G2076

Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a

Medicare pricing data for 694 providers across 42 states

🤖AI Overview

Prices vary significantly by location — from $103 in Nevada to $242 in Alaska. Where you get this procedure matters more than almost any other factor. 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

Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a (HCPCS code G2076) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $185.20, but hospitals typically charge $235.58 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$37.04

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $185.20, your out-of-pocket cost would be approximately $37.04. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$185.20
Average Hospital Charge
$235.58
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$235.58
Medicare Allowed$185.20
Medicare Payment$174.62

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $174.62 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$242$285519+30.6%
California$202$22565510+9.2%
New Jersey$200$28832174+7.8%
Massachusetts$196$2059483+6.1%
Connecticut$196$217754+5.9%
Illinois$196$2391875+5.7%
Maryland$194$22047427+4.9%
Colorado$192$270717+3.9%
Michigan$192$26026558+3.7%
New Hampshire$192$394785+3.6%
Rhode Island$191$1941129+3.1%
Montana$189$280415+2.2%
Delaware$189$379516+2.0%
Oregon$189$26211119+1.8%
Washington$188$19816122+1.6%
Pennsylvania$187$2682974+1.1%
Virginia$187$34026109+0.9%
Texas$186$3332238+0.5%
Vermont$185$190639+0.1%
Arizona$185$2681990-0.3%
Minnesota$184$2491051-0.6%
New York$184$19428236-0.8%
Georgia$182$3362476-1.5%
Maine$182$242893-1.6%
New Mexico$182$343735-1.7%
North Carolina$181$220362,809-2.4%
Louisiana$181$184533-2.5%
Ohio$180$26029113-3.0%
Wisconsin$179$2291483-3.3%
Missouri$179$394821-3.3%
South Carolina$179$3222065-3.6%
West Virginia$178$181752-3.6%
Indiana$178$2241171-4.0%
Kentucky$178$3181663-4.1%
Kansas$177$189314-4.4%
Alabama$177$4291227-4.5%
Florida$176$34032180-5.1%
Idaho$175$190312-5.7%
Mississippi$174$258312-6.0%
Tennessee$174$1791761-6.0%
Utah$173$205735-6.6%
Nevada$103$10510105-44.2%

⚠️ 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

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