44970

Removal of appendix using an endoscope

Medicare pricing data for 10,846 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

Removal of appendix using an endoscope (HCPCS code 44970) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $532.76, but hospitals typically charge $2,093 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$106.55

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $532.76, your out-of-pocket cost would be approximately $106.55. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$532.76
Average Hospital Charge
$2,093
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,093.16
Medicare Allowed$532.76
Medicare Payment$419.20

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $419.20 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$647$4,2983667+21.4%
Hawaii$600$1,5563670+12.6%
California$581$2,1828391,867+9.0%
Maryland$579$1,653205474+8.7%
Virginia$579$1,493295643+8.6%
New Jersey$579$5,905259572+8.6%
Illinois$577$2,399429904+8.3%
District of Columbia$568$1,8192950+6.6%
Michigan$560$1,573343573+5.2%
Massachusetts$557$2,117275621+4.5%
New York$556$3,5986231,127+4.4%
Texas$553$2,1296691,344+3.8%
Louisiana$552$1,669143255+3.7%
Georgia$549$1,907290567+3.0%
Nevada$548$1,89880171+2.8%
Ohio$541$1,661399743+1.5%
Rhode Island$538$1,6194788+1.0%
Florida$538$1,8316891,730+0.9%
Pennsylvania$532$1,754527993-0.2%
Kentucky$531$1,460161326-0.2%
Connecticut$529$2,218143223-0.8%
Tennessee$529$1,558228435-0.8%
North Dakota$525$2,0363467-1.5%
Arizona$524$1,774226586-1.7%
Puerto Rico$523$6501111-1.8%
South Carolina$519$1,720202485-2.6%
Vermont$513$2,3962651-3.7%
Delaware$510$1,24850108-4.3%
Washington$507$1,687277559-4.9%
Colorado$506$1,913231380-5.1%
Oklahoma$506$1,436120289-5.1%
North Carolina$505$1,722373712-5.2%
Montana$504$1,57556100-5.4%
Missouri$503$1,703231538-5.5%
Oregon$502$1,821168284-5.8%
Wyoming$499$2,6713571-6.4%
Iowa$494$1,665125281-7.2%
West Virginia$493$1,53770109-7.5%
Kansas$493$1,409115284-7.5%
Alabama$491$1,371158288-7.8%
Utah$488$1,42399215-8.4%
Mississippi$486$1,607101219-8.7%
Indiana$479$1,520262522-10.0%
Arkansas$478$1,259107231-10.3%
New Hampshire$476$2,53889141-10.7%
Minnesota$474$2,374231413-11.0%
Wisconsin$467$4,949257444-12.3%
New Mexico$466$1,92986181-12.5%
South Dakota$454$1,50261130-14.7%
Maine$453$1,4446599-15.1%
Idaho$435$1,39884184-18.3%
Nebraska$409$1,63488206-23.2%

⚠️ 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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