33949

Daily management of ecmo external vein to artery blood circulation in heart and lungs using a pump

Medicare pricing data for 955 providers across 30 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

Daily management of ecmo external vein to artery blood circulation in heart and lungs using a pump (HCPCS code 33949) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $228.15, but hospitals typically charge $992.17 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$45.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $228.15, your out-of-pocket cost would be approximately $45.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$228.15
Average Hospital Charge
$992.17
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$992.17
Medicare Allowed$228.15
Medicare Payment$181.94

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $181.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$253$1,22341294+10.7%
District of Columbia$251$7251268+10.0%
Connecticut$249$1,259442+9.2%
New York$249$1,71440253+9.2%
New Jersey$248$1,56517100+8.7%
Maryland$243$77423116+6.5%
Florida$242$91146388+5.9%
California$238$1,11290742+4.3%
Michigan$236$81942141+3.4%
Virginia$231$70833172+1.1%
Pennsylvania$227$85764444-0.5%
Massachusetts$226$99743278-0.8%
Colorado$226$8431249-1.1%
Texas$225$83794711-1.6%
Georgia$222$96427155-2.6%
North Carolina$222$1,13314116-2.8%
Utah$220$6701342-3.4%
Ohio$219$1,05868307-3.9%
Oklahoma$219$4747134-4.0%
South Carolina$215$1,0021347-5.6%
Kentucky$215$6502879-5.7%
Minnesota$212$1,23229340-7.0%
Alabama$212$96110115-7.1%
Arizona$211$1,0091981-7.4%
Indiana$210$6741263-7.9%
Missouri$209$7961372-8.4%
Wisconsin$209$2,6251252-8.4%
Arkansas$206$525746-9.9%
Tennessee$205$77429130-10.0%
Nebraska$184$61919113-19.3%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber