00534

Anesthesia for insertion or replace of pacing heart defibrillator

Medicare pricing data for 17,070 providers across 52 states

🤖AI Overview

This procedure has a 10.7x markup — hospitals charge $2,299 but Medicare allows only $213.91. Uninsured patients may face bills 10.7 times higher than what insurance negotiates. Prices vary significantly by location — from $154 in Alabama to $366 in Alaska. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Anesthesia for insertion or replace of pacing heart defibrillator (HCPCS code 00534) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $213.91, but hospitals typically charge $2,299 — a 10.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$42.78

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $213.91, your out-of-pocket cost would be approximately $42.78. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$213.91
Average Hospital Charge
$2,299
Markup Ratio
10.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,299.10
Medicare Allowed$213.91
Medicare Payment$168.67

Hospitals charge 10.7x more than what Medicare allows for this procedure. Medicare actually pays $168.67 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$366$2,2141733+71.0%
Wyoming$349$2,384912+63.2%
Utah$328$2,10996163+53.1%
Montana$303$1,59756119+41.5%
California$295$2,2831,0812,251+38.1%
Idaho$287$2,2904052+34.0%
Puerto Rico$286$1,4822964+33.6%
Oregon$282$1,892130197+31.8%
New Mexico$277$2,5013559+29.3%
Nevada$273$3,42986181+27.7%
Arkansas$256$1,47288222+19.8%
New York$253$3,6649792,859+18.1%
Illinois$249$2,986559906+16.5%
Indiana$245$2,465257533+14.5%
Oklahoma$242$2,23082270+13.2%
Colorado$242$2,382185280+13.1%
Arizona$240$2,404270634+12.3%
Maryland$239$2,099289889+11.9%
Minnesota$239$2,035300606+11.7%
Nebraska$238$1,415120219+11.1%
Vermont$237$1,4721925+10.9%
Iowa$234$1,711129276+9.4%
New Hampshire$234$3,699112197+9.4%
Washington$231$1,845298518+7.8%
Louisiana$228$1,614181342+6.6%
Mississippi$226$1,547133285+5.8%
Hawaii$225$1,6942334+5.4%
Delaware$223$2,08299310+4.2%
Florida$223$2,5131,4723,103+4.2%
Kentucky$222$2,153224384+3.7%
Massachusetts$221$2,057433978+3.2%
New Jersey$218$1,9044101,337+1.7%
Texas$216$2,8981,2452,992+0.9%
Connecticut$214$3,036242487-0.1%
Wisconsin$212$2,943400689-1.0%
District of Columbia$209$1,435112374-2.5%
Ohio$208$1,8367021,374-2.9%
Missouri$206$1,841423971-3.6%
Rhode Island$203$1,7284495-5.2%
Virginia$197$2,3855621,432-8.0%
Tennessee$192$2,2604791,321-10.4%
North Carolina$181$2,0145821,335-15.6%
North Dakota$180$1,62681127-16.0%
Pennsylvania$173$1,7111,3973,293-18.9%
West Virginia$173$1,61584202-19.3%
Michigan$172$2,6817831,460-19.8%
Kansas$168$1,090156335-21.7%
Maine$167$2,09991183-22.0%
Georgia$160$1,7336081,386-25.1%
South Carolina$155$2,0844851,656-27.5%
South Dakota$154$1,3064599-27.8%
Alabama$154$1,563291828-28.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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