Comparison of Medicare Payment with Medicaid Payment

CPT CODE DESCRIPTION 2011 NUMBER OF ALLOWED TESTS 2011 MEDICARE-ALLOWED AMOUNT NUMBER OF TESTS WITH POTENTIAL FOR SAVINGS ALLOWED AMOUNT IF MEDICAID LOWEST RATE USED PERCENTAGE MEDICARE PAID MORE THAN MEDICAID 80048 Metabolic panel, total calcium 8,622,383 $85,612,322 5,668,213 $75,265,426 14% 80053 Comprehensive metabolic panel 26,667,106 $308,060,147 13,365,771 $279,044,002 10% 80061 Lipid panel 20,096,974 $293,294,006 9,799,707 $254,514,132 15% 81001 Urinalysis, automated, with microscopy 6,636,868 $29,518,138 6,307,849 $25,392,723 16% 81002 Urinalysis, nonautomated, without microscopy 4,153,597 $14,808,195 3,980,171 $11,481,389 29% 81003 Urinalysis, automated, without microscopy 4,808,096 $15,157,960 4,530,759 $12,590,841 20% 82306 Vitamin D, 25 hydroxy 5,308,512 $218,018,917 5,200,763 $173,834,730 25% 82570 Assay of urine creatinine 4,432,117 $31,958,084 4,274,416 $26,437,934 21% 82607 Vitamin B-12 3,283,484 $69,600,580 3,208,218 $54,998,544 27% 82728 Assay of ferritin 2,343,336 $44,791,773 2,285,840 $36,235,474 24% 83036 Glycosylated hemoglobin test 12,374,324 $168,495,108 11,889,154 $139,534,720 21% 83540 Assay of iron 2,573,826 $22,783,202 2,416,826 $17,777,978 28% 83550 Iron binding test 2,001,213 $24,090,743 1,952,675 $18,554,959 30% 83880 Natriuretic peptide 982,145 $46,274,487 947,719 $38,836,439 19% 83970 Assay of parathormone 1,131,955 $65,699,438 1,103,363 $54,696,192 20% 84153 Assay of prostate-specific antigen, total 3,530,885 $91,280,209 3,415,111 $78,423,161 16% 84443 Thyroid stimulating hormone 14,431,323 $340,218,728 13,470,738 $278,608,047 22% 85025 Complete blood count with automated differential white blood cell count […]