G2079

Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure

Medicare pricing data for 274 providers across 15 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

Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure (HCPCS code G2079) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $78.64, but hospitals typically charge $103.95 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.73

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $78.64, your out-of-pocket cost would be approximately $15.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$78.64
Average Hospital Charge
$103.95
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$103.95
Medicare Allowed$78.64
Medicare Payment$77.85

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $77.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Virginia$79$859398+0.5%
South Carolina$79$827328+0.4%
Delaware$79$964219+0.4%
Texas$79$16115320+0.4%
West Virginia$79$815303+0.4%
Illinois$79$1517218+0.4%
Arizona$79$2109177+0.4%
North Carolina$79$115251,176+0.3%
Washington$79$1249358+0.3%
Ohio$79$104175,007+0.3%
Vermont$79$1456195+0.3%
New Jersey$79$11811455+0.2%
Tennessee$79$816225+0.2%
California$78$8240949-0.3%
Maryland$77$85291,896-1.6%

⚠️ 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