Hormone Test · 82642

Measurement Of Dihydrotestosterone

What Medicare pays for 82642, what providers bill, and how the price varies across 29 states, drawn from CMS 2023 claims data.

82642 · the short answer

For measurement of dihydrotestosterone, Medicare pays about $28.62 while providers bill $185.04 on average, a 6.5× markup, an above-median markup. State-level Medicare rates range 11% from lowest to highest.

Medicare pays
$28.62
Providers bill
$185.04
Markup
6.5×
Markup percentile
63th

Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.

Medicare Payment (avg)
$28.62
What Medicare actually pays
Billed Charge (avg)
$185.04
What providers submit
Markup
6.5x
547% above Medicare rate
18.6K
Total Services
13.2K
Beneficiaries
157
Providers
29
States with Data

Price Range Across States

Lowest State Avg
$25.80
Massachusetts
Highest State Avg
$28.69
South Carolina

What You Might Pay

Est. Commercial Insurance
$64.10
Range: $44.87 – $89.74
Est. Cash / Self-Pay
$72.35
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Hormone Test procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Where this markup sits nationally

Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate

6 Among the most affordable more affordable than 63% of 8,901 procedures

1–2: 466 procedures (5%). Below this entry. 2–3: 681 procedures (8%). Below this entry. 3–4: 845 procedures (9%). Below this entry. 4–5: 1,308 procedures (15%). Below this entry. 5–6: 1,725 procedures (19%). Below this entry. 6–7: 1,217 procedures (14%). This entry sits in this band. 7–8: 801 procedures (9%). Above this entry. 8–9: 541 procedures (6%). Above this entry. 9–10: 351 procedures (4%). Above this entry. 10–11: 246 procedures (3%). Above this entry. 11–12: 151 procedures (2%). Above this entry. 12–13: 175 procedures (2%). Above this entry. 13–14: 140 procedures (2%). Above this entry. 14–15: 40 procedures (0%). Above this entry. 15–16: 39 procedures (0%). Above this entry. 16–17: 26 procedures (0%). Above this entry. 17–18: 25 procedures (0%). Above this entry. 18–19: 21 procedures (0%). Above this entry. 19–20: 12 procedures (0%). Above this entry. 20–21: 16 procedures (0%). Above this entry. 21–22: 13 procedures (0%). Above this entry. 22–23: 8 procedures (0%). Above this entry. 23–24: 9 procedures (0%). Above this entry. 24–25: 4 procedures (0%). Above this entry. 25–26: 3 procedures (0%). Above this entry. 26–27: 3 procedures (0%). Above this entry. 27–28: 4 procedures (0%). Above this entry. 28–29: 3 procedures (0%). Above this entry. 29–30: 2 procedures (0%). Above this entry. 30–31: 26 procedures (0%). Above this entry. this procedure 1 31 × markup, bucketed by value

Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners · 2023

Prices by State

State Medicare Payment Billed Charge
South Carolina $28.69 $54.39
Texas $28.69 $227.28
Alabama $28.69 $178.52
Colorado $28.69 $184.78
Florida $28.69 $213.01
Georgia $28.69 $233.58
Hawaii $28.69 $127.54
Idaho $28.69 $78.80
Kansas $28.69 $225.88
Louisiana $28.69 $77.64
Maryland $28.69 $219.67
Nevada $28.69 $221.30
Ohio $28.69 $207.85
Oklahoma $28.69 $210.45
Oregon $28.69 $48.60
Pennsylvania $28.69 $184.72
Tennessee $28.69 $169.00
Utah $28.69 $66.98
Virginia $28.69 $106.16
Washington $28.69 $198.94
Wisconsin $28.69 $102.50
New Jersey $28.69 $146.64
New York $28.68 $127.19
California $28.67 $186.00
North Carolina $28.67 $170.67
Arizona $28.65 $195.39
Illinois $28.62 $222.61
Puerto Rico $28.24 $36.83
Massachusetts $25.80 $170.88

What the Data Says About Measurement Of Dihydrotestosterone

Across 29 states with reporting providers, CPT code 82642 (Measurement Of Dihydrotestosterone) shows a national average Medicare payment of $28.62 against an average billed charge of $185.04. That gap, a 6.5x markup, or 547% above the Medicare allowed amount, is roughly in line with what most procedures show, chargemaster pricing that no major payer pays in full but that still anchors negotiations.

Hormone Test procedures like this one saw 18.6K services billed to Medicare in 2023 by 157 distinct providers, serving 13.2K unique beneficiaries. State-level variation is significant: Massachusetts reports the lowest average payment at $25.80, while South Carolina reports the highest at $28.69. At just 11%, this procedure prices remarkably consistently nationwide, GPCI adjustments barely move the needle for this particular code.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Hormone Test category (2.24x), the estimated commercial insurance price lands near $64.10, with self-pay cash discounts commonly bringing the figure closer to $72.35. Within Hormone Test, Measurement Of Dihydrotestosterone ranks #19 of 69 tracked procedures by national average Medicare payment.

What to do with this

If you may have measurement of dihydrotestosterone done, these steps turn the numbers above into a real-world cost estimate.

  • Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
  • Compare measurement of dihydrotestosterone costs in your state, Medicare rates vary by locality. Browse states
  • Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
  • Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide

Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.

Frequently Asked Questions

How much does Measurement Of Dihydrotestosterone cost?

Measurement Of Dihydrotestosterone (CPT 82642) is priced fairly consistently nationwide: Medicare pays $28.62 on average, and the $25.80-$28.69 state range stays relatively tight. Providers typically bill $185.04.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Measurement Of Dihydrotestosterone cost with insurance?

With commercial insurance, measurement of dihydrotestosterone costs an estimated $64.10 on average (range: $44.87-$89.74), a moderate premium over Medicare's $28.62. Without insurance, the estimated cash price is $72.35.

Which state has the lowest cost for Measurement Of Dihydrotestosterone?

Massachusetts and South Carolina bookend the range for Measurement Of Dihydrotestosterone, at $25.80 and $28.69 respectively - a relatively tight $2.89 spread nationwide.

How many providers perform Measurement Of Dihydrotestosterone?

Measurement Of Dihydrotestosterone is comparatively uncommon: only 157 providers nationally billed Medicare for it in 2023, serving 13.2K beneficiaries via 18.6K total services.

What is the billed-to-Medicare markup for Measurement Of Dihydrotestosterone?

Providers bill 6.5x what Medicare pays for Measurement Of Dihydrotestosterone - an above-median markup at 547% above the Medicare rate.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.