RxDoctor Payments Data

CPT 80171

Gabapentin level

$21.20Medicare-allowed amount per service, averaged across 3,800 services
Providers submitted
$146.68

Asking price, not received

Medicare allowed
$21.20

The fee schedule figure

Medicare paid
$21.20

Balance is patient coinsurance

Providers submitted an average of $146.68 for this code and Medicare allowed $21.206.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $21.20 (100%); the rest is the patient’s coinsurance and deductible.

Services
3,800

Medicare Part B, 2024

Beneficiaries
2,636
Providers billing it
44
Total allowed
$80,560

Services × allowed amount

What Medicare pays for CPT 80171

Across 3,800 services billed by 44 providers to 2,636 beneficiaries, Medicare allowed an average of $21.20 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. 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 80171

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory3,8002,636$21.2044

80171 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.

StateServicesAllowedStandardized pmtProviders
North Carolina1,421$21.23$21.242
Georgia300$21.24$21.242
Alabama294$21.18$21.243
New Jersey279$21.24$21.243
Ohio243$21.24$21.242
California192$21.24$21.243
Oklahoma172$21.24$21.242
Texas167$21.24$21.245
Michigan96$21.24$21.241
Florida87$21.24$21.243
Virginia76$21.24$21.241
Massachusetts64$19.58$21.242
Wisconsin50$21.24$21.242
Tennessee49$21.24$21.242
New York49$21.24$21.241
Arizona48$21.24$21.241
Minnesota34$21.24$21.241
Illinois30$21.24$21.241
Kansas27$21.24$21.241
Nevada24$21.24$21.241
Washington23$21.24$21.241
Maryland20$21.24$21.241
Mississippi20$21.24$21.241
Utah18$21.24$21.241
Colorado17$21.24$21.241

Related codes

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.