00862

Anesthesia for procedure on upper urinary tubes or removal of kidney for transplant

Medicare pricing data for 27,173 providers across 52 states

🤖AI Overview

This procedure has a 10.1x markup — hospitals charge $2,801 but Medicare allows only $278.64. Uninsured patients may face bills 10.1 times higher than what insurance negotiates. Prices vary significantly by location — from $201 in Alabama to $561 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 procedure on upper urinary tubes or removal of kidney for transplant (HCPCS code 00862) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $278.64, but hospitals typically charge $2,801 — a 10.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$55.73

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $278.64, your out-of-pocket cost would be approximately $55.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$278.64
Average Hospital Charge
$2,801
Markup Ratio
10.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,801.14
Medicare Allowed$278.64
Medicare Payment$221.85

Hospitals charge 10.1x more than what Medicare allows for this procedure. Medicare actually pays $221.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$561$3,2624057+101.2%
Montana$397$2,14975101+42.5%
Wyoming$378$2,5132534+35.8%
California$377$2,9361,6933,312+35.2%
Utah$376$2,424171252+35.1%
Idaho$345$2,36591126+23.7%
Oregon$344$2,197276470+23.4%
New Mexico$343$3,00899133+23.1%
Iowa$341$2,196258469+22.5%
Arkansas$337$1,975222376+20.8%
Puerto Rico$335$1,8352946+20.1%
Delaware$334$2,99590169+19.8%
Hawaii$327$2,3084788+17.5%
Washington$326$2,597543985+17.1%
Nevada$322$3,438130215+15.6%
Maryland$313$2,8584901,102+12.4%
New York$309$3,6881,6243,372+11.0%
Nebraska$307$1,878208343+10.3%
Arizona$304$3,400495923+9.1%
Louisiana$303$2,346407665+8.8%
Oklahoma$302$2,456283601+8.5%
Rhode Island$301$2,61869128+8.1%
District of Columbia$296$2,591165366+6.3%
New Jersey$296$3,3716001,131+6.1%
Illinois$295$3,6091,0751,891+5.7%
Massachusetts$293$2,2358761,651+5.1%
Colorado$287$2,814371555+3.0%
Vermont$280$1,6694164+0.6%
Connecticut$278$3,194327566-0.1%
Indiana$276$2,3865251,053-0.9%
Florida$276$3,0171,8713,499-1.0%
Texas$269$3,2461,9773,786-3.3%
Tennessee$264$2,6207441,330-5.2%
New Hampshire$262$4,553151270-5.8%
Missouri$260$2,0816351,183-6.7%
Kentucky$258$2,656419676-7.3%
Kansas$257$1,510342722-7.6%
Ohio$257$2,2071,2222,326-7.8%
Virginia$251$3,0337351,509-9.8%
Wisconsin$251$3,746563929-10.1%
North Dakota$250$1,805105178-10.3%
Michigan$250$3,2369421,445-10.3%
Pennsylvania$245$2,3801,5372,661-12.1%
Mississippi$242$1,732240481-13.1%
West Virginia$234$2,623188353-16.0%
North Carolina$232$2,7441,0531,884-16.8%
Minnesota$231$2,2367201,319-17.0%
Maine$231$2,567173263-17.0%
South Carolina$215$3,0125931,197-22.8%
Georgia$214$2,3269511,691-23.3%
South Dakota$201$2,160128262-27.8%
Alabama$201$2,030459767-27.8%

⚠️ 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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