23430

Anchoring of biceps tendon

Medicare pricing data for 7,753 providers across 51 states

🤖AI Overview

This procedure has a 5.3x markup — hospitals charge $4,068 but Medicare allows only $762.78. Uninsured patients may face bills 5.3 times higher than what insurance negotiates. Prices vary significantly by location — from $213 in South Dakota to $1,561 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

Anchoring of biceps tendon (HCPCS code 23430) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $762.78, but hospitals typically charge $4,068 — a 5.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$152.56

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $762.78, your out-of-pocket cost would be approximately $152.56. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$762.78
Average Hospital Charge
$4,068
Markup Ratio
5.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,068.28
Medicare Allowed$762.78
Medicare Payment$607.72

Hospitals charge 5.3x more than what Medicare allows for this procedure. Medicare actually pays $607.72 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,561$9,67549351+104.7%
Mississippi$1,217$8,25756479+59.5%
Wyoming$1,156$5,30441148+51.6%
Oregon$1,140$3,52290407+49.5%
Hawaii$1,069$5,0422082+40.1%
Montana$1,058$3,18869444+38.7%
North Dakota$1,045$3,0791894+37.0%
Illinois$1,022$6,1232941,174+34.0%
Minnesota$1,009$4,306187451+32.3%
New Hampshire$1,008$5,69355253+32.2%
Virginia$991$4,325178981+29.9%
Connecticut$985$5,664129585+29.1%
California$928$4,1676593,216+21.7%
Colorado$924$4,2502561,358+21.2%
Maryland$919$4,949164849+20.5%
Indiana$917$5,475196753+20.2%
Georgia$900$4,446196954+18.0%
Utah$866$3,519111361+13.5%
Washington$823$2,8242621,242+7.9%
Tennessee$793$3,637174913+4.0%
West Virginia$770$4,55029110+1.0%
Michigan$728$3,080158633-4.6%
Missouri$727$4,561151758-4.7%
Iowa$715$3,42679261-6.2%
North Carolina$704$3,0332701,249-7.7%
Rhode Island$699$3,02734174-8.3%
Nebraska$699$2,96868450-8.4%
Nevada$698$3,03163641-8.4%
Texas$698$3,7275442,901-8.6%
Ohio$694$2,8453001,298-9.1%
Arizona$690$3,4602021,051-9.5%
New Jersey$674$8,2162301,114-11.6%
Florida$659$4,2964612,446-13.6%
Pennsylvania$657$3,335242766-13.9%
South Carolina$640$3,188138888-16.1%
Alabama$608$2,652150643-20.3%
Kansas$598$3,43093455-21.6%
New Mexico$595$2,65935198-22.0%
New York$568$5,2263371,505-25.5%
Idaho$561$2,46299718-26.5%
Oklahoma$546$1,840109467-28.4%
Kentucky$513$2,24085445-32.8%
Massachusetts$504$3,176166663-33.9%
Arkansas$489$2,14671382-35.8%
Wisconsin$465$5,665131466-39.0%
District of Columbia$464$2,753918-39.1%
Louisiana$460$2,68399410-39.7%
Maine$303$1,86930124-60.3%
Delaware$276$2,21236334-63.9%
Vermont$272$2,72219120-64.4%
South Dakota$213$1,32039246-72.0%

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