📚 Billing Basics
57 guides on billing basics.
CPT Codes & Medicare Rates: The Complete Patient's Guide (2026)
Understand CPT billing codes, look up Medicare reimbursement rates for 50 common procedures, and learn how to spot overbilling on your hospital bill.
Read guide →What Is a Medical Bill Audit?
A medical bill audit is a line-by-line review of your hospital bill against Medicare rates and billing rules to find overcharges, duplicates, and errors. Here's how it works.
Read guide →What Is the Average Hospital Markup Over Medicare Rates?
The average US hospital charges 4–5x the Medicare rate. Private equity-owned hospitals average 7–12x. Learn what markup means for your bill and when to dispute.
Read guide →All Billing Basics Guides (57)
CPT Codes & Medicare Rates: The Complete Patient's Guide (2026)
Understand CPT billing codes, look up Medicare reimbursement rates for 50 common procedures, and learn how to spot overbilling on your hospital bill.
What Is a Medical Bill Audit?
A medical bill audit is a line-by-line review of your hospital bill against Medicare rates and billing rules to find overcharges, duplicates, and errors. Here's how it works.
What Is the Average Hospital Markup Over Medicare Rates?
The average US hospital charges 4–5x the Medicare rate. Private equity-owned hospitals average 7–12x. Learn what markup means for your bill and when to dispute.
What Percentage of Hospital Bills Have Errors?
Studies show 49–80% of hospital bills contain at least one error. The most common are duplicate charges, upcoding, and unbundled codes. Here's how to find them.
Can Hospitals Charge Whatever They Want?
No — but in practice, US hospitals have wide latitude to set prices. Hospital chargemaster prices are often 2–10x Medicare rates, and there's no federal cap. Here's what limits them.
What Does the No Surprises Act Cover?
The No Surprises Act limits surprise medical bills for emergency care and out-of-network providers. Here's exactly what it covers, what it doesn't, and how to use it.
How to Find Hospital Prices Before Your Visit
Since 2021, hospitals are required to post their prices online. Here's how to find them — and how to use Medicare rates to judge whether the price is fair.
Is a Hospital Required to Give You an Itemized Bill?
Yes — you have the legal right to request an itemized hospital bill in all 50 states. Here's how to request it, what to look for, and what to do if they refuse.
How Much Does an MRI Cost? (2026 Price Guide)
MRI scans average $1,325 but hospitals charge $400–$12,000. See 2026 Medicare rates for 5 common CPT codes and learn how to dispute inflated bills.
How Much Does a CT Scan Cost? (2026 Price Guide)
CT scans average $3,275 at hospitals but only $270 at imaging centers. See 2026 Medicare rates for 5 common CPT codes and how to dispute inflated bills.
How Much Does an Ultrasound Cost? (2026 Price Guide)
Hospital ultrasounds average $1,000–$3,000 but imaging centers charge $200–$600. See 2026 Medicare rates for 6 CPT codes and how to dispute overcharges.
Hernia Surgery Cost: What to Expect (2026 Price Guide)
Hernia repair costs $3,500–$15,000 depending on type and facility. See 2026 CPT codes, Medicare rates, and how to dispute overcharges on your surgery bill.
Hysterectomy Cost: What You’ll Pay in 2026
Hysterectomy costs $12,000–$35,000+ depending on approach and facility. See 2026 CPT codes, robotic surgery markups, and how to dispute billing errors.
Endoscopy Billing: Costs, Codes & Common Errors (2026)
Upper endoscopy costs $800–$8,000 depending on facility. See 2026 CPT codes, Medicare rates, and how to dispute the preventive-to-diagnostic billing trap.
Stroke Treatment Billing: Costs & How to Dispute (2026)
Stroke bills average $20,396 for ischemic and $40,000+ for hemorrhagic events. Learn 7 common billing errors and how to dispute tPA markups and ICU overcharges.
Podiatry Billing: Costs, Codes & Medicare Rules (2026)
Medicare denies routine foot care but covers podiatry for diabetics. Learn 9 common CPT codes, Medicare rates vs. hospital charges, and how to dispute denials.
Nursing Home Billing: Common Errors and How to Dispute Them
Nursing homes average $8,929/month. Medicare covers only days 1–100. Learn common billing errors like therapy upcoding and phantom charges, and how to dispute.
Hospital vs Surgery Center Cost Comparison (2026)
ASCs cost 40–60% less than hospitals for the same procedure. BillKarma found patients saved an average of $4,200 by choosing a surgery center.
Medical Expense Tax Deduction: How to Deduct Medical Bills
You can deduct medical expenses exceeding 7.5% of your AGI. See what qualifies, how to calculate your deduction, and common mistakes that trigger audits.
Surgery Center vs Hospital: Cost Comparison (2026)
Ambulatory surgery centers cost 40-60% less than hospitals for the same procedure. Compare costs for 10 common surgeries and see if an ASC is right for you.
Medical Billing Codes Explained: CPT
Confused by medical billing codes? Plain-English guide to CPT, ICD-10, HCPCS, and DRG codes on your hospital bill. Learn to spot upcoding and billing errors.
10 Medical Billing and Coding Mistakes That Cost You Money
Medical billing errors inflate 30-80% of hospital bills. Learn the 10 most common coding mistakes, how to spot them, and how to get overcharges reversed.
NICU Bills Explained: Why They're High & How to Lower Them
NICU stays average $3,000-$10,000+ per day. Understand every line item, spot common billing errors, and find financial assistance for your baby's care.
Hospital Chargemaster Explained
Every hospital has a chargemaster with 10,000–50,000 items at wildly inflated prices. Learn how it works, who pays full price, and how to use it to.
Surprise Medical Bills After Surgery: Why They Happen
Got a surprise bill after surgery from the anesthesiologist, assistant surgeon, or lab? Learn why it happens and exactly how to dispute it legally.
Double Billing and Duplicate Charges on Hospital Bills
Duplicate charges appear on up to 30% of hospital bills. Learn the 8 types of double billing, how to spot them on your itemized bill, and how to get your.
How Long Do You Have to Pay a Medical Bill? Deadlines, Grace
Medical bill due dates are not as final as they look. Learn the real timeline from billing to collections, grace periods, and how to use time strategically.
Hospital Facility Fees Explained: Why You’re Billed Twice
Facility fees add $350–$1,500 to routine doctor visits at hospital-owned offices. Learn what facility fees are, when they’re legal, and how to avoid or.
Medical Billing Errors: How Common Are They in 2026?
Up to 80% of medical bills contain errors. See the latest statistics, most common error types, and how to audit your own hospital bill.
Dental Billing: Codes, Insurance & How to Save (2026)
Dental bills use CDT codes, not CPT codes. Learn how dental billing works, what common procedures cost, insurance coverage tiers, and how to fight.
Skilled Nursing Facility Billing: Costs
Medicare covers up to 100 days in a skilled nursing facility, but coinsurance starts at day 21. Learn SNF costs, coverage rules, and how to appeal denials.
Medical Bill Audit Checklist: 12 Things to Check (2026)
Don't pay a medical bill without checking it first. This 12-point audit checklist catches duplicate charges, upcoding, unbundling, and billing errors.
Freestanding ER Bills: Why They're 3x Higher (2026)
Freestanding ERs charge hospital-level facility fees for minor visits. Learn why they cost 3x more, which states regulate them, and how to dispute inflated.
Inpatient Rehab Billing: Costs
Inpatient rehab stays average $38,000. Medicare requires the 60% rule and 3 hours of daily therapy. Learn IRF vs SNF costs, coverage rules, and how to appeal.
Medical Device and Implant Billing
Hospitals mark up medical devices 300-1000%. A $3,500 knee implant gets billed at $47,000. Learn how device pricing works, common markups, and how to dispute.
ICD-10 and DRG Codes
A wrong DRG code can inflate your hospital bill by $14,000 or more. Learn how ICD-10 and DRG codes work, how upcoding happens, and how to verify your coding.
Children's Hospital Bills: Pediatric Billing
Children's hospitals charge 2-3x more than adult facilities. Learn CHIP eligibility, NICU billing, vaccine coverage under the ACA, and how to dispute.
Hospice Billing: What Medicare Covers
Medicare hospice covers nearly all end-of-life care. Learn the 4 care levels, what is NOT covered, room and board rules, and how to spot billing errors.
Prescription Drug Billing Errors: How Pharmacies Overcharge
Pharmacy billing errors cost Americans billions annually. A generic drug that costs $4 can be billed at $80. Learn the most common prescription billing.
Cardiac Procedure Billing: Stents
Cardiac bills have the highest error rate of any procedure. A stent billed at $78,000 may cost Medicare $2,800. Learn what to look for and how to dispute.
Sleep Study Billing: Polysomnography Costs
In-lab sleep studies have a $900 Medicare rate but hospitals charge $3,000–$8,000. Learn CPT codes, CPAP rental traps, and how to dispute overcharges.
Home Health Billing: What Medicare Covers
Medicare covers skilled home health care but billing errors cost thousands. Learn PDGM episode billing, HCPCS codes, visit log rights, and how to dispute.
Inpatient vs. Outpatient Billing
Inpatient vs. outpatient billing changes your cost dramatically — the same knee surgery can cost $4,800 or $18,000. Learn how to check your status and.
Maternity Hospital Bill: What Every Charge Means
The average vaginal delivery costs $14,768 — and maternity bills are among the most error-prone. Learn what every charge means and how to dispute common.
Physical Therapy Billing: Common Errors & Disputes (2026)
Physical therapy billing errors cost patients hundreds. Learn the CPT codes, 8-minute rule, and how to spot duplicate charges before paying your PT bill.
Urgent Care Billing: Facility Fees
Urgent care bills often include surprise facility fees, wrong CPT codes, and ER-level charges. Learn billing rules and how to dispute inflated charges.
How Much Does an MRI or CT Scan Cost? A Complete Price Guide
MRI scans cost $400-$3,500 and CT scans $300-$6,750 depending on where you go. Learn what drives imaging costs and 5 ways to pay less for your scan.
How Much Does Surgery Cost? Common Procedure Prices (2026)
Surgery costs range from $3,500 to $100,000+ depending on procedure and location. Learn what drives costs, compare prices, and find ways to save thousands.
Hospital Billing Grades Explained: What A Through F Means
BillKarma grades every hospital A–F based on how much they charge vs. Medicare. Learn what each grade means, how it's calculated, and how to use it before.
For-Profit vs. Nonprofit Hospitals
For-profit hospitals charge higher markups on average — but nonprofit doesn't mean fair billing. Learn how ownership type affects your bill and your rights.
Private Equity Hospitals
PE-acquired hospitals raise prices 20–30% above comparable hospitals within 3 years. Learn how to spot PE ownership and protect yourself from inflated.
Why Lab Test Bills Are So High — And How to Get a Fair Price
A basic blood panel costs $14 at Medicare rates but hospitals bill $300–$500. Learn how lab test pricing works, which codes to check, and how to cut your.
Observation Status vs. Inpatient
Observation status instead of inpatient admission can cost thousands more. Learn the difference, Medicare rules, and how to challenge your status.
What Are CPT Codes? How to Audit Your Medical Bill (2026)
CPT codes are the five-digit numbers on every medical bill. Learn what they mean, how hospitals misuse them, and how to audit your own bill using CPT codes.
Hospital Drug Markups: What a $30 Tylenol Really Costs
Hospitals mark up common drugs by 1,000% or more. See real chargemaster prices, understand why, and learn how to dispute inflated pharmacy charges.
How to Read Your Medical Bill and Spot Overcharges
Learn how to decode every line on a medical bill. Understand CPT codes, Medicare rates, and how to identify billing errors that could save you hundreds.
Why Emergency Room Bills Are So High (And How to Lower Them)
The average ER visit costs $2,200 before insurance. Learn why ER bills are so expensive, what each charge actually covers, and 6 proven ways to reduce your.