Replacement of stomach stoma tube
Medicare pricing data for 22,671 providers across 52 states
This procedure has a 6.7x markup — hospitals charge $484.42 but Medicare allows only $72.53. Uninsured patients may face bills 6.7 times higher than what insurance negotiates. Prices vary significantly by location — from $32 in North Dakota to $111 in Rhode Island. 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
Replacement of stomach stoma tube (HCPCS code 43762) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $72.53, but hospitals typically charge $484.42 — a 6.7x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $72.53, your out-of-pocket cost would be approximately $14.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.7x more than what Medicare allows for this procedure. Medicare actually pays $56.17 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Rhode Island | $111 | $530 | 67 | 157 | +53.0% |
| California | $105 | $547 | 2,442 | 6,987 | +45.2% |
| New York | $104 | $538 | 1,600 | 4,324 | +43.9% |
| Hawaii | $100 | $413 | 81 | 164 | +38.0% |
| Nevada | $94 | $472 | 125 | 247 | +29.4% |
| Florida | $88 | $566 | 1,487 | 3,010 | +21.9% |
| New Hampshire | $88 | $438 | 70 | 127 | +21.5% |
| Montana | $84 | $377 | 49 | 76 | +16.4% |
| South Dakota | $84 | $372 | 50 | 115 | +16.0% |
| Nebraska | $84 | $479 | 144 | 239 | +15.1% |
| Washington | $81 | $471 | 274 | 450 | +11.5% |
| Delaware | $78 | $422 | 110 | 196 | +8.1% |
| Maryland | $78 | $362 | 405 | 777 | +7.3% |
| District of Columbia | $77 | $353 | 74 | 114 | +5.5% |
| New Jersey | $75 | $686 | 631 | 1,272 | +3.0% |
| Virginia | $74 | $416 | 464 | 819 | +2.5% |
| North Carolina | $70 | $452 | 720 | 1,136 | -3.1% |
| Massachusetts | $68 | $522 | 648 | 1,229 | -6.4% |
| Oregon | $67 | $444 | 130 | 247 | -8.2% |
| New Mexico | $65 | $372 | 89 | 173 | -11.0% |
| Indiana | $63 | $573 | 472 | 781 | -13.1% |
| Georgia | $61 | $429 | 689 | 1,146 | -16.2% |
| Minnesota | $60 | $523 | 271 | 502 | -17.6% |
| Iowa | $58 | $510 | 170 | 283 | -20.3% |
| Louisiana | $58 | $456 | 555 | 1,118 | -20.4% |
| Texas | $57 | $503 | 1,884 | 3,532 | -20.9% |
| Arizona | $57 | $450 | 206 | 296 | -21.0% |
| South Carolina | $57 | $448 | 474 | 924 | -21.2% |
| Colorado | $57 | $336 | 233 | 332 | -22.0% |
| Connecticut | $56 | $485 | 256 | 393 | -22.3% |
| Kansas | $56 | $346 | 201 | 372 | -23.3% |
| Ohio | $56 | $351 | 975 | 1,527 | -23.5% |
| Tennessee | $55 | $407 | 539 | 1,071 | -24.3% |
| Idaho | $54 | $308 | 69 | 94 | -25.0% |
| Wisconsin | $53 | $841 | 403 | 832 | -26.7% |
| Illinois | $53 | $550 | 1,052 | 1,880 | -27.5% |
| Pennsylvania | $52 | $364 | 1,048 | 1,869 | -28.3% |
| Kentucky | $52 | $421 | 394 | 635 | -28.5% |
| Missouri | $50 | $362 | 437 | 768 | -31.1% |
| Oklahoma | $48 | $356 | 316 | 599 | -33.8% |
| Alaska | $46 | $1,192 | 29 | 36 | -36.7% |
| Alabama | $45 | $388 | 378 | 633 | -37.9% |
| Michigan | $45 | $318 | 899 | 1,461 | -38.6% |
| Mississippi | $44 | $337 | 350 | 925 | -39.2% |
| Arkansas | $44 | $376 | 276 | 604 | -39.2% |
| Puerto Rico | $37 | $312 | 29 | 41 | -49.2% |
| Wyoming | $35 | $313 | 22 | 25 | -51.3% |
| West Virginia | $35 | $274 | 113 | 174 | -52.0% |
| Maine | $34 | $256 | 59 | 85 | -53.3% |
| Vermont | $33 | $378 | 20 | 29 | -54.0% |
| Utah | $33 | $358 | 64 | 123 | -54.8% |
| North Dakota | $32 | $571 | 66 | 166 | -55.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber
🏥 See Medicare hospital data on OpenMedicare