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Average Medicare Charges for Hospital Outpatient Services, 2020

Average Medicare charges (average prices) for selected hospital outpatient services are listed here for calendar year 2020. Types of services include biopsy, breast surgery, musculoskeletal (e.g. bunions, knee cartilage, broken bone added together) procedures, ENT, cochlear implant, pacemaker charges, upper GI procedures, endoscopy, and more. File includes charges, what Medicare allowed, and what Medicare paid, and how many Medicare beneficiaries used that service. File shows charges to Medicare patients by physician name, state average and national average prices. Extremely difficult to use, even if somewhat familiar with using Excel files. High level price summary for about 60 categories in APC. More detail (such as bunions and bone spurs) is found in the HCPCS file, a couple of thousand procedures are listed there. In 2020, this file shows that the most common types of Comprehensive Observation Services (given to over 1.6 million Medicare patients) had an average charge close to $19,000, with Medicare allowing $2,172 on average; Medicare paid an average of $1,814. A Cataract removal with lens insertion was about $10,000 in charges, with Medicare allowing $2,004 (and paying $1,595 on average). A Repair of Knee Joint had an average charge in 2020 of $59,600. Medicare allowed $11,717, and it paid $10,309 on average. Good information, very user-unfriendly. From CMS updated August 2021 and September 2022.

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