G0070

Professional services for the administration of intravenous chemotherapy or other intravenous highly complex drug or biological infusion for each infusion drug administration calendar day in the individual's home, each 15 minutes

Medicare pricing data for 37 providers across 8 states

🤖AI Overview

Prices vary significantly by location — from $90 in Maryland to $304 in Pennsylvania. Where you get this procedure matters more than almost any other factor. 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

Professional services for the administration of intravenous chemotherapy or other intravenous highly complex drug or biological infusion for each infusion drug administration calendar day in the individual's home, each 15 minutes (HCPCS code G0070) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $196.30, but hospitals typically charge $254.73 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$39.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $196.30, your out-of-pocket cost would be approximately $39.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$196.30
Average Hospital Charge
$254.73
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$254.73
Medicare Allowed$196.30
Medicare Payment$155.89

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $155.89 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Pennsylvania$304$34133,371+54.9%
New Jersey$199$25332,151+1.2%
Washington$155$3123623-21.2%
New York$122$17531,373-37.7%
Indiana$122$1451297-37.9%
Massachusetts$119$1971221-39.5%
Minnesota$107$1881756-45.3%
Maryland$90$1413550-54.1%

⚠️ 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