North Carolina · G0498

Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in North Carolina

North Carolina Medicare Avg
$169.96
14% above national avg
National Medicare Avg
$148.58
All states combined
Billed Charge (NC)
$726.60
What providers submit
Est. Commercial (NC)
$466.46
National avg: $419.65
Est. Cash / Self-Pay (NC)
$360.30
Typical self-pay discount

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

1.2K
Services in NC
66
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in North Carolina

Provider Medicare Services
Schaefer-Cutillo, Julia M.D. $176.95 99
Jayaram, Nagesh MD $179.51 80

North Carolina Pricing in Context

In North Carolina, CPT code G0498 (Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L) carries an average Medicare payment of $169.96 — 14% above the national benchmark of $148.58. 66 providers across the state submitted claims for this procedure in 2023, performing 1.2K 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 $726.60, 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 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 North Carolina lands near $466.46, with self-pay cash prices typically around $360.30. 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 Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cost in North Carolina?

The average Medicare payment for Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in North Carolina is $169.96, which is 14% above the national average of $148.58. Providers in NC typically bill $726.60 for this procedure.

What does Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cost with insurance in North Carolina?

With commercial insurance in North Carolina, Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L costs an estimated $466.46. Without insurance, the estimated cash price is $360.30. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in North Carolina?

66 providers in North Carolina billed Medicare for Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in 2023, performing 1.2K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cheaper in North Carolina than the national average?

No — Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L costs 14% above the national average in North Carolina. The state average Medicare payment is $169.96 compared to $148.58 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