20612

Aspiration and/or injection of cyst of tendon

Medicare pricing data for 10,452 providers across 52 states

🤖AI Overview

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

Aspiration and/or injection of cyst of tendon (HCPCS code 20612) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $59.43, but hospitals typically charge $192.10 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.89

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $59.43, your out-of-pocket cost would be approximately $11.89. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$59.43
Average Hospital Charge
$192.10
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$192.10
Medicare Allowed$59.43
Medicare Payment$43.47

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $43.47 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$74$3312943+24.8%
District of Columbia$72$1981539+21.3%
New Jersey$68$2614241,148+14.5%
California$66$1938362,417+11.7%
Connecticut$66$240126315+11.2%
Maryland$65$151254737+10.2%
Massachusetts$63$209290747+6.7%
Hawaii$63$1262391+6.3%
New York$63$2676662,337+5.8%
Illinois$61$207371846+2.5%
Nevada$61$48271211+2.0%
Florida$60$1637772,292+1.7%
Wyoming$60$2162560+1.6%
Colorado$60$185190327+0.5%
Delaware$59$19149143+0.0%
Washington$59$1612635350.0%
Oregon$59$175119256-0.1%
Michigan$59$134315714-0.2%
Rhode Island$59$1754389-1.3%
Pennsylvania$59$1575671,341-1.5%
Georgia$58$204281702-1.9%
Montana$58$1365098-2.8%
New Hampshire$58$23167159-2.9%
Virginia$58$180346906-3.0%
North Carolina$57$168404909-4.5%
Texas$57$1846411,739-4.7%
South Carolina$56$154179429-5.9%
Kansas$56$163103201-6.4%
Missouri$56$191179402-6.6%
Arizona$55$162245755-6.9%
Tennessee$55$178224497-7.3%
Indiana$55$154191344-7.5%
Ohio$55$141374766-7.6%
Louisiana$55$197137305-7.7%
Kentucky$55$140111233-7.8%
Utah$55$139109202-8.1%
Alabama$54$115113219-8.4%
Maine$54$1252948-9.5%
Vermont$54$971531-9.7%
Minnesota$53$215177267-10.1%
Iowa$53$167121235-11.0%
Arkansas$53$13687214-11.5%
Oklahoma$53$137100168-11.7%
Puerto Rico$52$100717-11.8%
Nebraska$52$17772152-11.8%
Wisconsin$52$354218373-13.1%
Mississippi$52$17975155-13.1%
West Virginia$51$1554087-13.6%
Idaho$51$15375139-13.7%
New Mexico$50$14364127-16.5%
South Dakota$47$2083857-21.7%
North Dakota$46$1433465-23.1%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber