46221

Removal of external hemorrhoids by rubber banding

Medicare pricing data for 6,419 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 external hemorrhoids by rubber banding (HCPCS code 46221) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $265.25, but hospitals typically charge $818.35 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$53.05

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $265.25, your out-of-pocket cost would be approximately $53.05. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$265.25
Average Hospital Charge
$818.35
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$818.35
Medicare Allowed$265.25
Medicare Payment$202.12

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $202.12 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$315$1,1383194,285+18.7%
New Jersey$308$1,1821852,887+16.0%
Connecticut$306$1,28874791+15.2%
California$304$9035737,943+14.5%
District of Columbia$303$72814190+14.1%
Hawaii$301$45221305+13.5%
Maryland$291$7911201,994+9.6%
Washington$286$8011411,089+7.8%
Massachusetts$285$9271421,276+7.4%
Puerto Rico$278$345740+4.9%
Virginia$277$6811681,881+4.4%
Alaska$271$1,9712180+2.2%
Florida$268$6704947,891+1.1%
Colorado$268$9701601,143+1.0%
Pennsylvania$263$6053394,427-0.7%
Nevada$259$1,00563742-2.3%
Minnesota$259$1,149119588-2.5%
Oregon$259$84783438-2.5%
New Mexico$258$43030369-2.7%
Arizona$256$7271431,921-3.3%
Michigan$256$5511691,177-3.4%
Delaware$253$54122268-4.8%
Texas$251$8944705,323-5.2%
North Carolina$250$7452662,563-5.7%
Illinois$249$9282742,600-6.2%
Rhode Island$245$8931675-7.5%
Missouri$245$6351081,279-7.6%
New Hampshire$243$72629252-8.4%
Ohio$243$6582472,164-8.5%
Kansas$239$81972565-9.7%
South Dakota$239$36826217-9.9%
Georgia$238$8092592,758-10.1%
Utah$238$71673680-10.2%
South Carolina$237$677931,121-10.5%
Alabama$237$41147270-10.7%
Arkansas$235$54928170-11.4%
Louisiana$232$659109983-12.7%
Wisconsin$231$1,275111378-12.9%
Kentucky$228$59364259-14.0%
Maine$228$6241982-14.1%
Wyoming$225$73727141-15.0%
Mississippi$219$65856599-17.6%
Montana$217$45623153-18.3%
Indiana$217$8631421,454-18.3%
North Dakota$216$5571763-18.7%
Tennessee$211$7901201,131-20.6%
Oklahoma$211$85170631-20.6%
Idaho$198$60751322-25.3%
Nebraska$192$77260336-27.5%
Iowa$187$95572600-29.5%
Vermont$186$3521361-29.8%
West Virginia$171$53940266-35.5%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber