Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent in Pennsylvania
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Pennsylvania
| Provider | Medicare | Services |
|---|---|---|
| Cherian, John MD | $6.29 | 295 |
| Warnick, William M.D. | $7.10 | 112 |
| Geyfman, Vitaly D.O. | $6.29 | 106 |
| Waxler, Andrew MD | $6.33 | 105 |
| Modi, Mayank MD | $6.32 | 103 |
| Stopper, Matthew MD | $6.74 | 93 |
| Borgatta, Louis MD | $6.70 | 93 |
| Polinsky, Ronald MD | $6.45 | 89 |
| Russo, Michael M.D. | $6.28 | 87 |
| Gitter, Howard MD | $6.85 | 64 |
Pennsylvania Pricing in Context
In Pennsylvania, CPT code G0250 (Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent) carries an average Medicare payment of $6.56 — 5% above the national benchmark of $6.24. 223 providers across the state submitted claims for this procedure in 2023, performing 6.3K total services. Individual payments in PA 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 Pennsylvania is $25.96, 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 Pennsylvania 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 Pennsylvania lands near $19.20, with self-pay cash prices typically around $13.68. 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 Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent cost in Pennsylvania?
The average Medicare payment for Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent in Pennsylvania is $6.56, which is 5% above the national average of $6.24. Providers in PA typically bill $25.96 for this procedure.
What does Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent cost with insurance in Pennsylvania?
With commercial insurance in Pennsylvania, Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent costs an estimated $19.20. Without insurance, the estimated cash price is $13.68. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent in Pennsylvania?
223 providers in Pennsylvania billed Medicare for Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent in 2023, performing 6.3K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent cheaper in Pennsylvania than the national average?
No — Physician Review, Interpretation, And Patient Management Of Home Inr Testing For Patient With Either Mechanical Heart Valve(s), Chronic Atrial Fibrillation, Or Venous Thromboembolism Who Meets Medicare Coverage Criteria; Testing Not Occurring More Frequent costs 5% above the national average in Pennsylvania. The state average Medicare payment is $6.56 compared to $6.24 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.