27130

Replacement of thigh bone and hip joint with prosthesis

Medicare pricing data for 17,826 providers across 52 states

🤖AI Overview

This procedure has a 6.2x markup — hospitals charge $8,268 but Medicare allows only $1,325. Uninsured patients may face bills 6.2 times higher than what insurance negotiates. Prices vary significantly by location — from $666 in South Dakota to $2,511 in Mississippi. 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

Replacement of thigh bone and hip joint with prosthesis (HCPCS code 27130) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,325, but hospitals typically charge $8,268 — a 6.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$264.98

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,325, your out-of-pocket cost would be approximately $264.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,325
Average Hospital Charge
$8,268
Markup Ratio
6.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$8,268.08
Medicare Allowed$1,324.88
Medicare Payment$1,053.58

Hospitals charge 6.2x more than what Medicare allows for this procedure. Medicare actually pays $1,054 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Mississippi$2,511$14,8631203,052+89.5%
Hawaii$2,504$6,97636476+89.0%
Oregon$1,873$8,5652464,208+41.4%
New Hampshire$1,863$15,4111332,671+40.6%
Maryland$1,825$11,7973427,558+37.8%
Tennessee$1,755$8,0113757,312+32.5%
Georgia$1,755$9,8914478,320+32.5%
Nevada$1,649$7,9461442,750+24.5%
Michigan$1,633$9,0796028,514+23.3%
Indiana$1,562$12,8484358,079+17.9%
Arizona$1,541$9,5944228,308+16.3%
Ohio$1,450$8,23976012,505+9.5%
Connecticut$1,414$8,3723013,696+6.7%
Florida$1,412$9,0891,25125,010+6.6%
Minnesota$1,408$8,1834675,866+6.3%
Montana$1,402$5,3901202,646+5.8%
Alaska$1,388$14,706751,062+4.7%
Rhode Island$1,375$6,971721,103+3.8%
California$1,356$6,5091,36023,980+2.3%
Wyoming$1,355$7,49567997+2.3%
Virginia$1,324$6,6883619,753-0.0%
New York$1,318$11,61498015,085-0.5%
Washington$1,310$5,0964748,857-1.1%
South Carolina$1,294$6,9422536,721-2.3%
Colorado$1,286$6,7284007,069-3.0%
Missouri$1,285$7,7783245,340-3.0%
New Jersey$1,280$22,0414568,475-3.4%
Kentucky$1,273$6,5512173,293-4.0%
District of Columbia$1,235$7,70625545-6.8%
North Carolina$1,206$5,57159711,067-9.0%
Illinois$1,194$9,60668513,460-9.9%
Utah$1,192$4,8992042,969-10.0%
North Dakota$1,146$5,486731,455-13.5%
Wisconsin$1,139$14,4614716,711-14.1%
West Virginia$1,134$5,0821021,359-14.4%
Pennsylvania$1,126$6,03880713,526-15.0%
Puerto Rico$1,122$1,8932968-15.3%
Texas$1,116$6,4811,10215,709-15.8%
New Mexico$1,104$3,925811,290-16.7%
Massachusetts$1,059$6,3374428,308-20.0%
Arkansas$1,041$4,2061402,568-21.5%
Iowa$994$5,0252044,744-25.0%
Louisiana$962$5,1872413,024-27.4%
Oklahoma$891$3,0581823,619-32.7%
Maine$880$2,8781011,387-33.6%
Delaware$862$4,801681,589-35.0%
Kansas$815$4,7892254,809-38.5%
Idaho$783$4,1941392,762-40.9%
Nebraska$774$4,8241663,359-41.6%
Alabama$772$4,8422893,649-41.7%
Vermont$764$4,17748717-42.4%
South Dakota$666$3,3881102,305-49.7%

⚠️ 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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