Repair of groin hernia (5 years or older)
Medicare pricing data for 10,408 providers across 52 states
Prices vary significantly by location — from $378 in Maine to $792 in California. 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
Repair of groin hernia (5 years or older) (HCPCS code 49505) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $587.86, but hospitals typically charge $2,627 — a 4.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $587.86, your out-of-pocket cost would be approximately $117.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 4.5x more than what Medicare allows for this procedure. Medicare actually pays $463.22 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $792 | $4,466 | 844 | 4,358 | +34.7% |
| Alaska | $762 | $7,531 | 30 | 80 | +29.5% |
| Colorado | $680 | $2,991 | 197 | 643 | +15.7% |
| Oregon | $661 | $2,693 | 165 | 695 | +12.5% |
| Maryland | $633 | $2,779 | 206 | 1,213 | +7.6% |
| Washington | $627 | $1,838 | 261 | 1,140 | +6.6% |
| New Jersey | $626 | $4,518 | 281 | 1,433 | +6.5% |
| Florida | $625 | $2,697 | 631 | 2,878 | +6.3% |
| Delaware | $616 | $2,026 | 53 | 168 | +4.8% |
| Nebraska | $604 | $2,379 | 97 | 426 | +2.8% |
| Wyoming | $604 | $3,489 | 42 | 159 | +2.7% |
| Arkansas | $601 | $1,629 | 111 | 529 | +2.2% |
| Indiana | $601 | $3,071 | 274 | 1,131 | +2.2% |
| Hawaii | $599 | $1,533 | 28 | 125 | +1.9% |
| Virginia | $589 | $1,719 | 264 | 1,236 | +0.2% |
| New Mexico | $586 | $2,067 | 61 | 177 | -0.3% |
| Texas | $584 | $2,900 | 561 | 2,182 | -0.7% |
| Alabama | $582 | $2,039 | 136 | 508 | -1.1% |
| Tennessee | $580 | $2,040 | 214 | 902 | -1.3% |
| Illinois | $575 | $2,608 | 393 | 1,562 | -2.2% |
| Mississippi | $571 | $1,766 | 105 | 363 | -2.8% |
| Pennsylvania | $569 | $1,946 | 498 | 2,300 | -3.2% |
| Arizona | $567 | $2,477 | 179 | 878 | -3.5% |
| Iowa | $566 | $2,309 | 124 | 504 | -3.7% |
| South Carolina | $565 | $2,441 | 161 | 825 | -3.9% |
| Kentucky | $560 | $1,789 | 165 | 575 | -4.8% |
| Michigan | $552 | $1,640 | 337 | 970 | -6.2% |
| District of Columbia | $546 | $1,591 | 26 | 134 | -7.1% |
| New York | $545 | $3,122 | 714 | 2,812 | -7.3% |
| Massachusetts | $536 | $2,217 | 266 | 1,693 | -8.8% |
| Ohio | $535 | $2,219 | 414 | 1,456 | -9.0% |
| Nevada | $528 | $2,700 | 54 | 189 | -10.2% |
| North Carolina | $523 | $1,885 | 359 | 1,564 | -11.1% |
| Louisiana | $517 | $1,808 | 152 | 454 | -12.1% |
| Minnesota | $516 | $2,393 | 251 | 683 | -12.3% |
| Georgia | $514 | $2,085 | 256 | 1,028 | -12.6% |
| Oklahoma | $512 | $1,436 | 100 | 350 | -12.9% |
| Idaho | $508 | $1,652 | 55 | 218 | -13.5% |
| Missouri | $506 | $1,946 | 206 | 766 | -13.9% |
| North Dakota | $497 | $1,968 | 49 | 221 | -15.4% |
| Vermont | $493 | $1,851 | 32 | 165 | -16.1% |
| Utah | $493 | $1,545 | 101 | 413 | -16.1% |
| Kansas | $492 | $1,535 | 135 | 605 | -16.4% |
| Connecticut | $478 | $1,920 | 125 | 360 | -18.7% |
| New Hampshire | $476 | $2,843 | 74 | 215 | -19.0% |
| Rhode Island | $476 | $1,541 | 41 | 134 | -19.0% |
| Puerto Rico | $475 | $709 | 16 | 23 | -19.3% |
| Montana | $473 | $1,636 | 61 | 214 | -19.6% |
| Wisconsin | $453 | $4,002 | 252 | 690 | -22.9% |
| West Virginia | $436 | $1,457 | 70 | 194 | -25.9% |
| South Dakota | $389 | $1,166 | 52 | 238 | -33.8% |
| Maine | $378 | $1,123 | 56 | 175 | -35.6% |
⚠️ 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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