37224

Balloon dilation of artery of leg

Medicare pricing data for 6,927 providers across 51 states

🤖AI Overview

This procedure has a 8.5x markup — hospitals charge $5,017 but Medicare allows only $587.30. Uninsured patients may face bills 8.5 times higher than what insurance negotiates. Prices vary significantly by location — from $250 in Hawaii to $1,340 in Alaska. 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

Balloon dilation of artery of leg (HCPCS code 37224) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $587.30, but hospitals typically charge $5,017 — a 8.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$117.46

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $587.30, your out-of-pocket cost would be approximately $117.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$587.30
Average Hospital Charge
$5,017
Markup Ratio
8.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,017.42
Medicare Allowed$587.30
Medicare Payment$467.03

Hospitals charge 8.5x more than what Medicare allows for this procedure. Medicare actually pays $467.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,340$21,8231796+128.2%
Connecticut$1,000$8,98278273+70.3%
Maryland$997$4,551117705+69.8%
Arizona$848$4,528183559+44.4%
California$796$7,1666322,703+35.5%
Michigan$725$2,680248735+23.5%
Louisiana$725$7,388144367+23.4%
Florida$703$4,3245911,941+19.7%
Delaware$700$5,04632118+19.2%
Mississippi$698$5,34469268+18.9%
Georgia$676$7,776195579+15.0%
New Jersey$670$6,588198722+14.2%
Massachusetts$647$4,425137673+10.2%
New York$641$10,0153541,477+9.1%
Nevada$635$5,83949136+8.1%
Texas$622$5,0196792,139+5.9%
Virginia$596$2,756182663+1.5%
Oregon$565$2,82168273-3.9%
Tennessee$564$3,177180627-4.0%
Alabama$549$2,563105280-6.5%
Kansas$535$4,76361370-8.8%
North Carolina$523$5,415212865-11.0%
South Carolina$479$7,741111435-18.5%
Illinois$466$5,2993071,216-20.7%
Washington$454$2,623118535-22.6%
Colorado$444$2,99173274-24.4%
Iowa$431$6,01056209-26.6%
Wisconsin$417$8,089143560-29.0%
Kentucky$405$1,727104385-31.0%
Arkansas$405$1,87285386-31.0%
Missouri$395$3,794141536-32.7%
Minnesota$386$4,05799423-34.2%
District of Columbia$385$2,81114141-34.5%
Pennsylvania$382$2,9182931,169-34.9%
Ohio$377$1,939212979-35.8%
Indiana$357$4,168150573-39.2%
Oklahoma$350$1,928101478-40.4%
New Hampshire$348$4,73237173-40.7%
Montana$343$2,3403087-41.7%
West Virginia$340$2,13942201-42.1%
Wyoming$334$5,906928-43.1%
Maine$330$2,53832105-43.8%
Rhode Island$329$3,42919124-44.0%
New Mexico$327$2,9571577-44.3%
Utah$313$3,4062671-46.8%
North Dakota$306$3,25326132-47.9%
Idaho$306$3,07431156-47.9%
Puerto Rico$297$3,1501221-49.4%
South Dakota$296$1,41823161-49.7%
Nebraska$286$6,14433208-51.3%
Hawaii$250$2,2301647-57.4%

⚠️ 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