Wisconsin · G0372

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

Wisconsin Medicare Avg
$5.67
11% below national avg
National Medicare Avg
$6.35
All states combined
Billed Charge (WI)
$31.92
What providers submit
Est. Commercial (WI)
$16.87
National avg: $18.49
Est. Cash / Self-Pay (WI)
$14.75
Typical self-pay discount

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

20
Services in WI
11
Providers
N/A
Min Payment
N/A
Max Payment

Wisconsin Pricing in Context

In Wisconsin, CPT code G0372 (Physician Service Required To Establish And Document The Need For A Power Mobility Device) carries an average Medicare payment of $5.67 — 11% below the national benchmark of $6.35. 11 providers across the state submitted claims for this procedure in 2023, performing 20 total services. Individual payments in WI 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 Wisconsin is $31.92, 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 Wisconsin 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 Wisconsin lands near $16.87, with self-pay cash prices typically around $14.75. 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 Wisconsin?

The average Medicare payment for Physician Service Required To Establish And Document The Need For A Power Mobility Device in Wisconsin is $5.67, which is 11% below the national average of $6.35. Providers in WI typically bill $31.92 for this procedure.

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

With commercial insurance in Wisconsin, Physician Service Required To Establish And Document The Need For A Power Mobility Device costs an estimated $16.87. Without insurance, the estimated cash price is $14.75. 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 Wisconsin?

11 providers in Wisconsin billed Medicare for Physician Service Required To Establish And Document The Need For A Power Mobility Device in 2023, performing 20 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 Wisconsin than the national average?

Yes — Physician Service Required To Establish And Document The Need For A Power Mobility Device costs 11% below the national average in Wisconsin. The state average Medicare payment is $5.67 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