37226

Insertion of stent in arteries of leg

Medicare pricing data for 5,134 providers across 52 states

🤖AI Overview

This procedure has a 7.5x markup — hospitals charge $9,796 but Medicare allows only $1,312. Uninsured patients may face bills 7.5 times higher than what insurance negotiates. Prices vary significantly by location — from $349 in Nebraska to $2,953 in Maryland. 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

Insertion of stent in arteries of leg (HCPCS code 37226) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,312, but hospitals typically charge $9,796 — a 7.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$262.31

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,312, your out-of-pocket cost would be approximately $262.31. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,312
Average Hospital Charge
$9,796
Markup Ratio
7.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$9,795.56
Medicare Allowed$1,311.54
Medicare Payment$1,044.65

Hospitals charge 7.5x more than what Medicare allows for this procedure. Medicare actually pays $1,045 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$2,953$8,66797414+125.2%
Delaware$2,730$13,22222108+108.1%
Connecticut$2,446$18,09357139+86.5%
California$2,360$16,2983851,242+80.0%
Kansas$2,291$9,10754264+74.7%
Georgia$1,723$16,136156429+31.3%
New Jersey$1,692$13,431159548+29.0%
Michigan$1,647$6,127174453+25.6%
Florida$1,630$7,7944471,302+24.2%
Massachusetts$1,588$9,332127455+21.1%
Louisiana$1,582$15,509105246+20.6%
North Carolina$1,579$11,428150497+20.4%
Mississippi$1,505$12,2394082+14.7%
Arizona$1,427$6,952122352+8.8%
South Dakota$1,374$5,33929142+4.8%
Texas$1,345$9,3944601,199+2.6%
Oregon$1,309$7,71553172-0.2%
Alabama$1,223$6,88875223-6.8%
New York$1,184$19,0853141,204-9.7%
Tennessee$1,176$8,170146537-10.4%
South Carolina$971$6,85396322-26.0%
Illinois$927$12,279200556-29.3%
Virginia$926$8,123131319-29.4%
Alaska$903$51,044821-31.1%
Wisconsin$867$9,628111296-33.9%
Arkansas$741$3,46861258-43.5%
Indiana$734$9,705103302-44.0%
Missouri$720$7,343111374-45.1%
Washington$681$4,33676282-48.1%
Kentucky$666$3,18583366-49.3%
Pennsylvania$565$4,898252857-56.9%
District of Columbia$496$3,448948-62.2%
Oklahoma$451$1,88964218-65.6%
Nevada$450$2,9093170-65.7%
Rhode Island$432$5,7031470-67.0%
Montana$430$4,1991639-67.3%
West Virginia$429$2,72528141-67.3%
Wyoming$427$2,977945-67.4%
New Mexico$422$5,0871232-67.8%
Ohio$414$3,190156477-68.4%
Maine$408$5,2931853-68.9%
Minnesota$407$5,67180294-69.0%
New Hampshire$401$6,7543399-69.4%
Colorado$384$5,09357120-70.7%
North Dakota$381$4,3292063-71.0%
Iowa$372$13,2983594-71.6%
Hawaii$372$3,388721-71.7%
Idaho$368$3,7302591-71.9%
Utah$354$1,5022362-73.0%
Puerto Rico$352$2,279915-73.2%
Vermont$351$44,090516-73.2%
Nebraska$349$12,12930136-73.4%

⚠️ 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