27506

Treatment of broken shaft of thigh bone with implant

Medicare pricing data for 5,904 providers across 51 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

Treatment of broken shaft of thigh bone with implant (HCPCS code 27506) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,026, but hospitals typically charge $4,635 — a 4.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$205.14

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,026, your out-of-pocket cost would be approximately $205.14. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,026
Average Hospital Charge
$4,635
Markup Ratio
4.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,635.26
Medicare Allowed$1,025.71
Medicare Payment$815.64

Hospitals charge 4.5x more than what Medicare allows for this procedure. Medicare actually pays $815.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$1,220$3,7971534+19.0%
Massachusetts$1,198$5,715105228+16.8%
Virginia$1,189$4,091137323+16.0%
New York$1,189$7,186267484+16.0%
Nevada$1,177$5,9464098+14.8%
California$1,155$4,071495961+12.6%
Hawaii$1,142$3,5091522+11.3%
Maryland$1,140$3,928101198+11.1%
Ohio$1,134$4,165188349+10.6%
Rhode Island$1,123$5,4272330+9.5%
New Jersey$1,105$11,714189382+7.7%
Michigan$1,098$3,308168300+7.1%
Pennsylvania$1,082$5,210226419+5.5%
Illinois$1,080$5,508228401+5.3%
Kentucky$1,079$3,41486169+5.2%
North Dakota$1,067$4,4242452+4.1%
Missouri$1,049$4,282125214+2.3%
Connecticut$1,047$7,27474118+2.1%
Tennessee$1,031$4,100130239+0.6%
Texas$1,031$3,931396785+0.5%
Oklahoma$1,025$3,40186205-0.1%
North Carolina$1,005$3,619224421-2.0%
West Virginia$1,003$3,4603665-2.2%
New Mexico$1,002$3,4513455-2.3%
Arkansas$1,002$2,71872118-2.3%
Georgia$998$4,307195310-2.7%
South Carolina$988$4,054117230-3.7%
Washington$979$3,321120200-4.6%
Louisiana$978$3,615102169-4.6%
Florida$969$4,786469967-5.6%
Alaska$957$7,1601836-6.7%
New Hampshire$952$6,1473651-7.1%
Vermont$939$4,1731217-8.5%
Mississippi$938$3,69259119-8.6%
Utah$935$2,8636087-8.8%
Indiana$917$3,837160286-10.6%
Minnesota$893$4,688115192-12.9%
Oregon$880$4,03072127-14.2%
Colorado$878$3,555102152-14.4%
Kansas$877$3,26157125-14.5%
Alabama$877$3,325124191-14.5%
Arizona$869$3,498146271-15.3%
Wisconsin$841$8,675129187-18.0%
Iowa$837$3,67869152-18.4%
Wyoming$834$3,7732631-18.7%
Maine$822$2,5652944-19.9%
Montana$811$2,9774966-20.9%
Idaho$790$3,2793961-23.0%
Delaware$741$5,9502581-27.7%
South Dakota$706$2,2693683-31.2%
Nebraska$664$3,3465089-35.2%

⚠️ 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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