How much does Medicare pay for HCPCS Q0091?

Medicare allowed an average of $43.15 per service and paid $43.15 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $103.53, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code Q0091?

Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory. It was billed 278,719 times to 278,697 Medicare beneficiaries by 7,295 providers in 2024.

Does Q0091 pay differently in an office than a hospital?

Yes. The allowed amount averaged $43.58 in an office setting and $16.91 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 Q0091 most?

Obstetrics & Gynecology, with 236,857 services from 5,708 clinicians. Next are Nurse Practitioner, Physician Assistant, Certified Nurse Midwife.

HCPCS Q0091

Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory

$43.15Medicare-allowed amount per service, averaged across 278,719 services

Providers submitted

$103.53

Asking price, not received

Medicare allowed

$43.15

The fee schedule figure

Medicare paid

$43.15

Balance is patient coinsurance

Providers submitted an average of $103.53 for this code and Medicare allowed $43.15 — 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 $43.15 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $43.58
Hospital / facility: $16.91

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 274,229 services were billed in an office setting and 4,490 in a facility.

Services: 278,719
Beneficiaries: 278,697
Providers billing it: 7,295
Total allowed: $12,026,725

What Medicare pays for HCPCS Q0091

Across 278,719 services billed by 7,295 providers to 278,697 beneficiaries, Medicare allowed an average of $43.15 per service. 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 Q0091

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	236,857	236,837	$44.28	5,708
Nurse Practitioner	27,735	27,734	$35.15	1,035
Physician Assistant	5,742	5,742	$36.00	221
Certified Nurse Midwife	2,785	2,785	$42.45	95
Family Practice	1,771	1,770	$43.96	90
Internal Medicine	1,770	1,770	$43.32	93
Gynecological Oncology	1,676	1,676	$41.32	38
Endocrinology	63	63	$50.72	1
Hospitalist	61	61	$44.36	3
Emergency Medicine	47	47	$39.65	1
Otolaryngology	43	43	$47.01	1
General Practice	40	40	$40.61	3
Hematology-Oncology	39	39	$39.77	1
General Surgery	31	31	$39.38	2
Thoracic Surgery	29	29	$52.06	1

Q0091 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	43,047	$48.60	$42.27	868
Florida	32,274	$41.55	$41.65	692
New Jersey	23,653	$48.16	$42.80	480
California	22,167	$48.06	$41.78	530
Pennsylvania	16,727	$41.97	$41.81	424
Texas	14,368	$41.87	$42.79	468
Massachusetts	8,594	$43.73	$40.67	265
Georgia	8,437	$40.51	$42.59	245
Tennessee	8,237	$38.76	$41.82	215
Ohio	7,952	$38.76	$40.53	249
Illinois	7,645	$41.11	$40.85	235
Virginia	7,323	$42.39	$42.03	193
Maryland	7,082	$43.97	$40.89	193
Louisiana	6,377	$34.92	$38.81	152
Mississippi	6,203	$37.80	$42.38	111
South Carolina	5,709	$39.62	$41.84	150
Connecticut	5,498	$46.59	$42.48	183
North Carolina	5,232	$39.14	$41.06	183
Michigan	4,852	$41.89	$41.74	175
Missouri	4,755	$39.54	$41.57	158
Alabama	4,716	$38.12	$42.24	157
Arizona	3,820	$40.32	$41.06	105
Kentucky	2,901	$35.48	$38.24	108
Arkansas	2,850	$38.06	$42.90	75
Indiana	2,807	$39.17	$41.71	104
Delaware	2,353	$42.19	$42.11	34
Oklahoma	1,795	$37.47	$40.96	70
Nevada	1,417	$40.25	$41.80	50
New Hampshire	1,008	$40.01	$38.92	47
West Virginia	930	$35.05	$38.23	30
Nebraska	839	$39.09	$41.99	31
Kansas	763	$38.06	$40.91	34
Colorado	732	$44.04	$42.80	31
Rhode Island	706	$44.41	$42.82	19
Washington	577	$38.20	$36.56	30
Oregon	507	$39.65	$39.58	21
District of Columbia	450	$50.82	$43.26	17
Vermont	409	$34.14	$34.53	13
New Mexico	395	$38.86	$40.65	17
Iowa	364	$33.71	$36.21	25
Hawaii	354	$43.54	$39.79	11
Idaho	271	$30.36	$32.39	14
Puerto Rico	247	$41.22	$43.23	15
Wisconsin	235	$38.13	$39.79	17
Maine	228	$35.69	$37.82	8
Montana	168	$39.02	$39.26	10
Alaska	153	$50.02	$42.48	4
South Dakota	152	$26.84	$27.19	7
Minnesota	143	$42.27	$41.37	7
Utah	134	$43.60	$42.37	7
Wyoming	127	$38.26	$38.41	6
North Dakota	36	$23.36	$23.59	2

Related codes

Q0092Set-up portable x-ray equipment$25.53

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.