44207

Partial removal of large bowel and reattachment to rectum using an endoscope

Medicare pricing data for 4,366 providers across 52 states

🤖AI Overview

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 and reattachment to rectum using an endoscope (HCPCS code 44207) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,398, but hospitals typically charge $5,472 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$279.66

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,398, your out-of-pocket cost would be approximately $279.66. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,398
Average Hospital Charge
$5,472
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,472.32
Medicare Allowed$1,398.32
Medicare Payment$1,114.17

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $1,114 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$1,761$2,440818+25.9%
Maryland$1,678$5,35374226+20.0%
Virginia$1,619$4,41290256+15.8%
Rhode Island$1,608$5,9571138+15.0%
Michigan$1,575$4,161107237+12.7%
Illinois$1,563$6,616175480+11.8%
New York$1,561$8,162260724+11.6%
Massachusetts$1,555$6,339111342+11.2%
Pennsylvania$1,548$4,838173458+10.7%
Connecticut$1,503$6,65150119+7.5%
Texas$1,501$6,156310903+7.3%
Ohio$1,477$6,365166390+5.6%
Alaska$1,474$15,6121026+5.4%
Georgia$1,472$5,021111305+5.3%
Montana$1,464$4,1562956+4.7%
California$1,450$5,1053501,042+3.7%
Florida$1,445$4,8883441,055+3.3%
New Jersey$1,444$9,356116383+3.3%
Louisiana$1,420$4,2874598+1.5%
Missouri$1,398$4,71676260-0.0%
Kentucky$1,375$3,78868144-1.7%
Minnesota$1,367$7,12692185-2.3%
Oklahoma$1,365$3,68251214-2.3%
Vermont$1,361$7,154917-2.6%
District of Columbia$1,357$4,3321964-3.0%
Tennessee$1,324$5,18783249-5.3%
West Virginia$1,320$4,4851826-5.6%
New Mexico$1,320$4,7161938-5.6%
New Hampshire$1,308$8,7062768-6.5%
Kansas$1,298$4,05667180-7.2%
Indiana$1,294$3,95996218-7.5%
Iowa$1,285$4,1514295-8.1%
Hawaii$1,270$4,231712-9.2%
Washington$1,259$4,480126335-10.0%
South Carolina$1,243$4,92287274-11.1%
Wisconsin$1,235$12,871103197-11.7%
Nevada$1,231$6,4852090-11.9%
Arizona$1,228$4,329105353-12.2%
Colorado$1,213$4,23792194-13.3%
Alabama$1,205$3,18271194-13.8%
Oregon$1,200$4,704102239-14.2%
Arkansas$1,194$3,71458179-14.6%
Mississippi$1,178$4,19251150-15.7%
South Dakota$1,172$4,4611938-16.2%
Utah$1,154$3,8703262-17.5%
North Carolina$1,146$4,143151483-18.0%
Delaware$1,096$2,6341972-21.6%
North Dakota$1,089$4,1781631-22.1%
Maine$1,066$3,5402445-23.8%
Wyoming$1,030$2,274527-26.3%
Nebraska$940$4,39237107-32.7%
Idaho$924$3,5303387-33.9%

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

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