Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons in Virginia
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Virginia Pricing in Context
In Virginia, CPT code G0245 (Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons) carries an average Medicare payment of $48.37 — 23% above the national benchmark of $39.33. 10 providers across the state submitted claims for this procedure in 2023, performing 19 total services. Individual payments in VA ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Virginia is $108.84, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Virginia sits above the national Medicare average, commercial rates in the state may also run higher than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in Virginia lands near $133.56, with self-pay cash prices typically around $75.46. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons cost in Virginia?
The average Medicare payment for Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons in Virginia is $48.37, which is 23% above the national average of $39.33. Providers in VA typically bill $108.84 for this procedure.
What does Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons cost with insurance in Virginia?
With commercial insurance in Virginia, Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons costs an estimated $133.56. Without insurance, the estimated cash price is $75.46. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons in Virginia?
10 providers in Virginia billed Medicare for Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons in 2023, performing 19 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons cheaper in Virginia than the national average?
No — Initial Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) Which Must Include: (1) The Diagnosis Of Lops, (2) A Patient History, (3) A Physical Examination That Cons costs 23% above the national average in Virginia. The state average Medicare payment is $48.37 compared to $39.33 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.