01232

Anesthesia for amputation on upper 2/3rd of thigh bone

Medicare pricing data for 8,276 providers across 50 states

🤖AI Overview

This procedure has a 10.8x markup — hospitals charge $1,977 but Medicare allows only $183.82. Uninsured patients may face bills 10.8 times higher than what insurance negotiates. Prices vary significantly by location — from $134 in Alabama to $345 in Alaska. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 amputation on upper 2/3rd of thigh bone (HCPCS code 01232) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $183.82, but hospitals typically charge $1,977 — a 10.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$36.76

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $183.82, your out-of-pocket cost would be approximately $36.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$183.82
Average Hospital Charge
$1,977
Markup Ratio
10.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,977.22
Medicare Allowed$183.82
Medicare Payment$145.66

Hospitals charge 10.8x more than what Medicare allows for this procedure. Medicare actually pays $145.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$345$1,9661515+87.5%
Puerto Rico$281$8891519+52.7%
California$261$2,161453515+41.7%
Washington$249$1,930116128+35.7%
Utah$248$1,7152224+34.9%
Oregon$245$1,6096268+33.4%
Montana$243$1,4001620+32.3%
Nebraska$240$1,6525057+30.4%
Iowa$237$1,5815461+29.0%
Arizona$232$2,53296111+26.4%
New Mexico$231$2,3662630+25.4%
Nevada$229$2,5605665+24.5%
New York$226$2,976449540+23.0%
Colorado$212$2,2315966+15.5%
Hawaii$212$1,4041213+15.2%
Maryland$209$2,097190215+13.7%
Illinois$206$2,585285323+12.0%
Vermont$205$1,3411919+11.7%
New Jersey$205$2,619212243+11.6%
Massachusetts$204$1,700175204+10.7%
Arkansas$204$1,40290102+10.7%
Oklahoma$199$1,86399126+8.3%
Kansas$196$1,3257385+6.4%
District of Columbia$194$1,3245057+5.3%
Louisiana$193$1,604231306+5.2%
Indiana$190$1,584159187+3.6%
Florida$188$2,132522612+2.0%
Kentucky$183$1,722112130-0.4%
Texas$182$2,394641749-0.9%
Tennessee$182$1,718212261-1.1%
New Hampshire$180$3,0685763-2.2%
Missouri$176$1,601199232-4.0%
Connecticut$176$2,351103115-4.5%
Ohio$172$1,465335385-6.5%
Delaware$171$1,7393340-6.7%
North Dakota$171$1,4584354-7.1%
Rhode Island$170$1,6381617-7.5%
Wisconsin$168$2,721172198-8.9%
Minnesota$161$1,629131145-12.2%
Virginia$161$2,036245291-12.4%
West Virginia$158$1,77183101-14.3%
Pennsylvania$156$1,756501573-15.2%
Michigan$155$2,109297356-15.6%
Maine$150$1,8494553-18.4%
South Dakota$149$2,2164551-19.2%
North Carolina$144$1,918355426-21.7%
Georgia$139$1,625360458-24.1%
South Carolina$139$1,845256335-24.1%
Mississippi$139$1,068187301-24.3%
Alabama$134$1,279220281-27.0%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber