Procedures priced
9,297
HCPCS / CPT codes
National reference · CMS 2023
U.S. Medical Procedure Cost Statistics
According to the Centers for Medicare & Medicaid Services (CMS), in 2023 providers billed Medicare for 9,297 distinct procedure codes across 56 jurisdictions and 5,426 hospitals. Volume-weighted submitted charges run about 4.1x Medicare payment. This page distils those headline figures from the CMS Medicare Physician & Other Practitioners dataset (2023) only; commercial/cash RAND estimates are a separate population (see /methodology); portal compile stamp May 15, 2026.
- 9,297
- procedure codes priced from CMS data
- 4.1x
- volume-weighted submitted vs. Medicare
- 3.4B
- annual Medicare Part B services
The national picture
Across 9,297 procedure codes billed to Medicare in 2023, volume-weighted submitted charges are about 4.1x Medicare payment. That ratio includes per-milligram drug codes; it is not a typical office-visit bill.
- 4.1x
- volume-weighted submitted / Medicare
- 9,297
- procedure codes priced
- 56
- states and territories
- 5,426
- hospitals in the dataset
Source: CMS Medicare Physician & Other Practitioners, 2023. Headline markup is volume-weighted across all 9,297 codes with a Medicare payment above $0. Category bars below drop codes with Medicare payment under $5.
Key findings
Short, attributable one-liners from the same live queries as the charts. Quote with the Cite this page block. CMS claims year 2023; rebuild extract May 15, 2026.
- CMS 2023 in this rebuild: 9,297 procedure codes, 3.4B Part B services, 56 jurisdictions (50 states plus DC and AS, GU, MP, PR, VI), and 5,426 hospitals.
- Volume-weighted submitted charge is 4.1x the Medicare payment across all 9,297 codes (submitted times services, divided by Medicare times services). That ratio includes per-milligram drug codes; it is not a typical office-visit bill.
- K1034 (Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-C) is the single highest-volume code at 153.5 million services [DME (Temporary)]. That is not an office visit.
- Drugs (Administered) is the largest category by service units (1319.1 million of 3411.0 million). Many of those codes bill per milligram, so unit count is not patient-visit count.
- Among categories in this rebuild, Anesthesia has the highest mean markup at 12.7x (Medicare payment at least $5 per code).
- Among codes with more than 1,000 services and Medicare payment above $10, 95938 (Placement Of Skin Electrodes And Measurement Of Stimulated Sites) leads markup at 76.4x.
- Hospital Compare overall_rating is present for 2,866 of 5,426 hospitals. The rest are unrated, not zero-star.
- California leads jurisdiction volume at 364.0 million services. Among jurisdictions with at least 1 million services, Wisconsin has the highest submitted-over-Medicare ratio at 12.46x. American Samoa's 86 services are not that comparison.
Key figures
Volume-weighted markup
4.1x
submitted vs. Medicare, all codes
States & territories
56
Hospitals in dataset
5,426
Annual Part B services
3.4B
3,410,971,712 services
Avg Medicare payment
$384.96
per service, all codes
Markup by procedure category
Average markup ratio for the highest-volume procedure categories. Even routine categories are billed several times the Medicare rate; blood test runs the highest at about 6.4x.
Average markup by procedure category
Highest-markup common procedures
High-volume procedures (over 1,000 annual services) where the billed charge runs furthest above the Medicare rate.
| Procedure | Medicare | Billed | Markup |
|---|---|---|---|
| Placement Of Skin Electrodes And Measurement Of Stim CPT 95938 | $44.15 | $3,375.08 | 76.4x |
| Measurement Of Brain Wave Activity (eeg) Outside The CPT 95955 | $43.54 | $3,186.41 | 73.2x |
| Cell-Based Immunofluorescence (cba) Detection Of Aqu CPT 86052 | $11.80 | $684.11 | 58.0x |
| Needle Measurement Of Electrical Activity In Arm, Le CPT 95870 | $16.05 | $876.87 | 54.6x |
| Cell-Based Immunofluorescence (cba) Detection Of Mye CPT 86362 | $11.80 | $582.53 | 49.4x |
| Exam Of Lung Airways Using An Endoscope CPT 31623 | $13.64 | $663.76 | 48.6x |
| Elisa Detection Of Aquaporin-4 (neuromyelitis Optica CPT 86051 | $11.30 | $517.12 | 45.8x |
| Placement Of Skin Electrodes And Measurement Of Cent CPT 95939 | $98.40 | $4,356.26 | 44.3x |
Using these statistics
National averages set the baseline; your specific procedure and state are what you actually pay.
- Look up any of the 9,297 procedures for its Medicare rate, billed charge, and markup percentile. Browse procedures
- See which states bill the most above Medicare in the rankings. Rankings
- Estimate your own out-of-pocket cost by procedure and state. Cost estimator
Figures are CMS 2023 averages. Headline markup is volume-weighted across all codes with a Medicare payment above $0. Category bars drop codes under $5. Benchmarks, not quotes.
Download the data (CSV) (56 jurisdictions, CMS 2023 Part B averages). Extract 2026-05-15. Licensed CC BY 4.0.
Source: CMS Medicare Physician & Other Practitioners dataset, 2023 National averages, volume-weighted
See our methodology for how these national averages and markup percentiles are computed.
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.