37228

Balloon dilation of artery of leg, initial vessel

Medicare pricing data for 6,330 providers across 52 states

🤖AI Overview

This procedure has a 6.9x markup — hospitals charge $7,308 but Medicare allows only $1,060. Uninsured patients may face bills 6.9 times higher than what insurance negotiates. Prices vary significantly by location — from $397 in Nebraska to $1,737 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

Balloon dilation of artery of leg, initial vessel (HCPCS code 37228) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,060, but hospitals typically charge $7,308 — a 6.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$211.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,060, your out-of-pocket cost would be approximately $211.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,060
Average Hospital Charge
$7,308
Markup Ratio
6.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$7,307.66
Medicare Allowed$1,059.84
Medicare Payment$844.45

Hospitals charge 6.9x more than what Medicare allows for this procedure. Medicare actually pays $844.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$1,737$7,052114764+63.9%
Arizona$1,723$7,130185664+62.6%
Connecticut$1,697$13,70366251+60.1%
Nevada$1,673$5,77843138+57.9%
Delaware$1,606$8,79025156+51.6%
California$1,391$10,1896023,046+31.2%
Alaska$1,363$36,5871871+28.6%
Mississippi$1,319$9,41864273+24.4%
Kansas$1,264$6,67156409+19.3%
New Jersey$1,251$8,699191835+18.0%
Michigan$1,245$4,453214732+17.5%
South Dakota$1,218$5,66229287+14.9%
Georgia$1,186$10,705191622+11.9%
Florida$1,171$6,2195512,215+10.5%
Massachusetts$1,136$7,282121582+7.2%
Louisiana$1,132$9,620118337+6.8%
Texas$1,126$7,2536432,598+6.3%
New York$1,105$13,4553461,692+4.3%
Utah$1,011$4,84535107-4.6%
District of Columbia$992$4,48713146-6.4%
New Mexico$982$5,37322118-7.4%
Tennessee$978$5,331154683-7.7%
Oregon$960$4,53959243-9.4%
Virginia$917$4,774168569-13.5%
North Carolina$909$7,2111921,002-14.2%
Washington$899$4,24685439-15.2%
South Carolina$876$9,414116414-17.3%
Alabama$830$3,59696308-21.7%
Arkansas$791$3,65880441-25.4%
Illinois$781$6,9612781,272-26.3%
Iowa$772$10,24652183-27.2%
Wisconsin$763$8,209119450-28.0%
Colorado$704$4,40074265-33.6%
Indiana$696$5,951135576-34.3%
Kentucky$689$3,12181417-35.0%
Missouri$671$5,526125478-36.7%
Oklahoma$636$3,50485362-40.0%
Ohio$591$2,490181808-44.2%
Pennsylvania$582$4,215255898-45.1%
Minnesota$562$6,02690364-46.9%
Rhode Island$509$4,0291584-52.0%
Puerto Rico$494$5631222-53.4%
West Virginia$489$2,84034183-53.8%
Montana$489$2,6931860-53.9%
Maine$484$4,4272465-54.3%
New Hampshire$483$8,68833119-54.4%
Hawaii$473$2,4051556-55.4%
Vermont$467$19,837414-55.9%
North Dakota$461$3,86119109-56.5%
Wyoming$461$3,691831-56.5%
Idaho$423$3,36230118-60.1%
Nebraska$397$9,68628121-62.6%

⚠️ 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