49650

Repair of groin hernia using an endoscope

Medicare pricing data for 11,234 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $300 in South Dakota to $919 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

Repair of groin hernia using an endoscope (HCPCS code 49650) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $532.46, but hospitals typically charge $2,649 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$106.49

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $532.46, your out-of-pocket cost would be approximately $106.49. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$532.46
Average Hospital Charge
$2,649
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,648.86
Medicare Allowed$532.46
Medicare Payment$419.61

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $419.61 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$919$9,34937337+72.6%
California$741$3,3668687,277+39.1%
Wyoming$685$3,79530185+28.6%
Colorado$631$3,6312551,776+18.5%
Maryland$625$3,7781751,683+17.3%
Indiana$612$3,3522401,218+15.0%
Arizona$603$3,0262422,673+13.2%
Washington$599$2,1992871,962+12.6%
Oregon$581$2,400184946+9.1%
Ohio$574$2,8274542,591+7.9%
Texas$566$2,9707104,755+6.3%
Illinois$563$2,9654343,160+5.8%
Nebraska$557$2,18697640+4.6%
Virginia$545$1,8292592,156+2.4%
North Carolina$545$2,4223492,292+2.3%
Kansas$536$2,475119821+0.7%
Tennessee$528$2,0252191,427-0.8%
Florida$517$2,4368057,147-2.9%
Iowa$508$1,828103708-4.7%
Utah$503$2,049113798-5.4%
Montana$497$1,81352350-6.7%
New York$489$3,4177554,836-8.2%
South Carolina$479$2,1841721,616-10.0%
Michigan$473$1,6613891,918-11.1%
Massachusetts$471$1,8962491,662-11.6%
Louisiana$467$1,894157765-12.4%
Missouri$465$2,0292121,568-12.7%
New Mexico$464$2,90562489-12.9%
New Jersey$461$4,6782741,978-13.5%
Hawaii$461$1,46429149-13.5%
Wisconsin$456$4,4013131,425-14.3%
Minnesota$453$2,5112461,020-15.0%
New Hampshire$444$2,55389531-16.5%
Georgia$442$1,9353031,942-17.1%
Mississippi$436$1,858113843-18.0%
Puerto Rico$434$9811639-18.6%
Kentucky$429$1,263168838-19.4%
Nevada$426$2,42585721-19.9%
Pennsylvania$426$1,7774863,025-20.0%
Alabama$425$1,567171866-20.1%
Connecticut$424$2,342198991-20.4%
Arkansas$415$1,31896562-22.1%
Rhode Island$402$1,27336187-24.6%
North Dakota$387$2,00431149-27.4%
Idaho$381$1,44877550-28.5%
Oklahoma$380$1,162110869-28.7%
District of Columbia$371$1,38327327-30.3%
Vermont$371$1,4081776-30.4%
West Virginia$332$1,22468281-37.6%
Delaware$320$88662514-39.9%
Maine$319$95865269-40.0%
South Dakota$300$1,31466278-43.6%

⚠️ 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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