29085

Application of hand and lower forearm cast

Medicare pricing data for 2,009 providers across 43 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Application of hand and lower forearm cast (HCPCS code 29085) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $90.53, but hospitals typically charge $296.89 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.11

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $90.53, your out-of-pocket cost would be approximately $18.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$90.53
Average Hospital Charge
$296.89
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$296.89
Medicare Allowed$90.53
Medicare Payment$69.39

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $69.39 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$106$33730107+17.2%
California$103$315174758+13.9%
Connecticut$100$3063392+10.3%
New York$98$43079172+8.7%
Massachusetts$98$34035174+8.0%
Maryland$98$22332110+7.7%
Illinois$96$316116494+6.3%
Florida$96$31598398+6.2%
Delaware$96$29519111+6.2%
Washington$93$27443114+3.3%
Pennsylvania$92$27251145+1.9%
Colorado$92$28848143+1.6%
Michigan$91$23262311+0.7%
Texas$91$2821113430.0%
Nevada$90$44434116-0.9%
Ohio$89$2273364-2.2%
Georgia$88$33773240-2.4%
Arizona$88$26554193-2.7%
Virginia$88$26968179-3.0%
New Hampshire$87$2601975-3.8%
Minnesota$87$3263881-3.8%
Louisiana$87$2913083-4.4%
Montana$86$2341739-5.1%
South Carolina$86$21842137-5.3%
Missouri$86$2542667-5.3%
Kentucky$85$2021013-5.6%
South Dakota$84$3881129-7.1%
Wisconsin$84$62851134-7.2%
Oklahoma$84$21546237-7.6%
Oregon$83$29643135-7.9%
North Carolina$83$292133379-8.0%
Utah$83$2081441-8.1%
Indiana$81$25851139-10.3%
Alabama$81$21542108-10.4%
Tennessee$80$27882263-11.4%
Nebraska$80$3272167-11.4%
Arkansas$80$1982152-11.8%
Maine$79$2252171-12.4%
Kansas$78$2302462-13.4%
Iowa$76$3041928-15.8%
Mississippi$68$2431022-24.7%
Vermont$64$161513-28.9%
Idaho$56$2341174-38.0%

⚠️ 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