25605

Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation

Medicare pricing data for 12,952 providers across 52 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $2,564 but Medicare allows only $421.55. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Prices vary significantly by location — from $209 in Wisconsin to $521 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

Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation (HCPCS code 25605) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $421.55, but hospitals typically charge $2,564 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$84.31

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $421.55, your out-of-pocket cost would be approximately $84.31. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$421.55
Average Hospital Charge
$2,564
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,564.34
Medicare Allowed$421.55
Medicare Payment$331.32

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $331.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$521$3,4874760+23.7%
New York$512$3,607658995+21.4%
New Jersey$510$3,996309450+20.9%
Puerto Rico$496$1,6592436+17.7%
Connecticut$496$2,400176234+17.7%
California$479$2,5581,3562,008+13.7%
Maryland$472$2,518278399+12.0%
New Hampshire$469$2,34588120+11.4%
Rhode Island$469$2,7104454+11.3%
Hawaii$466$2,5395368+10.5%
Delaware$448$2,6626481+6.3%
District of Columbia$447$2,4921825+6.1%
Florida$446$3,0058541,156+5.7%
Pennsylvania$443$2,118595786+5.2%
Montana$441$1,5526590+4.6%
Colorado$439$2,625247321+4.1%
Wyoming$438$2,1663753+4.0%
Michigan$436$2,531467585+3.5%
Nevada$434$3,628102129+3.0%
New Mexico$432$2,259100126+2.4%
Washington$431$2,517283369+2.2%
West Virginia$430$2,203100122+2.1%
Louisiana$426$3,166140172+1.0%
North Dakota$425$1,7104668+0.9%
Missouri$420$2,358247325-0.4%
Ohio$417$2,452481594-1.0%
Texas$417$3,3018191,019-1.1%
Georgia$417$2,975310395-1.1%
Oregon$416$2,464170209-1.3%
Kansas$414$2,365103129-1.9%
Minnesota$413$2,377294377-1.9%
Nebraska$412$2,0516492-2.2%
South Carolina$412$2,294269342-2.2%
South Dakota$411$2,0374759-2.4%
Oklahoma$409$2,704171221-3.1%
Arizona$406$2,937288381-3.7%
North Carolina$405$2,289470636-3.9%
Maine$405$1,7586182-4.0%
Vermont$402$2,2933444-4.7%
Utah$398$2,444125167-5.7%
Indiana$396$2,227284359-6.1%
Kentucky$392$2,532163192-7.0%
Massachusetts$390$1,682331601-7.4%
Alabama$390$2,480184231-7.5%
Iowa$389$1,748160238-7.7%
Mississippi$387$2,727118171-8.3%
Arkansas$382$2,743105148-9.4%
Idaho$378$2,4606481-10.2%
Illinois$372$2,294543906-11.8%
Tennessee$322$2,328283466-23.6%
Virginia$301$1,777328618-28.5%
Wisconsin$209$1,702223496-50.5%

⚠️ 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