01402

Anesthesia for procedure for total knee joint replacement

Medicare pricing data for 58,762 providers across 52 states

🤖AI Overview

This procedure has a 10.2x markup — hospitals charge $2,353 but Medicare allows only $230.88. Uninsured patients may face bills 10.2 times higher than what insurance negotiates. Prices vary significantly by location — from $169 in Alabama to $407 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 for total knee joint replacement (HCPCS code 01402) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $230.88, but hospitals typically charge $2,353 — a 10.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$46.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $230.88, your out-of-pocket cost would be approximately $46.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$230.88
Average Hospital Charge
$2,353
Markup Ratio
10.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,353.47
Medicare Allowed$230.88
Medicare Payment$182.62

Hospitals charge 10.2x more than what Medicare allows for this procedure. Medicare actually pays $182.62 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$407$2,639121873+76.2%
California$334$2,5753,48025,660+44.6%
Puerto Rico$323$2,41861393+40.0%
Utah$317$2,0004843,481+37.3%
Montana$313$1,8752031,853+35.6%
Wyoming$301$2,44580630+30.5%
Oregon$300$1,8925793,806+29.8%
Idaho$299$1,8742741,855+29.6%
Hawaii$295$2,004117598+27.9%
Washington$295$2,0461,1798,074+27.8%
Arizona$289$3,4411,0508,415+25.1%
Oklahoma$284$2,2005825,685+22.8%
Nevada$280$2,6613162,462+21.4%
Arkansas$279$1,5835124,337+20.9%
New Mexico$275$2,6342581,913+19.1%
Nebraska$267$1,5504614,481+15.8%
Iowa$266$1,7365555,611+15.4%
New York$262$3,6202,69623,494+13.6%
Maryland$262$2,3278979,419+13.5%
Colorado$256$2,4289947,132+10.8%
Indiana$250$2,0911,12910,486+8.5%
Kansas$249$1,7247556,872+7.9%
Louisiana$248$1,9109395,826+7.3%
Florida$246$2,7774,02929,403+6.6%
Delaware$246$2,1952092,400+6.3%
District of Columbia$244$2,4672241,495+5.6%
Illinois$237$2,9152,30320,026+2.8%
New Jersey$237$2,7661,15310,718+2.7%
Texas$228$2,9824,28234,258-1.3%
Kentucky$227$2,0999477,601-1.8%
Tennessee$226$2,1111,80114,141-2.2%
New Hampshire$222$2,6393673,300-3.8%
Missouri$221$1,8261,56611,788-4.2%
Rhode Island$220$1,7441551,199-4.5%
Vermont$219$1,630121830-5.1%
Massachusetts$213$1,6581,47714,812-7.5%
Mississippi$211$1,3925274,441-8.7%
Wisconsin$210$3,1161,2999,092-9.2%
Ohio$206$1,8042,69922,926-11.0%
Connecticut$204$2,2866545,199-11.7%
Maine$199$2,0643982,581-13.7%
North Dakota$197$1,6332832,098-14.6%
Virginia$197$2,2131,61116,950-14.7%
West Virginia$195$2,1024543,200-15.6%
South Dakota$192$1,9413243,584-16.8%
Michigan$192$2,4792,42315,465-17.0%
Minnesota$181$1,7281,61710,466-21.6%
South Carolina$181$2,3411,16511,992-21.7%
North Carolina$180$2,3882,26719,094-22.1%
Pennsylvania$179$1,8593,32929,217-22.3%
Georgia$179$2,0362,16116,284-22.4%
Alabama$169$1,8261,1178,215-27.0%

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

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