How much does Medicare pay for HCPCS A4648?

Medicare allowed an average of $222.95 per service and paid $177.55 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $527.84, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code A4648?

Tissue marker, implantable, any type, each. It was billed 11,385 times to 4,364 Medicare beneficiaries by 161 providers in 2024.

Does A4648 pay differently in an office than a hospital?

Yes. The allowed amount averaged $222.76 in an office setting and $263.98 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills A4648 most?

Radiation Oncology, with 5,680 services from 51 clinicians. Next are Urology, Interventional Radiology, Diagnostic Radiology.

HCPCS A4648

Tissue marker, implantable, any type, each

$222.95Medicare-allowed amount per service, averaged across 11,385 services

Providers submitted

$527.84

Asking price, not received

Medicare allowed

$222.95

The fee schedule figure

Medicare paid

$177.55

Balance is patient coinsurance

Providers submitted an average of $527.84 for this code and Medicare allowed $222.95 — 2.4× 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 $177.55 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $222.76
Hospital / facility: $263.98

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 11,333 services were billed in an office setting and 52 in a facility.

Services: 11,385
Beneficiaries: 4,364
Providers billing it: 161
Total allowed: $2,538,286

What Medicare pays for HCPCS A4648

Across 11,385 services billed by 161 providers to 4,364 beneficiaries, Medicare allowed an average of $222.95 per service. That is 2.6 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 A4648

Specialty	Services	Beneficiaries	Avg allowed	Providers
Radiation Oncology	5,680	1,922	$188.36	51
Urology	5,659	2,416	$258.56	108
Interventional Radiology	32	12	$99.94	1
Diagnostic Radiology	14	14	$142.49	1

A4648 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
New York	2,052	$132.27	$106.04	14
Illinois	1,513	$245.59	$197.55	10
California	1,500	$134.40	$107.78	22
Florida	643	$220.43	$175.64	10
Tennessee	544	$126.56	$100.84	3
Massachusetts	429	$93.00	$74.05	6
Texas	388	$198.21	$161.70	9
Ohio	385	$890.99	$709.80	3
South Carolina	354	$41.19	$32.82	4
New Jersey	318	$588.64	$471.63	5
Arizona	311	$266.66	$212.80	8
Oklahoma	300	$693.49	$552.54	6
Maryland	264	$357.43	$284.46	11
Indiana	222	$66.36	$52.87	2
Delaware	189	$177.30	$142.71	2
Colorado	187	$399.22	$318.08	8
Kentucky	174	$62.02	$49.41	2
Pennsylvania	170	$323.00	$260.04	6
Hawaii	170	$118.97	$99.62	2
North Dakota	148	$23.05	$18.36	3
Louisiana	142	$292.14	$238.44	2
Guam	136	$32.76	$26.10	1
Alabama	117	$108.63	$89.38	2
Nevada	101	$272.79	$217.35	1
District of Columbia	88	$647.48	$520.04	2
North Carolina	82	$163.93	$130.61	2
Virginia	79	$123.35	$101.25	2
Alaska	72	$197.06	$157.01	2
Missouri	69	$59.72	$51.85	2
Minnesota	55	$79.59	$79.70	2
Michigan	54	$80.06	$63.79	1
Arkansas	54	$369.06	$303.81	2
Oregon	33	$23.94	$19.07	1
Kansas	15	$84.62	$67.42	1
Georgia	14	$144.72	$115.30	1
Mississippi	13	$501.38	$444.15	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.