,788,905+1.8%
Arizona$9$231101,461,384+1.8%
Utah$9$4177389,728+1.7%
West Virginia$9$171401,658,491+1.4%
Tennessee$9$241323,203,115+1.3%
Michigan$9$202483,063,653+1.2%
Virginia$9$172612,862,971+1.1%
Nevada$9$3442516,514+1.0%
Colorado$9$29169904,927+0.7%
Louisiana$9$32451,877,296-0.2%
Illinois$9$285463,864,222-0.3%
Pennsylvania$9$176503,498,808-0.4%
New York$9$265644,294,319-1.0%
Nebraska$9$212751,370,500-1.7%
Texas$9$246428,185,668-1.7%
California$9$522646,667,930-3.3%
Maryland$9$141252,243,889-3.9%
Florida$9$151714,908,333-4.7%
South Carolina$9$161193,137,936-5.3%
Georgia$9$212665,101,126-5.4%
Connecticut$9$241411,220,199-5.6%
Massachusetts$9$542813,488,107-6.5%
District of Columbia$9$18240,387-7.2%
Rhode Island$8$3850256,718-8.6%
Puerto Rico$8$817754,534-12.4%
New Jersey$8$212662,536,192-13.8%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber