31600

Incision of windpipe for insertion of breathing tube (older than 2 years)

Medicare pricing data for 7,334 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

Incision of windpipe for insertion of breathing tube (older than 2 years) (HCPCS code 31600) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $289.78, but hospitals typically charge $1,357 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$57.96

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $289.78, your out-of-pocket cost would be approximately $57.96. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$289.78
Average Hospital Charge
$1,357
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,357.43
Medicare Allowed$289.78
Medicare Payment$230.78

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $230.78 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$354$2,8901521+22.3%
New York$332$2,3004401,301+14.7%
Illinois$310$1,642270657+7.0%
Maryland$305$1,202168417+5.1%
Nevada$304$99467160+5.0%
Hawaii$304$8372329+4.8%
Florida$303$1,2445891,417+4.5%
New Jersey$302$1,871207522+4.1%
District of Columbia$301$1,33049175+4.0%
Massachusetts$301$1,503180447+3.8%
Connecticut$298$1,65670154+2.9%
Montana$298$1,1842341+2.7%
Maine$297$1,0762040+2.6%
California$297$1,3977621,962+2.4%
Delaware$294$1,0453478+1.3%
New Mexico$292$1,0543962+0.8%
Washington$291$993137211+0.4%
Rhode Island$291$1,0461927+0.3%
New Hampshire$290$2,6823153+0.0%
Michigan$290$1,016241535+0.0%
Colorado$288$1,257108169-0.7%
Virginia$287$1,012169365-1.1%
Puerto Rico$286$7091721-1.4%
Louisiana$286$1,166136280-1.5%
Pennsylvania$285$1,420363760-1.7%
West Virginia$284$1,0774586-2.0%
Georgia$283$1,154228579-2.2%
Texas$282$1,1975771,278-2.6%
Missouri$282$1,202178368-2.8%
Idaho$281$1,0172943-3.2%
Arizona$280$978144273-3.5%
Ohio$279$1,279300654-3.8%
Kentucky$278$955145302-4.1%
Oklahoma$271$85789263-6.5%
Tennessee$271$1,056184448-6.6%
North Dakota$268$1,1742143-7.5%
Wisconsin$266$2,818104168-8.1%
South Carolina$266$1,262137279-8.1%
Minnesota$265$1,615108250-8.7%
Indiana$264$1,003133281-8.8%
Utah$264$8783356-8.8%
Mississippi$264$1,25387216-9.0%
North Carolina$262$1,216201391-9.6%
Arkansas$261$88766231-9.9%
Nebraska$259$9394269-10.5%
Alabama$257$1,093114318-11.2%
South Dakota$257$1,0581324-11.3%
Kansas$253$99642101-12.8%
Iowa$251$1,6175096-13.5%
Oregon$244$99755104-15.6%

⚠️ 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