27786

Closed treatment of broken outside lower leg bone at ankle

Medicare pricing data for 8,710 providers across 50 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 outside lower leg bone at ankle (HCPCS code 27786) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $280.93, but hospitals typically charge $1,164 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$56.19

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $280.93, your out-of-pocket cost would be approximately $56.19. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$280.93
Average Hospital Charge
$1,164
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,163.91
Medicare Allowed$280.93
Medicare Payment$216.66

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $216.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$336$2,101257516+19.5%
New York$330$1,7265641,028+17.3%
Puerto Rico$322$4051114+14.6%
Connecticut$319$1,064132250+13.5%
Maryland$311$1,162252427+10.9%
Rhode Island$306$1,0534363+8.9%
Montana$301$885718+7.3%
Wyoming$299$8331216+6.6%
Massachusetts$299$1,283284555+6.3%
Pennsylvania$297$1,0436041,187+5.9%
Hawaii$297$1,0672432+5.8%
California$293$1,247540812+4.4%
Florida$292$1,1596321,230+3.9%
Delaware$285$1,23051111+1.3%
New Hampshire$283$1,3062636+0.9%
Alaska$282$1,7901621+0.5%
Michigan$281$885398618+0.1%
Colorado$278$1,435122180-1.1%
Indiana$277$885239453-1.4%
Louisiana$276$90480157-1.7%
Utah$276$84580114-1.9%
South Carolina$276$938137284-1.9%
South Dakota$274$1,0052838-2.3%
Nevada$271$1,5466399-3.7%
Georgia$269$1,193216371-4.3%
New Mexico$269$9474679-4.4%
Alabama$268$884201372-4.5%
Washington$267$1,082120169-4.9%
Maine$267$9332130-5.0%
Oregon$266$1,0686285-5.3%
Iowa$266$947110222-5.5%
Arizona$265$1,160140222-5.6%
Arkansas$265$7853465-5.6%
Kansas$265$945101167-5.8%
North Dakota$264$1,1552430-6.0%
Wisconsin$263$1,883125173-6.5%
West Virginia$262$88281162-6.9%
Ohio$261$982536853-6.9%
Nebraska$260$8772735-7.6%
Missouri$259$973207358-7.7%
Texas$259$1,225442601-7.7%
Minnesota$259$1,195160216-7.7%
Kentucky$259$939127208-7.8%
Illinois$258$1,091347724-8.3%
Tennessee$256$1,125202329-8.9%
Oklahoma$255$1,05678113-9.1%
Idaho$254$9313144-9.5%
North Carolina$254$1,053286418-9.6%
Mississippi$254$1,229114200-9.7%
Virginia$225$876221461-19.9%

⚠️ 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