44005

Release of intestinal scar tissue

Medicare pricing data for 5,550 providers across 51 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Release of intestinal scar tissue (HCPCS code 44005) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $930.19, but hospitals typically charge $3,281 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$186.04

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $930.19, your out-of-pocket cost would be approximately $186.04. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$930.19
Average Hospital Charge
$3,281
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,280.97
Medicare Allowed$930.19
Medicare Payment$740.29

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $740.29 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,287$9,1131821+38.4%
District of Columbia$1,165$3,1692131+25.2%
Maryland$1,041$2,753117181+11.9%
Virginia$1,034$2,765147221+11.2%
Michigan$1,025$2,707188245+10.2%
New York$1,010$4,760297391+8.6%
Illinois$1,003$3,779233336+7.8%
Louisiana$986$2,83578122+6.0%
Georgia$982$3,233152216+5.5%
Massachusetts$978$3,524150217+5.1%
North Dakota$974$3,5641523+4.7%
Florida$965$3,165353510+3.7%
Nevada$957$3,0244775+2.9%
Texas$955$3,340329457+2.6%
California$955$3,376398549+2.6%
Pennsylvania$953$3,054280377+2.4%
Ohio$942$3,037225305+1.3%
Hawaii$937$1,9911417+0.7%
New Jersey$925$5,897139195-0.5%
West Virginia$924$3,1153144-0.7%
Oklahoma$920$2,62071101-1.1%
Rhode Island$919$3,0401920-1.2%
Tennessee$918$2,666127182-1.3%
Mississippi$913$2,41772124-1.8%
Kansas$912$2,5323952-2.0%
Connecticut$906$3,7616983-2.6%
Montana$901$2,5903350-3.1%
North Carolina$892$2,912179239-4.1%
Washington$891$2,816133173-4.2%
Utah$888$2,5954273-4.5%
Kentucky$879$2,42392115-5.5%
Oregon$876$3,05988111-5.9%
Alabama$875$2,19580103-5.9%
Colorado$871$2,741123162-6.3%
Delaware$871$2,3132745-6.4%
New Hampshire$871$4,7554359-6.4%
Arizona$863$2,975114159-7.2%
South Carolina$856$2,790105156-8.0%
Missouri$853$2,849126164-8.3%
Arkansas$850$2,1225367-8.6%
New Mexico$825$2,6443347-11.3%
Minnesota$818$4,075124151-12.1%
Iowa$813$2,9887084-12.6%
Maine$809$2,3343236-13.1%
Indiana$806$2,160122172-13.3%
Wisconsin$799$6,314151189-14.1%
Vermont$771$3,1631418-17.1%
South Dakota$763$2,4523138-18.0%
Wyoming$734$2,9222130-21.1%
Idaho$722$2,2603551-22.3%
Nebraska$720$2,4914255-22.6%

⚠️ 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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