TX CMS Medicare PUF 2023 Avg payment #5 of 56

Texas procedure costs

465 hospitals · 11,933 Medicare providers · 6,275 procedure codes with Texas locality adjustments.

The short answer

Texas has 465 hospitals and 11,933 Medicare-billing providers across 6,275 procedure codes. The average Medicare payment per procedure is $303.51; the average submitted (billed) charge is $1,833.29.

Procedure codes
6,275
Providers per hospital
25.7
Billed-to-Medicare ratio
6.0x
Markup rank
#16 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.

465
Hospitals
11,933
Providers
$303.51
Avg Medicare Payment
$1,833.29
Avg Billed Charge

Texas against every US state

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

$304 higher than 91% 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%). Below this entry. $225–$250: 9 states (16%). Below this entry. $250–$275: 11 states (20%). Below this entry. $275–$300: 4 states (7%). Below this entry. $300–$325: 4 states (7%). This entry sits in this band. $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 Texas

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

Top procedures by Medicare payment - Texas

Sipuleucel-T, Minimum Of 50 …41433Generator, Neurostimulator (…13710Radioelements For Brachyther…10554Generator, Neurostimulator (…9123Implantable Neurostimulator,…7406Removal Of Plaque And Insert…6749Insertion Of Spinal Neurosti…6707Removal Of Plaque And Insert…6467
Top procedures by Medicare payment - Texas-Average Medicare payment per procedure (CMS 2023)

Top Procedures by Volume

Procedure Medicare Services
Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count $11.72 25.1M
Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml $0.11 8.8M
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) $3.87 8.3M
Ground Mileage, Per Statute Mile $7.23 8.2M
Established Patient Office Or Other Outpatient Visit, 30-39 Minutes $82.30 7.0M
Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-Esrd Use) $0.39 6.4M
Injection, Testosterone Cypionate, 1 Mg $0.02 5.6M
Injection, Gadoterate Meglumine, 0.1 Ml $0.11 5.0M
Injection, Daptomycin, 1 Mg $0.04 5.0M
Established Patient Office Or Other Outpatient Visit, 20-29 Minutes $57.25 4.5M
Injection, Iron Sucrose, 1 Mg $0.16 4.3M
Injection, Pembrolizumab, 1 Mg $42.91 3.8M
Injection, Tocilizumab, 1 Mg $4.57 3.6M
Insertion Of Needle Into Vein For Collection Of Blood Sample $8.19 3.4M
Injection, Ferric Carboxymaltose, 1 Mg $0.87 3.4M
Injection, Denosumab, 1 Mg $18.24 3.3M
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes $60.08 3.1M
Injection, Onabotulinumtoxina, 1 Unit $4.87 3.1M
Therapy Procedure Using Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes $17.15 3.0M
Injection, Darbepoetin Alfa, 1 Microgram (non-Esrd Use) $2.34 2.9M
Injection, Fosaprepitant, 1 Mg $0.12 2.8M
Blood Test, Comprehensive Group Of Blood Chemicals $10.33 2.7M
Injection, Oxaliplatin, 0.5 Mg $0.06 2.6M
Injection, Filgrastim-Aafi, Biosimilar, (nivestym), 1 Microgram $0.25 2.5M
Complete Blood Cell Count (red Cells, White Blood Cell, Platelets), Automated Test And Automated Differential White Blood Cell Count $7.59 2.5M
Injection, Romosozumab-Aqqg, 1 Mg $7.83 2.5M
Injection, Faricimab-Svoa, 0.1 Mg $28.86 2.4M
Injection, Nivolumab, 1 Mg $23.38 2.3M
Detection Test By Nucleic Acid For Organism, Amplified Probe Technique $34.36 2.3M
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 $1.07 2.1M

Texas Healthcare Cost Landscape

CMS lists 465 hospitals in Texas across 262 cities. HOUSTON holds 28 (6%). The three densest cities together hold 14% of the state roster. Statewide that is 11,933 Medicare-billing providers, 25.7 per listed hospital.

197 hospitals carry a CMS overall star rating (22 five-star, 61 four-star, 65 three-star, 40 two-star, 9 one-star) ; five-star share among rated facilities is 11%. 268 hospitals in this extract have no published overall rating.

Facility-type mix: Acute Care Hospitals 284 (61%); Critical Access Hospitals 92 (20%); Psychiatric 61 (13%); Childrens 16 (3%).

Among the 30 highest-volume procedure codes billed in Texas, Drugs (Administered) leads with 55.9M services (39% of this top-volume slice) across 15 codes. Next is DME (Temporary) at 18%.

Submitted charges average $1,833.29 against $303.51 Medicare payment (6.0x billed-to-Medicare). That ratio ranks #16 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #5 of 56.

Volume leaders are not the high-payment codes. Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count is in the top volume slice but not the highest Medicare payments; Sipuleucel-T, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-Gm-Csf, Including Leukapheresis And All Other Preparatory Procedures, Per Infusion is in the high-payment set without matching volume rank.

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

Where Texas hospitals sit

City of the CMS hospital roster, not a travel or care recommendation. 262 distinct cities appear on 465 listed facilities.

City Hospitals Share of state roster
HOUSTON 28 6%
DALLAS 19 4%
SAN ANTONIO 19 4%
AUSTIN 15 3%
FORT WORTH 13 3%
EL PASO 10 2%
LUBBOCK 8 2%
ARLINGTON 7 2%

Nationwide states with similar hospital scale or Medicare payment

Two CMS-extract-derived peer sets for Texas: 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 (465 here).

Similar average Medicare payment

Nearest states with published averages ($303.51 here).

How Texas Compares Nationally

Texas's average Medicare payment is #5 of 56 in this extract. Submitted-over-Medicare markup ranks #16 of 56 (6.0x). Hospital-count peers (nearest CMS roster size to 465): California 378, Florida 222, Ohio 196, Illinois 194. Payment peers (nearest average Medicare payment to $303.51): Maryland $310.43, New York $313.07, Arizona $286.66, Pennsylvania $284.85.

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 Texas, not an out-of-pocket quote.

Related registry pages

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

Figures here are Texas 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.