43244

Tying of dilated veins of stomach and/or esophagus using a flexible endoscope

Medicare pricing data for 6,644 providers across 51 states

🤖AI Overview

Prices vary significantly by location — from $212 in Nebraska to $430 in Wyoming. 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

Tying of dilated veins of stomach and/or esophagus using a flexible endoscope (HCPCS code 43244) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $265.63, but hospitals typically charge $1,116 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$53.13

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $265.63, your out-of-pocket cost would be approximately $53.13. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$265.63
Average Hospital Charge
$1,116
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,115.82
Medicare Allowed$265.63
Medicare Payment$206.55

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $206.55 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wyoming$430$1,7111149+61.7%
Alaska$369$1,8341846+38.8%
Nevada$369$1,00155209+38.7%
Rhode Island$343$1,3632156+28.9%
Mississippi$326$1,25764232+22.6%
Louisiana$313$1,14382225+17.7%
California$307$1,2286722,068+15.7%
Kansas$306$1,83261324+15.2%
Utah$284$1,38660188+6.8%
Minnesota$280$1,328140328+5.3%
Colorado$279$1,023123315+5.2%
Iowa$276$1,40061196+3.8%
Indiana$275$1,822166531+3.5%
Texas$272$1,2225601,665+2.6%
South Dakota$271$7992074+2.1%
Florida$270$9504471,077+1.5%
Arizona$268$1,009146370+0.9%
Illinois$267$1,360249761+0.6%
New York$265$1,116276556-0.1%
New Jersey$265$1,420159301-0.1%
District of Columbia$264$8732177-0.5%
Tennessee$260$1,108163495-2.1%
Washington$255$833165591-4.1%
Michigan$254$815241567-4.4%
Ohio$253$920279739-4.6%
Massachusetts$250$963182408-5.9%
Maryland$250$841110275-6.0%
Connecticut$248$1,10381133-6.6%
Arkansas$247$81750163-6.9%
Pennsylvania$247$880325732-6.9%
Idaho$247$70944117-7.1%
Georgia$243$927169451-8.4%
Alabama$242$1,04093245-9.0%
Wisconsin$241$2,461138341-9.1%
Missouri$241$1,103156419-9.3%
Oregon$240$85579191-9.5%
South Carolina$240$999104282-9.8%
Delaware$239$5901840-10.0%
Montana$239$6741759-10.2%
New Hampshire$238$1,80946110-10.4%
Hawaii$234$6821527-11.8%
North Carolina$231$942222612-12.9%
Virginia$231$816173528-12.9%
New Mexico$230$78822100-13.6%
West Virginia$227$72831101-14.5%
Oklahoma$225$65460242-15.2%
Vermont$225$1,247818-15.2%
North Dakota$225$1,0001675-15.5%
Maine$224$8692373-15.7%
Kentucky$224$742102414-15.7%
Nebraska$212$83841113-20.3%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber