23600

Closed treatment of broken top of upper arm bone

Medicare pricing data for 12,037 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

Closed treatment of broken top of upper arm bone (HCPCS code 23600) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $299.42, but hospitals typically charge $1,289 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$59.88

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $299.42, your out-of-pocket cost would be approximately $59.88. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$299.42
Average Hospital Charge
$1,289
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,289.27
Medicare Allowed$299.42
Medicare Payment$232.51

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $232.51 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$356$2,452330874+18.8%
New York$356$2,1667911,781+18.8%
Connecticut$332$1,347181367+10.9%
Maryland$327$1,274327701+9.1%
Wyoming$326$8191424+8.9%
Massachusetts$326$1,3413981,006+8.7%
California$320$1,3958651,583+7.0%
New Hampshire$320$1,3333361+7.0%
Hawaii$311$1,0153562+3.8%
Louisiana$310$1,175101236+3.5%
Florida$309$1,2379392,319+3.2%
Pennsylvania$308$1,0177201,611+3.0%
Colorado$307$1,268135217+2.5%
Rhode Island$302$1,13568140+1.0%
Michigan$302$916507997+0.9%
District of Columbia$301$1,4871426+0.6%
Delaware$301$1,46062152+0.6%
South Carolina$297$934197505-0.7%
Alaska$297$2,0581316-0.9%
Nevada$297$1,523103177-1.0%
Montana$294$8951824-1.9%
Utah$292$1,062103189-2.3%
Indiana$291$963355782-2.9%
Illinois$290$1,4004681,095-3.1%
New Mexico$289$1,03856138-3.3%
West Virginia$289$940113268-3.5%
Maine$289$8862347-3.6%
Iowa$287$1,030144292-4.0%
Missouri$287$1,150228493-4.2%
Washington$287$1,215223373-4.2%
Georgia$287$1,337310581-4.2%
Ohio$286$1,0266761,366-4.5%
Alabama$285$1,198272557-5.0%
Texas$284$1,2826431,151-5.2%
South Dakota$283$9335094-5.4%
Nebraska$283$1,0933352-5.5%
North Carolina$283$1,104406777-5.6%
Oregon$282$1,32371140-5.8%
North Dakota$282$1,2822065-5.9%
Kansas$281$1,070108233-6.1%
Kentucky$281$966155379-6.1%
Arizona$281$1,447203422-6.1%
Vermont$281$606411-6.3%
Wisconsin$279$1,780192322-6.8%
Puerto Rico$277$5111114-7.3%
Oklahoma$271$1,214140319-9.4%
Tennessee$271$1,198308621-9.4%
Mississippi$270$1,313167370-9.7%
Arkansas$251$9665499-16.3%
Idaho$246$1,4222742-17.8%
Minnesota$237$1,140276492-20.9%
Virginia$224$798303997-25.3%

⚠️ 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