Michigan · G9880

The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight in Michigan

Michigan Medicare Avg
$180.32
1% above national avg
National Medicare Avg
$179.42
All states combined
Billed Charge (MI)
$184.58
What providers submit
Est. Commercial (MI)
$382.28
National avg: $401.90
Est. Cash / Self-Pay (MI)
$186.00
Typical self-pay discount

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

43
Services in MI
3
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Michigan

Provider Medicare Services
National Kidney Foundation Of... $180.32 32

Michigan Pricing in Context

In Michigan, CPT code G9880 (The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight) carries an average Medicare payment of $180.32 — 1% above the national benchmark of $179.42. 3 providers across the state submitted claims for this procedure in 2023, performing 43 total services. Individual payments in MI 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 Michigan is $184.58, 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 Michigan 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 Michigan lands near $382.28, with self-pay cash prices typically around $186.00. 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 The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight cost in Michigan?

The average Medicare payment for The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight in Michigan is $180.32, which is 1% above the national average of $179.42. Providers in MI typically bill $184.58 for this procedure.

What does The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight cost with insurance in Michigan?

With commercial insurance in Michigan, The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight costs an estimated $382.28. Without insurance, the estimated cash price is $186.00. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight in Michigan?

3 providers in Michigan billed Medicare for The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight in 2023, performing 43 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight cheaper in Michigan than the national average?

No — The Mdpp Beneficiary Achieved At Least 5% Weight Loss (wl) From His/her Baseline Weight In Months 1-12 Of The Mdpp Services Period Under The Mdpp Expanded Model (em). This Is A One-Time Payment Available When A Beneficiary First Achieves At Least 5% Weight costs 1% above the national average in Michigan. The state average Medicare payment is $180.32 compared to $179.42 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