Temporary Procedures · G9878

Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl

What Medicare pays for G9878, what providers bill, and how the price varies across 6 states, drawn from CMS 2023 claims data.

$94.73
Medicare pays
$109.01
Providers bill
1.2×
Markup
#6,700 of 9,297
Volume rank

The verdict

Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl pairs modest national service volume with one of the smaller markups in the catalog.

28th pct.
national service volume
3rd pct.
billed-to-Medicare markup
1.2×
billed vs. Medicare
$94.73
Medicare pays, national avg

Volume percentile ranks this code's national service volume against every tracked procedure; markup percentile ranks its billed-to-Medicare ratio the same way. The same two figures drive both the verdict sentence and the chips above.

According to the Centers for Medicare & Medicaid Services (CMS), the 2023 Medicare Physician & Other Practitioners dataset records payments for 9,297 procedure codes billed across 5,426 hospitals in 56 states and territories; see our methodology for how each figure is sourced and computed.

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Payment tier in Temporary Procedures
Above-median in category
#59 of 172 procedures in Temporary Procedures by national average Medicare payment.
Markup tier vs. tracked procedures
1.2x markup
1.2x the Medicare rate. This procedure has too little volume for a reliable catalog-wide rank.
217
Total Services
217
Beneficiaries
59
Providers
6
States with Data

Price Range Across States

Lowest State Avg
$81.61
Wisconsin
Highest State Avg
$99.20
South Carolina

What You Might Pay

Est. Commercial Insurance
$212.20
Range: $148.54 – $297.08
Est. Cash / Self-Pay
$101.03
Typical self-pay discount

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

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024). We map each PlainProcedure category onto a RAND CPT-section bucket (Surgery, Radiology, Pathology and Laboratory, Medicine, Anesthesia, Evaluation and Management) or fall back to the national average when no bucket matches. For Temporary Procedures, the applied ratio is 2.24x Medicare (RAND 2024 national average (2.24x); no matching CPT-section bucket for this category + CMS Medicare baseline). Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Where this markup sits nationally

Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate

1 more affordable than 3% of 8,901 procedures

1–2: 466 procedures (5%). This entry sits in this band. 2–3: 681 procedures (8%). Above this entry. 3–4: 845 procedures (9%). Above this entry. 4–5: 1,308 procedures (15%). Above this entry. 5–6: 1,725 procedures (19%). Above this entry. 6–7: 1,217 procedures (14%). Above this entry. 7–8: 801 procedures (9%). Above this entry. 8–9: 541 procedures (6%). Above this entry. 9–10: 351 procedures (4%). Above this entry. 10–11: 246 procedures (3%). Above this entry. 11–12: 151 procedures (2%). Above this entry. 12–13: 175 procedures (2%). Above this entry. 13–14: 140 procedures (2%). Above this entry. 14–15: 40 procedures (0%). Above this entry. 15–16: 39 procedures (0%). Above this entry. 16–17: 26 procedures (0%). Above this entry. 17–18: 25 procedures (0%). Above this entry. 18–19: 21 procedures (0%). Above this entry. 19–20: 12 procedures (0%). Above this entry. 20–21: 16 procedures (0%). Above this entry. 21–22: 13 procedures (0%). Above this entry. 22–23: 8 procedures (0%). Above this entry. 23–24: 9 procedures (0%). Above this entry. 24–25: 4 procedures (0%). Above this entry. 25–26: 3 procedures (0%). Above this entry. 26–27: 3 procedures (0%). Above this entry. 27–28: 4 procedures (0%). Above this entry. 28–29: 3 procedures (0%). Above this entry. 29–30: 2 procedures (0%). Above this entry. 30–31: 26 procedures (0%). Above this entry. this procedure 1 31 × markup, bucketed by value

Each bar is a 1-wide band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners · 2023

Prices by State

State Medicare Payment Billed Charge
South Carolina $99.20 $118.18
Florida $98.98 $109.50
Michigan $98.98 $101.00
Oregon $98.98 $112.25
Washington $87.40 $89.18
Wisconsin $81.61 $83.27

What the Data Says About Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl

Across 6 states with reporting providers, CPT code G9878 (Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl) shows a national average Medicare payment of $94.73 against an average billed charge of $109.01. That gap, a 1.2x markup, or 15% above the Medicare allowed amount, is among the tightest billed-to-paid spreads we track, this code's chargemaster rate tracks unusually close to the Medicare benchmark.

Temporary Procedures procedures like this one saw 217 services billed to Medicare in 2023 by 59 distinct providers, serving 217 unique beneficiaries. State-level variation is significant: Wisconsin reports the lowest average payment at $81.61, while South Carolina reports the highest at $99.20. The 22% spread here is a moderate, fairly ordinary GPCI effect, local cost-of-practice adjustments nudging the allowed amount up or down without reshaping it. Applying the RAND 2024 commercial-to-Medicare ratio for this category (2.24x Medicare; RAND 2024 national average (2.24x); no matching CPT-section bucket for this category + CMS Medicare baseline), the estimated commercial insurance price lands near $212.20, with self-pay cash discounts commonly bringing the figure closer to $101.03. Within Temporary Procedures, Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl ranks #59 of 172 tracked procedures by national average Medicare payment.

Where this sits in the registry

Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl (G9878) is a CMS 2023 Part B code. These pages keep the volume map and the markup map separate.

  • National volume versus markup on the statistics page, the same two maps as this capsule. Statistics
  • Other Temporary Procedures codes, ranked by Medicare payment inside the category. Category
  • How volume rank and markup rank are computed. Methodology
  • The full procedures listing in volume order. Procedures

Figures here are CMS averages, not a quote for any patient, plan, or visit.

Frequently Asked Questions

Where does Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl rank among Medicare procedures?

According to CMS Medicare Part B claims, Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl (CPT G9878) ranks #6,700 of 9,297 procedures by national service volume, the same sort as the procedures listing, and #59 of 172 within Temporary Procedures by national average Medicare payment. See /methodology#corpus-placement.

How much does Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl cost?

Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl (CPT G9878) is priced fairly consistently nationwide: Medicare pays $94.73 on average, and the $81.61-$99.20 state range stays relatively tight. Providers typically bill $109.01.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl cost with insurance?

With commercial insurance, two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp suppl costs an estimated $212.20 on average (range: $148.54-$297.08), a moderate premium over Medicare's $94.73. Without insurance, the estimated cash price is $101.03.

Which state has the lowest cost for Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl?

Wisconsin and South Carolina bookend the range for Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl, at $81.61 and $99.20 respectively - a relatively tight $17.60 spread nationwide.

How many providers perform Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl?

Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl is comparatively uncommon: only 59 providers nationally billed Medicare for it in 2023, serving 217 beneficiaries via 217 total services.

What is the billed-to-Medicare markup for Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl?

Providers bill 1.2x what Medicare pays for Two Medicare Diabetes Prevention Program (mdpp) Core Maintenance Sessions (ms) Were Attended By An Mdpp Beneficiary In Months (mo) 7-9 Under The Mdpp Expanded Model (em). A Core Maintenance Session Is An Mdpp Service That: (1) Is Furnished By An Mdpp Suppl - one of the smaller markups in the catalog at 15% above the Medicare rate.

Nationwide similar CPT codes

Data-derived peers across the CMS Physician & Other Practitioners extract: nearest national service volume and nearest average Medicare payment. Not clinical substitutes: claim-mass and payment neighborhoods only.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, the data changelog, or report a data error.