South Dakota · 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 South Dakota

South Dakota Medicare Avg
$129.04
13% below national avg
National Medicare Avg
$148.58
All states combined
Billed Charge (SD)
$743.07
What providers submit
Est. Commercial (SD)
$332.01
National avg: $419.65
Est. Cash / Self-Pay (SD)
$325.81
Typical self-pay discount

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

135
Services in SD
7
Providers
N/A
Min Payment
N/A
Max Payment

South Dakota Pricing in Context

In South Dakota, 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 $129.04 — 13% below the national benchmark of $148.58. 7 providers across the state submitted claims for this procedure in 2023, performing 135 total services. Individual payments in SD 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 South Dakota is $743.07, 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 South Dakota 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 South Dakota lands near $332.01, with self-pay cash prices typically around $325.81. 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 South Dakota?

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 South Dakota is $129.04, which is 13% below the national average of $148.58. Providers in SD typically bill $743.07 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 South Dakota?

With commercial insurance in South Dakota, 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 $332.01. Without insurance, the estimated cash price is $325.81. 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 South Dakota?

7 providers in South Dakota 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 135 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 South Dakota than the national average?

Yes — 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 13% below the national average in South Dakota. The state average Medicare payment is $129.04 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