Illinois · G0246

Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in Illinois

Illinois Medicare Avg
$26.90
9% above national avg
National Medicare Avg
$24.66
All states combined
Billed Charge (IL)
$85.03
What providers submit
Est. Commercial (IL)
$83.97
National avg: $77.80
Est. Cash / Self-Pay (IL)
$52.67
Typical self-pay discount

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

58
Services in IL
12
Providers
N/A
Min Payment
N/A
Max Payment

Illinois Pricing in Context

In Illinois, CPT code G0246 (Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a)) carries an average Medicare payment of $26.90 — 9% above the national benchmark of $24.66. 12 providers across the state submitted claims for this procedure in 2023, performing 58 total services. Individual payments in IL 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 Illinois is $85.03, 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 Illinois 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 Illinois lands near $83.97, with self-pay cash prices typically around $52.67. 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 Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) cost in Illinois?

The average Medicare payment for Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in Illinois is $26.90, which is 9% above the national average of $24.66. Providers in IL typically bill $85.03 for this procedure.

What does Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) cost with insurance in Illinois?

With commercial insurance in Illinois, Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) costs an estimated $83.97. Without insurance, the estimated cash price is $52.67. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in Illinois?

12 providers in Illinois billed Medicare for Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in 2023, performing 58 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) cheaper in Illinois than the national average?

No — Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) costs 9% above the national average in Illinois. The state average Medicare payment is $26.90 compared to $24.66 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

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