RxDoctor Payments Data

CPT 84154

Psa (prostate specific antigen) measurement, free

$18.00Medicare-allowed amount per service, averaged across 504,210 services
Providers submitted
$87.47

Asking price, not received

Medicare allowed
$18.00

The fee schedule figure

Medicare paid
$18.00

Balance is patient coinsurance

Providers submitted an average of $87.47 for this code and Medicare allowed $18.004.9× 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 $18.00 (100%); the rest is the patient’s coinsurance and deductible.

Services
504,210

Medicare Part B, 2024

Beneficiaries
419,059
Providers billing it
1,049
Total allowed
$9,075,780

Services × allowed amount

What Medicare pays for CPT 84154

Across 504,210 services billed by 1,049 providers to 419,059 beneficiaries, Medicare allowed an average of $18.00 per service. That is 1.2 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 84154

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory431,007360,725$18.00309
Urology38,52129,720$17.94435
Pathology23,66719,535$17.9526
Internal Medicine3,3542,805$17.9884
Family Practice3,2872,724$17.9793
Nurse Practitioner1,4301,246$17.9638
Physician Assistant1,2231,076$17.8938
General Practice434362$17.825
Hematology-Oncology381209$18.024
Endocrinology286197$17.975
Obstetrics & Gynecology204123$18.021
Pediatric Medicine128124$17.631
Rheumatology9146$18.021
Cardiology4940$17.652
Nephrology4835$18.022

84154 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
New Jersey98,336$18.00$18.0280
California82,037$18.00$18.0281
Florida62,309$18.01$18.0290
Texas41,938$17.98$18.01148
Arizona29,054$18.01$18.0243
New York28,428$18.01$18.0287
North Carolina26,657$18.01$18.027
Ohio14,684$17.99$18.0259
Maryland12,049$17.98$18.0213
Alabama10,881$17.99$18.0217
Tennessee9,937$17.93$18.0222
Pennsylvania9,302$18.01$18.0210
Massachusetts9,000$18.01$18.0232
Georgia8,890$18.01$18.0225
Washington8,792$18.01$18.0214
Illinois6,978$18.00$18.0225
Michigan5,413$17.95$18.0248
Kansas4,994$18.02$18.027
Nevada4,548$17.99$18.023
Virginia4,162$17.98$18.0238
Oklahoma3,757$18.02$18.0213
Colorado3,452$18.01$18.026
Oregon2,842$17.93$18.027
Hawaii1,965$17.95$18.022
South Carolina1,857$17.97$18.0221
Indiana1,817$17.94$18.0221
Arkansas1,457$17.91$18.0221
Louisiana1,425$18.02$18.0217
Kentucky1,186$17.90$18.0218
New Mexico1,163$17.87$18.023
Utah1,012$17.95$18.0214
Wisconsin737$17.97$18.027
Missouri639$18.02$18.0212
Minnesota357$17.77$18.023
Rhode Island343$18.02$18.021
Mississippi332$17.73$18.025
Puerto Rico284$17.41$18.025
U.S. Virgin Islands223$18.02$18.023
Iowa201$17.93$18.023
Maine174$18.02$18.022
Connecticut153$17.90$18.023
Nebraska114$17.92$18.024
South Dakota102$18.02$18.021
Wyoming84$17.97$18.021
New Hampshire51$18.02$18.022
Idaho38$17.33$18.022
Delaware22$18.02$18.021
West Virginia18$18.02$18.021
North Dakota16$18.02$18.021

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.