00865

Anesthesia for extensive removal of prostate

Medicare pricing data for 17,856 providers across 52 states

🤖AI Overview

This procedure has a 10.0x markup — hospitals charge $3,161 but Medicare allows only $317.65. Uninsured patients may face bills 10.0 times higher than what insurance negotiates. Prices vary significantly by location — from $213 in South Dakota to $610 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 extensive removal of prostate (HCPCS code 00865) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $317.65, but hospitals typically charge $3,161 — a 10.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$63.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $317.65, your out-of-pocket cost would be approximately $63.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$317.65
Average Hospital Charge
$3,161
Markup Ratio
10.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,160.63
Medicare Allowed$317.65
Medicare Payment$251.01

Hospitals charge 10.0x more than what Medicare allows for this procedure. Medicare actually pays $251.01 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$610$3,4472739+92.2%
Puerto Rico$477$1,7331231+50.1%
Montana$443$2,44389162+39.5%
California$438$3,3411,2762,484+37.9%
Wyoming$431$2,6081934+35.8%
Nevada$408$3,55879139+28.3%
Hawaii$407$2,8933355+28.0%
Utah$405$2,552127201+27.6%
Idaho$402$2,66289144+26.5%
Arkansas$399$2,366133262+25.7%
Oregon$387$2,535232381+22.0%
Washington$384$2,772418741+20.8%
New Mexico$383$3,4905971+20.7%
Iowa$378$2,468202393+18.9%
Arizona$367$4,271345594+15.6%
New York$356$3,8681,0792,002+12.1%
Oklahoma$356$2,451167295+11.9%
Delaware$344$3,1274666+8.2%
Rhode Island$338$3,2763549+6.3%
Connecticut$337$3,922190291+6.2%
Illinois$336$4,4627111,178+5.7%
New Jersey$329$3,811359614+3.4%
Missouri$325$2,648363573+2.3%
Indiana$320$2,870310467+0.8%
Kansas$319$1,837180324+0.5%
North Dakota$319$2,36268105+0.5%
Massachusetts$319$2,4545661,009+0.5%
Louisiana$317$2,398267397-0.2%
Texas$309$3,7091,2622,522-2.9%
Tennessee$307$3,031552853-3.3%
Maryland$307$3,207342802-3.3%
Colorado$305$3,000296518-3.9%
Kentucky$304$3,230194314-4.3%
District of Columbia$302$2,405102212-4.8%
Nebraska$301$1,924162340-5.2%
Mississippi$297$2,394129211-6.5%
Ohio$289$2,5408211,568-9.2%
Florida$288$3,1131,0512,184-9.5%
Michigan$287$3,783613935-9.5%
Virginia$282$3,395466854-11.2%
Wisconsin$281$4,489417642-11.4%
West Virginia$281$2,96798156-11.6%
Pennsylvania$279$2,6071,0291,807-12.0%
Maine$274$3,01786106-13.7%
North Carolina$269$3,235606977-15.4%
New Hampshire$265$4,386104166-16.5%
Vermont$264$1,6873862-16.7%
Georgia$251$2,7466481,149-21.0%
Minnesota$249$2,307494961-21.6%
South Carolina$237$3,631395717-25.3%
Alabama$233$2,740306539-26.6%
South Dakota$213$2,455139301-33.1%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber