29826

Shaving of part of shoulder bone and repair of ligament using an endoscope

Medicare pricing data for 12,656 providers across 52 states

🤖AI Overview

This procedure has a 14.8x markup — hospitals charge $1,742 but Medicare allows only $117.32. Uninsured patients may face bills 14.8 times higher than what insurance negotiates. Prices vary significantly by location — from $89 in Nebraska to $179 in District of Columbia. 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

Shaving of part of shoulder bone and repair of ligament using an endoscope (HCPCS code 29826) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $117.32, but hospitals typically charge $1,742 — a 14.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$23.46

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $117.32, your out-of-pocket cost would be approximately $23.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$117.32
Average Hospital Charge
$1,742
Markup Ratio
14.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,742.12
Medicare Allowed$117.32
Medicare Payment$93.61

Hospitals charge 14.8x more than what Medicare allows for this procedure. Medicare actually pays $93.61 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$179$2,17418104+52.7%
Puerto Rico$170$9611949+45.3%
Alaska$147$3,88844262+25.6%
New York$140$3,4807503,878+19.4%
California$136$1,3838996,672+16.0%
Hawaii$135$1,16728202+15.0%
New Mexico$134$1,57255309+14.0%
Maryland$131$1,2022381,797+11.7%
Mississippi$126$2,3951001,307+7.3%
Massachusetts$125$2,9673082,374+6.1%
Georgia$124$2,0403762,417+5.9%
Tennessee$123$1,5542972,170+5.1%
Florida$121$1,0158807,195+2.9%
Kentucky$120$1,394135974+2.7%
Michigan$120$1,0663622,372+2.6%
Virginia$120$1,5262842,868+2.4%
Illinois$120$3,4684873,133+2.3%
Connecticut$120$2,285183803+2.3%
Ohio$119$1,5855002,991+1.6%
Nevada$118$2,4411071,366+0.8%
Texas$118$1,1868106,223+0.7%
Oklahoma$117$7741941,940+0.0%
South Carolina$117$1,9222302,243-0.5%
Rhode Island$117$1,25951280-0.5%
New Hampshire$117$3,21781505-0.6%
Missouri$116$1,9092561,670-0.8%
West Virginia$116$1,22256284-0.8%
Wyoming$116$2,46842298-1.3%
Arkansas$115$9671161,155-2.4%
Pennsylvania$114$1,9215273,271-3.0%
New Jersey$114$6,1293881,895-3.2%
Louisiana$112$1,5161801,078-4.4%
Washington$111$9562942,010-5.7%
Delaware$110$1,58540471-6.5%
North Carolina$110$1,3174753,853-6.6%
Colorado$107$1,2703112,148-8.5%
Oregon$107$840127776-8.6%
Utah$107$1,0421511,210-9.2%
Arizona$105$9612742,281-10.5%
Alabama$104$2,1102962,602-11.3%
Iowa$104$1,089113862-11.5%
Minnesota$103$9532811,152-11.8%
Indiana$103$2,1433031,822-12.1%
Kansas$101$1,1171461,368-14.1%
Montana$98$59476855-16.3%
Idaho$97$71095673-17.0%
Maine$96$54468256-17.8%
Wisconsin$96$3,2712671,313-18.5%
North Dakota$96$61750333-18.5%
Vermont$95$1,72922139-19.3%
South Dakota$91$64893879-22.6%
Nebraska$89$1,1711171,051-24.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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