47000

Needle biopsy of liver through skin

Medicare pricing data for 7,656 providers across 52 states

🤖AI Overview

This procedure has a 7.7x markup — hospitals charge $708.22 but Medicare allows only $92.38. Uninsured patients may face bills 7.7 times higher than what insurance negotiates. Prices vary significantly by location — from $78 in Idaho to $168 in Alaska. Where you get this procedure matters more than almost any other factor. 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

Needle biopsy of liver through skin (HCPCS code 47000) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $92.38, but hospitals typically charge $708.22 — a 7.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.48

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $92.38, your out-of-pocket cost would be approximately $18.48. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$92.38
Average Hospital Charge
$708.22
Markup Ratio
7.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$708.22
Medicare Allowed$92.38
Medicare Payment$72.14

Hospitals charge 7.7x more than what Medicare allows for this procedure. Medicare actually pays $72.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$168$2,06722105+81.5%
Nebraska$124$86845495+34.2%
Arkansas$121$65074603+31.5%
New Mexico$119$71341203+29.2%
Nevada$106$78280286+15.2%
New York$105$1,0664342,348+13.3%
California$104$9206803,548+12.2%
Tennessee$103$6521701,158+11.1%
Arizona$102$999147927+10.6%
Utah$102$43872299+10.5%
New Jersey$100$704167913+8.3%
Oregon$99$555109531+7.1%
Washington$97$428170990+5.3%
Iowa$96$82075489+4.3%
Connecticut$94$790105431+1.8%
Texas$94$7905543,208+1.2%
Kansas$93$34277524+1.2%
Maryland$93$468146976+0.9%
Massachusetts$93$5842011,311+0.4%
Florida$92$7305262,667+0.1%
District of Columbia$91$49923178-1.5%
Illinois$91$8183002,017-1.5%
Michigan$88$3852431,204-4.9%
Delaware$87$29022187-6.3%
Colorado$86$797132566-6.6%
Kentucky$85$603108600-7.5%
Vermont$85$1,5481491-7.6%
Pennsylvania$85$5423382,019-7.6%
Montana$85$44431184-7.8%
Minnesota$85$7402051,000-8.4%
Ohio$85$5343061,474-8.5%
Georgia$84$7462191,037-8.8%
Puerto Rico$84$3281221-9.1%
Rhode Island$84$45639195-9.5%
Indiana$83$571163972-10.3%
Wyoming$82$5101764-11.0%
Virginia$82$5571901,343-11.3%
Oklahoma$82$38386570-11.3%
North Carolina$82$6472871,362-11.5%
Louisiana$81$553116608-11.9%
Maine$81$36343144-11.9%
New Hampshire$81$1,05935284-12.4%
Hawaii$81$3762384-12.8%
Missouri$81$5831471,034-12.8%
North Dakota$80$1,08519182-13.0%
South Carolina$80$537102731-13.2%
Alabama$80$518125535-13.3%
South Dakota$80$57521229-13.7%
Mississippi$79$74967538-14.2%
Wisconsin$79$1,282189965-14.3%
West Virginia$79$47245271-14.8%
Idaho$78$50846264-15.3%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber