G0372

Physician service required to establish and document the need for a power mobility device

Medicare pricing data for 937 providers across 29 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Physician service required to establish and document the need for a power mobility device (HCPCS code G0372) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.25, but hospitals typically charge $40.33 — a 4.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.65

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8.25, your out-of-pocket cost would be approximately $1.65. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$8.25
Average Hospital Charge
$40.33
Markup Ratio
4.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$40.33
Medicare Allowed$8.25
Medicare Payment$6.36

Hospitals charge 4.9x more than what Medicare allows for this procedure. Medicare actually pays $6.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$9$4232114+12.8%
California$9$3442214+11.9%
Maryland$9$211823+6.3%
Maine$9$23232+4.7%
Missouri$9$4913173+4.4%
Washington$9$251432+4.2%
New Jersey$9$3831143+3.9%
Oklahoma$9$4419314+3.9%
Illinois$9$264674+3.2%
Texas$9$42120704+3.2%
Georgia$8$394169+1.8%
Pennsylvania$8$251646+1.0%
Virginia$8$203060+0.4%
Ohio$8$29422580.0%
Massachusetts$8$27811-0.1%
South Carolina$8$331434-0.1%
North Carolina$8$473649-0.6%
Kentucky$8$301421-0.7%
Nevada$8$49142,505-1.7%
Louisiana$8$271114-2.1%
Arkansas$8$301420-2.5%
Minnesota$8$282136-2.9%
Tennessee$8$322428-2.9%
Wisconsin$8$321120-3.5%
Florida$8$23116357-3.8%
Mississippi$8$352133-4.4%
Michigan$8$1859149-4.6%
Indiana$8$192854-8.7%
Alabama$7$1928159-12.8%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber