Initial repair of entrapped hernia of abdomen, 3-10 cm in length
Medicare pricing data for 8,371 providers across 52 states
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
Initial repair of entrapped hernia of abdomen, 3-10 cm in length (HCPCS code 49594) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $673.05, but hospitals typically charge $2,820 — a 4.2x 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 $673.05, your out-of-pocket cost would be approximately $134.61. 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 4.2x more than what Medicare allows for this procedure. Medicare actually pays $533.67 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $777 | $3,462 | 633 | 1,449 | +15.4% |
| Colorado | $764 | $2,472 | 129 | 261 | +13.5% |
| Alaska | $735 | $6,244 | 20 | 45 | +9.2% |
| Texas | $725 | $3,078 | 579 | 1,433 | +7.7% |
| Nevada | $722 | $3,081 | 65 | 147 | +7.3% |
| Maryland | $719 | $2,354 | 175 | 524 | +6.8% |
| Florida | $718 | $2,903 | 619 | 1,731 | +6.7% |
| Arkansas | $709 | $1,774 | 97 | 256 | +5.3% |
| Illinois | $704 | $3,079 | 344 | 782 | +4.6% |
| Ohio | $695 | $2,365 | 288 | 546 | +3.3% |
| Arizona | $693 | $2,662 | 199 | 712 | +2.9% |
| Virginia | $692 | $1,811 | 204 | 458 | +2.8% |
| Tennessee | $691 | $2,313 | 175 | 394 | +2.7% |
| New Jersey | $690 | $6,844 | 256 | 755 | +2.5% |
| Washington | $690 | $2,423 | 232 | 521 | +2.4% |
| Michigan | $684 | $1,774 | 238 | 460 | +1.6% |
| Kansas | $677 | $2,893 | 98 | 251 | +0.5% |
| Massachusetts | $675 | $2,431 | 175 | 364 | +0.3% |
| Delaware | $672 | $2,451 | 58 | 203 | -0.1% |
| Louisiana | $666 | $2,149 | 129 | 239 | -1.1% |
| Indiana | $665 | $2,579 | 196 | 393 | -1.2% |
| Rhode Island | $661 | $2,164 | 24 | 32 | -1.8% |
| Hawaii | $659 | $1,793 | 13 | 14 | -2.1% |
| New York | $653 | $3,502 | 539 | 1,289 | -3.0% |
| Oregon | $650 | $2,805 | 135 | 253 | -3.4% |
| Alabama | $648 | $1,836 | 133 | 274 | -3.8% |
| District of Columbia | $646 | $2,015 | 24 | 61 | -4.0% |
| Utah | $643 | $1,852 | 69 | 108 | -4.4% |
| New Hampshire | $637 | $3,722 | 51 | 84 | -5.4% |
| Mississippi | $634 | $1,701 | 93 | 225 | -5.8% |
| North Carolina | $628 | $2,502 | 241 | 487 | -6.7% |
| South Carolina | $626 | $2,388 | 146 | 405 | -7.0% |
| Missouri | $626 | $2,149 | 175 | 465 | -7.0% |
| Pennsylvania | $618 | $1,864 | 352 | 753 | -8.2% |
| Oklahoma | $608 | $1,591 | 97 | 254 | -9.6% |
| Wisconsin | $602 | $5,328 | 187 | 319 | -10.6% |
| Georgia | $598 | $2,281 | 204 | 475 | -11.1% |
| Montana | $587 | $1,866 | 44 | 85 | -12.7% |
| Kentucky | $582 | $1,762 | 133 | 263 | -13.5% |
| Puerto Rico | $566 | $786 | 11 | 13 | -15.9% |
| Connecticut | $557 | $2,268 | 109 | 202 | -17.3% |
| North Dakota | $550 | $1,967 | 32 | 47 | -18.4% |
| Minnesota | $547 | $2,999 | 142 | 204 | -18.7% |
| West Virginia | $545 | $1,998 | 45 | 59 | -19.0% |
| Wyoming | $538 | $1,810 | 28 | 59 | -20.1% |
| Nebraska | $532 | $2,663 | 65 | 172 | -21.0% |
| New Mexico | $523 | $2,119 | 49 | 94 | -22.3% |
| Iowa | $520 | $1,735 | 83 | 147 | -22.7% |
| Maine | $518 | $1,726 | 35 | 61 | -23.1% |
| South Dakota | $498 | $1,474 | 49 | 79 | -26.0% |
| Vermont | $478 | $2,138 | 18 | 22 | -29.0% |
| Idaho | $426 | $1,543 | 52 | 94 | -36.7% |
⚠️ 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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