How much does Medicare pay for HCPCS C9290?

Medicare allowed an average of $1.39 per service and paid $1.11 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4.87, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code C9290?

Injection, bupivacaine liposome, 1 mg. It was billed 6,609,247 times to 32,317 Medicare beneficiaries by 503 providers in 2024.

Which specialty bills C9290 most?

Ambulatory Surgical Center, with 6,609,247 services from 503 clinicians.

HCPCS C9290

Injection, bupivacaine liposome, 1 mg

$1.39Medicare-allowed amount per service, averaged across 6,609,247 services

Providers submitted

$4.87

Asking price, not received

Medicare allowed

$1.39

The fee schedule figure

Medicare paid

$1.11

Balance is patient coinsurance

Providers submitted an average of $4.87 for this code and Medicare allowed $1.39 — 3.5× 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 $1.11 (80%); the rest is the patient’s coinsurance and deductible.

Services: 6,609,247
Beneficiaries: 32,317
Providers billing it: 503
Total allowed: $9,186,853

What Medicare pays for HCPCS C9290

Across 6,609,247 services billed by 503 providers to 32,317 beneficiaries, Medicare allowed an average of $1.39 per service. That is 204.5 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 C9290

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	6,609,247	32,317	$1.39	503

C9290 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
Florida	1,044,050	$1.40	$1.12	61
Texas	569,673	$1.38	$1.13	60
California	544,693	$1.40	$1.13	45
North Carolina	399,176	$1.39	$1.13	22
Ohio	272,136	$1.40	$1.13	14
New Jersey	220,904	$1.36	$1.13	17
Tennessee	217,760	$1.40	$1.13	10
Georgia	179,661	$1.38	$1.13	20
Arizona	173,876	$1.40	$1.13	18
Connecticut	170,174	$1.38	$1.13	13
Minnesota	166,679	$1.39	$1.13	11
Indiana	160,615	$1.39	$1.13	11
Illinois	158,112	$1.38	$1.12	13
Utah	145,900	$1.40	$1.13	10
Colorado	133,357	$1.37	$1.13	10
Virginia	131,032	$1.40	$1.13	13
New Hampshire	128,481	$1.41	$1.13	8
Maryland	127,574	$1.38	$1.13	15
Montana	127,269	$1.39	$1.13	4
Washington	125,554	$1.40	$1.12	11
Pennsylvania	125,525	$1.39	$1.13	12
Oregon	120,090	$1.39	$1.13	10
Alaska	111,051	$1.38	$1.13	5
Iowa	106,271	$1.39	$1.13	8
South Carolina	103,219	$1.31	$1.12	5
Wisconsin	92,165	$1.40	$1.13	8
Missouri	87,352	$1.41	$1.13	7
Idaho	68,553	$1.38	$1.13	5
Louisiana	67,474	$1.40	$1.13	6
Michigan	56,326	$1.41	$1.12	6
Mississippi	52,269	$1.40	$1.13	3
North Dakota	46,683	$1.41	$1.12	3
Rhode Island	44,185	$1.34	$1.12	1
Nevada	42,694	$1.38	$1.13	3
Nebraska	36,708	$1.41	$1.13	3
Alabama	35,474	$1.38	$1.12	3
West Virginia	34,983	$1.40	$1.13	2
Kansas	34,287	$1.38	$1.13	5
New York	29,932	$1.37	$1.13	6
Arkansas	29,816	$1.41	$1.12	3
Delaware	26,068	$1.41	$1.13	1
Wyoming	25,139	$1.40	$1.14	4
Oklahoma	17,291	$1.39	$1.13	3
Massachusetts	5,985	$1.40	$1.14	1
District of Columbia	5,187	$1.41	$1.13	1
Maine	4,124	$1.42	$1.13	1
Kentucky	3,721	$1.42	$1.13	2

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.