37227

Removal of plaque and insertion of stents in arteries of leg

Medicare pricing data for 3,230 providers across 46 states

🤖AI Overview

Prices vary significantly by location — from $491 in Montana to $12,701 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

Removal of plaque and insertion of stents in arteries of leg (HCPCS code 37227) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8,419, but hospitals typically charge $27,552 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1,684

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8,419, your out-of-pocket cost would be approximately $1,684. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$8,419
Average Hospital Charge
$27,552
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$27,552.07
Medicare Allowed$8,418.98
Medicare Payment$6,714.84

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $6,715 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$12,701$61,252218+50.9%
District of Columbia$12,249$31,188642+45.5%
Maryland$11,311$25,64667985+34.3%
Hawaii$11,181$36,011242+32.8%
New Jersey$10,603$33,6391271,124+25.9%
California$10,028$31,9612712,118+19.1%
New York$9,999$32,9251951,473+18.8%
Connecticut$9,992$42,50838142+18.7%
Virginia$9,471$35,60269303+12.5%
Oregon$9,237$31,13927150+9.7%
Delaware$9,177$30,7881693+9.0%
Massachusetts$9,065$40,96437244+7.7%
South Dakota$8,975$35,64514242+6.6%
Florida$8,724$24,6873982,811+3.6%
Michigan$8,298$20,86897500-1.4%
Tennessee$8,160$24,890108860-3.1%
Texas$8,107$27,3343651,634-3.7%
Arizona$7,961$23,587129614-5.4%
Nevada$7,737$20,96424128-8.1%
Washington$7,687$20,88430107-8.7%
South Carolina$7,542$25,04150170-10.4%
Kentucky$7,440$24,86037157-11.6%
Kansas$7,356$29,45437375-12.6%
Alabama$7,214$17,61863352-14.3%
Georgia$7,188$33,802110452-14.6%
Mississippi$7,115$29,69944251-15.5%
Pennsylvania$6,974$19,74487495-17.2%
Illinois$6,855$32,254113597-18.6%
Utah$6,737$17,5921285-20.0%
Colorado$6,610$29,1732773-21.5%
North Carolina$6,196$23,15378293-26.4%
Louisiana$5,762$30,36393307-31.6%
Wisconsin$5,747$19,8523380-31.7%
Indiana$5,531$20,88049172-34.3%
Oklahoma$5,454$27,36941265-35.2%
Missouri$5,142$19,79564275-38.9%
Iowa$4,740$25,71629128-43.7%
Nebraska$4,567$27,59116155-45.8%
New Mexico$4,370$14,709839-48.1%
Arkansas$4,328$11,57946224-48.6%
Minnesota$4,167$21,3372246-50.5%
Ohio$4,142$15,04373205-50.8%
West Virginia$684$2,9471144-91.9%
New Hampshire$679$23,976712-91.9%
Idaho$565$4,5471020-93.3%
Montana$491$11,890512-94.2%

⚠️ 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