KY CMS Medicare PUF 2023 Avg payment #35 of 56

Kentucky procedure costs

102 hospitals · 2,146 Medicare providers · 3,707 procedure codes with Kentucky locality adjustments.

The short answer

Kentucky has 102 hospitals and 2,146 Medicare-billing providers across 3,707 procedure codes. The average Medicare payment per procedure is $211.69; the average submitted (billed) charge is $1,027.87.

Procedure codes
3,707
Providers per hospital
21.0
Billed-to-Medicare ratio
4.9x
Markup rank
#46 of 56

Source: CMS Medicare Physician & Other Practitioners, 2023.

About this dataset, nationwide

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.

102
Hospitals
2,146
Providers
$211.69
Avg Medicare Payment
$1,027.87
Avg Billed Charge

Kentucky against every US state

Where the state's average Medicare payment per procedure falls, all 56 tracked jurisdictions

$212 higher than 38% of 56 states

$75–$100: 3 states (5%). Below this entry. $100–$125: 1 states (2%). Below this entry. $125–$150: 2 states (4%). Below this entry. $150–$175: 5 states (9%). Below this entry. $175–$200: 7 states (13%). Below this entry. $200–$225: 9 states (16%). This entry sits in this band. $225–$250: 9 states (16%). Above this entry. $250–$275: 11 states (20%). Above this entry. $275–$300: 4 states (7%). Above this entry. $300–$325: 4 states (7%). Above this entry. $325–$350: 1 states (2%). Above this entry. This state $75 $350 every US state, bucketed by value

Each bar is a $25-wide band; taller bars hold more states. 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

The priciest procedures in Kentucky

Highest average Medicare payment per procedure billed in Kentucky. Hover any bar for the exact figure; even these top procedures are billed well above what Medicare reimburses.

Top procedures by Medicare payment - Kentucky

Removal Of Plaque And Insert…5936Cystourethroscopy, With Inse…5135Insertion Of Peripheral Or G…4809Removal Of Plaque In Artery …4737Ambulance Service, Conventio…4447Insertion Of Spinal Neurosti…3956Transplantation Of 2 Lungs O…3680Removal Of Plaque In Arterie…3474
Top procedures by Medicare payment - Kentucky-Average Medicare payment per procedure (CMS 2023)

Top Procedures by Volume

Procedure Medicare Services
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $3.85 2.1M
Ground Mileage, Per Statute Mile $8.04 2.1M
Established Patient Office Or Other Outpatient Visit, 30-39 Minutes $74.33 1.4M
Established Patient Office Or Other Outpatient Visit, 20-29 Minutes $52.09 1.1M
Injection, Testosterone Cypionate, 1 Mg $0.02 995.9K
Travel Allowance One Way In Connection With Medically Necessary Laboratory Specimen Collection Drawn From Home Bound Or Nursing Home Bound Patient; Prorated Miles Actually Travelled $0.96 787.3K
Injection, Tocilizumab, 1 Mg $4.62 700.4K
Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count $11.53 664.0K
Therapy Procedure Using Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes $16.52 645.1K
Removal Of Cataract With Insertion Of Prosthetic Lens $33.46 623.0K
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes $58.43 575.1K
Injection, Daptomycin, 1 Mg $0.04 547.0K
Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml $0.11 519.4K
Therapy Procedure Using Functional Activities $22.62 443.2K
Injection, Triamcinolone Acetonide, Not Otherwise Specified, 10 Mg $0.77 433.9K
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $33.34 418.1K
Injection, Faricimab-Svoa, 0.1 Mg $28.95 410.1K
Injection, Onabotulinumtoxina, 1 Unit $4.78 385.3K
Injection, Golimumab, 1 Mg, For Intravenous Use $10.30 360.0K
Injection, Denosumab, 1 Mg $17.89 318.3K
Low Osmolar Contrast Material, 100-199 Mg/ml Iodine Concentration, Per Ml $1.04 310.8K
Therapy Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes $19.54 305.4K
Therapy Procedure Using Manual Technique, Each 15 Minutes $14.96 301.5K
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 50 Minutes $88.62 294.7K
Routine Electrocardiogram (ecg) Using At Least 12 Leads With Interpretation And Report Only $5.88 282.6K
Low Osmolar Contrast Material, 200-299 Mg/ml Iodine Concentration, Per Ml $0.37 236.7K
Destruction Of Precancer Skin Growth, 2-14 Growths $4.15 235.5K
Hyaluronan Or Derivitive, Genvisc 850, For Intra-Articular Injection, 1 Mg $5.29 229.7K
Insertion Of Needle Into Vein For Collection Of Blood Sample $8.11 224.9K
Injection, Dexamethasone Sodium Phosphate, 1 Mg $0.09 224.3K

Kentucky Healthcare Cost Landscape

CMS lists 102 hospitals in Kentucky across 84 cities. LOUISVILLE holds 8 (8%). The three densest cities together hold 18% of the state roster. Statewide that is 2,146 Medicare-billing providers, 21.0 per listed hospital.

56 hospitals carry a CMS overall star rating (2 five-star, 13 four-star, 13 three-star, 23 two-star, 5 one-star) ; five-star share among rated facilities is 4%. 46 hospitals in this extract have no published overall rating.

Facility-type mix: Acute Care Hospitals 59 (58%); Critical Access Hospitals 29 (28%); Psychiatric 10 (10%); Acute Care - Veterans Administration 2 (2%).

Among the 30 highest-volume procedure codes billed in Kentucky, Drugs (Administered) leads with 7.1M services (39% of this top-volume slice) across 12 codes. Next is Office Visit at 14%.

Submitted charges average $1,027.87 against $211.69 Medicare payment (4.9x billed-to-Medicare). That ratio ranks #46 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #35 of 56.

Volume leaders are not the high-payment codes. Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) is in the top volume slice but not the highest Medicare payments; Removal Of Plaque And Insertion Of Stents In Arteries Of Leg is in the high-payment set without matching volume rank.

These are CMS roster and claims aggregates for Kentucky, not a quote for any patient, plan, or visit. See the methodology and CMS Medicare Provider Charge Data.

Where Kentucky hospitals sit

City of the CMS hospital roster, not a travel or care recommendation. 84 distinct cities appear on 102 listed facilities.

City Hospitals Share of state roster
LOUISVILLE 8 8%
LEXINGTON 7 7%
BOWLING GREEN 3 3%
HOPKINSVILLE 3 3%
PADUCAH 2 2%
ALBANY 1 1%
ASHLAND 1 1%
BARBOURVILLE 1 1%

Nationwide states with similar hospital scale or Medicare payment

Two CMS-extract-derived peer sets for Kentucky: nearest hospital inventory and nearest statewide average Medicare payment. Not clinical substitutes: registry-scale and payment neighborhoods only.

Similar CMS hospital count

Nearest states with ≥5 hospitals (102 here).

Similar average Medicare payment

Nearest states with published averages ($211.69 here).

Hospitals in Kentucky

AdventHealthManchester
MANCHESTER · -
ARH OUR LADY OF THE WAY
MARTIN · -
BAPTIST HEALTH CORBIN
CORBIN · ★★★★☆
BAPTIST HEALTH DEACONESS MADISONVILLE
MADISONVILLE · ★★★☆☆
BAPTIST HEALTH HARDIN
ELIZABETHTOWN · ★★☆☆☆
BAPTIST HEALTH LAGRANGE
LA GRANGE · ★★★★☆
BAPTIST HEALTH LEXINGTON
LEXINGTON · ★★★★☆
BAPTIST HEALTH LOUISVILLE
LOUISVILLE · ★★★☆☆
BAPTIST HEALTH PADUCAH
PADUCAH · ★★★★★
BAPTIST HEALTH RICHMOND
RICHMOND · ★★★☆☆
Blanchfield ACH (FT Campbell)
Fort Campbell · -
BLUEGRASS COMMUNITY HOSPITAL
VERSAILLES · -
BOURBON COMMUNITY HOSPITAL
PARIS · ★★★★☆
BRECKINRIDGE MEMORIAL HOSPITAL
HARDINSBURG · ★★☆☆☆
CALDWELL MEDICAL CENTER
PRINCETON · -
CARROLL COUNTY MEMORIAL HOSPITAL
CARROLLTON · -
CASEY COUNTY HOSPITAL
LIBERTY · ★★☆☆☆
CAVERNA MEMORIAL HOSPITAL
HORSE CAVE · -
CENTRAL STATE HOSPITAL
LOUISVILLE · -
CHI SAINT JOSEPH BEREA NF
BEREA · -
CHI SAINT JOSEPH FLAGET MEMORIAL HOSPITAL
BARDSTOWN · -
CLARK REGIONAL MEDICAL CENTER
WINCHESTER · ★★★★☆
CRITTENDEN COMMUNITY HOSPITAL
MARION · -
CUMBERLAND COUNTY HOSPITAL
BURKESVILLE · -
CUMBERLAND HALL HOSPITAL
HOPKINSVILLE · -
DEACONESS HENDERSON HOSPITAL
HENDERSON · ★★☆☆☆
EASTERN STATE HOSPITAL
LEXINGTON · -
EPHRAIM MCDOWELL FORT LOGAN HOSPITAL
STANFORD · -
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
DANVILLE · ★★☆☆☆
FRANKFORT REGIONAL MEDICAL CENTER
FRANKFORT · ★★☆☆☆

View all 102 hospitals in Kentucky →

How Kentucky Compares Nationally

Kentucky's average Medicare payment is #35 of 56 in this extract. Submitted-over-Medicare markup ranks #46 of 56 (4.9x). Hospital-count peers (nearest CMS roster size to 102): Alabama 102, Washington 100, Arizona 106, Mississippi 106. Payment peers (nearest average Medicare payment to $211.69): Oklahoma $212.27, Delaware $208.28, Kansas $215.09, Utah $219.05.

Those peer sets are registry neighborhoods, not clinical substitutes. Markup rank and payment rank can diverge: a jurisdiction can sit high on billed-to-Medicare while sitting mid-pack on payment, or the reverse. Figures remain CMS averages for Kentucky, not an out-of-pocket quote.

Related registry pages

Kentucky averages sit on two maps: Medicare payment and submitted-over-Medicare markup.

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

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

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.