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 states and 5,426 hospitals, on average about 4.1x what Medicare actually paid. This page distils those headline figures from the CMS Medicare Physician & Other Practitioners dataset (2023), per the methodology described below; data last compiled March 2026.
- 9,297
- procedure codes priced from CMS data
- 4.1x
- typical billed charge vs. Medicare (volume-weighted)
- 3.4B
- annual Medicare Part B services
The national picture
Across 9,297 procedures billed to Medicare in 2023, the typical service is billed about 4.1x what Medicare actually pays — a gap driven almost entirely by hospital and physician chargemaster list prices, not by what insurers or Medicare reimburse.
- 4.1x
- typical markup over Medicare (volume-weighted)
- 9,297
- procedure codes priced
- 56
- states & territories covered
- 5,426
- hospitals in the dataset
Source: CMS Medicare Physician & Other Practitioners, 2023. Markup = submitted charge ÷ Medicare payment (volume-weighted; drug-administration codes excluded to avoid sub-$1-denominator artifacts).
Key figures
Typical markup
4.1x
billed vs. Medicare, volume-weighted
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 averages computed from CMS public data and exclude drug-administration codes from markup calculations to avoid sub-$1-denominator artifacts. They are benchmarks, not quotes.
Source: CMS Medicare Physician & Other Practitioners dataset, 2023 CMS Medicare Physician & Other Practitioners dataset, 2023 National averages, volume-weighted