How much does Medicare pay for HCPCS 0003M?

Medicare allowed an average of $490.50 per service and paid $484.88 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $514.61, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code 0003M?

Molecular pathology test for liver disease, including non-alcohol liver disease (nash fibrosure). It was billed 8,964 times to 8,619 Medicare beneficiaries by 11 providers in 2024.

Which specialty bills 0003M most?

Clinical Laboratory, with 8,964 services from 11 clinicians.

HCPCS 0003M

Molecular pathology test for liver disease, including non-alcohol liver disease (nash fibrosure)

$490.50Medicare-allowed amount per service, averaged across 8,964 services

Providers submitted

$514.61

Asking price, not received

Medicare allowed

$490.50

The fee schedule figure

Medicare paid

$484.88

Balance is patient coinsurance

Services: 8,964
Beneficiaries: 8,619
Providers billing it: 11
Total allowed: $4,396,842

What Medicare pays for HCPCS 0003M

Across 8,964 services billed by 11 providers to 8,619 beneficiaries, Medicare allowed an average of $490.50 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 0003M

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	8,964	8,619	$490.50	11

0003M reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
North Carolina	8,279	$490.20	$493.27	1
Ohio	161	$495.17	$381.80	2
Alabama	140	$492.46	$493.33	1
California	129	$495.16	$384.04	1
Washington	125	$495.11	$393.69	2
Arizona	49	$494.81	$394.26	1
Minnesota	38	$493.33	$493.33	1
Virginia	31	$488.30	$493.33	1
Pennsylvania	12	$493.33	$493.33	1

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.