South Carolina · 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 South Carolina

South Carolina Medicare Avg
$180.54
1% above national avg
National Medicare Avg
$179.42
All states combined
Billed Charge (SC)
$273.60
What providers submit
Est. Commercial (SC)
$424.27
National avg: $401.90
Est. Cash / Self-Pay (SC)
$210.65
Typical self-pay discount

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

30
Services in SC
3
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in South Carolina

Provider Medicare Services
Prisma Health University Medical... $180.69 15
Medical University Hospital... $180.32 12

South Carolina Pricing in Context

In South Carolina, 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 $180.54 — 1% above the national benchmark of $179.42. 3 providers across the state submitted claims for this procedure in 2023, performing 30 total services. Individual payments in SC 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 Carolina is $273.60, 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 South 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 South Carolina lands near $424.27, with self-pay cash prices typically around $210.65. 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 South Carolina?

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 South Carolina is $180.54, which is 1% above the national average of $179.42. Providers in SC typically bill $273.60 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 South Carolina?

With commercial insurance in South Carolina, 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 $424.27. Without insurance, the estimated cash price is $210.65. 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 South Carolina?

3 providers in South Carolina 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 30 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 South Carolina 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 South Carolina. The state average Medicare payment is $180.54 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