North Carolina · G0372

Physician Service Required To Establish And Document The Need For A Power Mobility Device in North Carolina

North Carolina Medicare Avg
$5.77
9% below national avg
National Medicare Avg
$6.35
All states combined
Billed Charge (NC)
$46.83
What providers submit
Est. Commercial (NC)
$17.89
National avg: $18.49
Est. Cash / Self-Pay (NC)
$19.03
Typical self-pay discount

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

49
Services in NC
36
Providers
N/A
Min Payment
N/A
Max Payment

North Carolina Pricing in Context

In North Carolina, CPT code G0372 (Physician Service Required To Establish And Document The Need For A Power Mobility Device) carries an average Medicare payment of $5.77 — 9% below the national benchmark of $6.35. 36 providers across the state submitted claims for this procedure in 2023, performing 49 total services. Individual payments in NC 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 North Carolina is $46.83, 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 North Carolina sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in North Carolina lands near $17.89, with self-pay cash prices typically around $19.03. 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 Service Required To Establish And Document The Need For A Power Mobility Device cost in North Carolina?

The average Medicare payment for Physician Service Required To Establish And Document The Need For A Power Mobility Device in North Carolina is $5.77, which is 9% below the national average of $6.35. Providers in NC typically bill $46.83 for this procedure.

What does Physician Service Required To Establish And Document The Need For A Power Mobility Device cost with insurance in North Carolina?

With commercial insurance in North Carolina, Physician Service Required To Establish And Document The Need For A Power Mobility Device costs an estimated $17.89. Without insurance, the estimated cash price is $19.03. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Physician Service Required To Establish And Document The Need For A Power Mobility Device in North Carolina?

36 providers in North Carolina billed Medicare for Physician Service Required To Establish And Document The Need For A Power Mobility Device in 2023, performing 49 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Physician Service Required To Establish And Document The Need For A Power Mobility Device cheaper in North Carolina than the national average?

Yes — Physician Service Required To Establish And Document The Need For A Power Mobility Device costs 9% below the national average in North Carolina. The state average Medicare payment is $5.77 compared to $6.35 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