CPT 99153

Across 207,748 services billed by 1,709 providers to 66,953 beneficiaries, Medicare allowed an average of $11.53 per service. That is 3.1 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.

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.

• 99152Use of a drug to induce depression of consciousness by physician perfo$15.74
• 99183Management of oxygen chamber therapy$102.12
• 99195Drawing of blood for a medical problem$93.96
• 99157Use of a drug to induce depression of consciousness by physician not p$57.09
• 99156Use of a drug to induce depression of consciousness by physician not p$70.75

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.

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