44143

Partial removal of large bowel with creation of opening from large bowel to skin

Medicare pricing data for 6,144 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

Partial removal of large bowel with creation of opening from large bowel to skin (HCPCS code 44143) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,363, but hospitals typically charge $4,995 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$272.60

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,363, your out-of-pocket cost would be approximately $272.60. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,363
Average Hospital Charge
$4,995
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,995.18
Medicare Allowed$1,363.00
Medicare Payment$1,086.70

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $1,087 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$1,738$5,2282234+27.5%
Michigan$1,526$4,114169239+11.9%
New York$1,513$7,509344545+11.0%
Virginia$1,505$4,187140208+10.4%
Hawaii$1,475$3,3501012+8.2%
Maryland$1,467$4,087140233+7.6%
Connecticut$1,451$5,99292145+6.5%
Illinois$1,447$5,449250415+6.2%
Georgia$1,427$4,698177267+4.7%
New Jersey$1,427$10,405186400+4.7%
Massachusetts$1,423$5,334154235+4.4%
Florida$1,419$4,596500883+4.1%
Nevada$1,413$4,3354978+3.6%
California$1,400$4,804444658+2.7%
Texas$1,400$5,310368534+2.7%
Pennsylvania$1,393$4,413317453+2.2%
Delaware$1,380$3,7362341+1.2%
Alaska$1,380$13,7582334+1.2%
Tennessee$1,377$4,305141215+1.0%
Ohio$1,372$4,500246340+0.6%
Louisiana$1,356$4,38776108-0.5%
Wyoming$1,349$3,9831323-1.1%
Mississippi$1,348$3,9305397-1.1%
Arizona$1,343$4,098118206-1.4%
Oklahoma$1,339$3,71569129-1.8%
Montana$1,330$4,1154157-2.4%
South Carolina$1,318$4,419119202-3.3%
North Carolina$1,310$4,143196274-3.9%
Alabama$1,297$3,07891137-4.8%
Iowa$1,296$4,3465892-4.9%
New Mexico$1,290$4,6744356-5.3%
Kentucky$1,282$3,600110195-5.9%
Missouri$1,274$4,052120189-6.5%
West Virginia$1,260$4,1115991-7.5%
Arkansas$1,254$3,18467118-8.0%
Rhode Island$1,247$4,1922228-8.5%
Washington$1,239$4,104151242-9.1%
Utah$1,226$3,8863143-10.1%
Wisconsin$1,221$8,517136183-10.4%
Kansas$1,220$3,3165796-10.5%
North Dakota$1,219$4,7921926-10.6%
Maine$1,185$3,4234967-13.1%
Minnesota$1,185$5,944121167-13.1%
Oregon$1,180$4,385101138-13.4%
Colorado$1,158$4,006102137-15.1%
Indiana$1,156$3,416137215-15.2%
New Hampshire$1,146$5,6684158-15.9%
Vermont$1,111$5,4341316-18.5%
Nebraska$1,051$3,9225177-22.9%
South Dakota$965$3,3943147-29.2%
Idaho$903$3,5603951-33.7%

⚠️ 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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