Repair of abdomen using abdominal lining graft
Medicare pricing data for 3,781 providers across 48 states
This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 abdomen using abdominal lining graft (HCPCS code 49905) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $294.58, but hospitals typically charge $1,257 — a 4.3x 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 $294.58, your out-of-pocket cost would be approximately $58.92. 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 4.3x more than what Medicare allows for this procedure. Medicare actually pays $235.20 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $367 | $1,062 | 24 | 39 | +24.6% |
| New York | $351 | $1,895 | 240 | 515 | +19.1% |
| Alaska | $338 | $2,838 | 10 | 14 | +14.8% |
| Maryland | $338 | $920 | 81 | 245 | +14.6% |
| Massachusetts | $328 | $1,300 | 111 | 265 | +11.2% |
| Michigan | $328 | $955 | 71 | 83 | +11.2% |
| Pennsylvania | $323 | $1,243 | 179 | 289 | +9.5% |
| Virginia | $322 | $968 | 104 | 201 | +9.1% |
| Ohio | $319 | $1,104 | 146 | 283 | +8.4% |
| Kentucky | $319 | $937 | 69 | 163 | +8.4% |
| New Hampshire | $319 | $3,463 | 23 | 49 | +8.2% |
| West Virginia | $311 | $986 | 17 | 29 | +5.7% |
| Illinois | $309 | $1,123 | 161 | 537 | +4.8% |
| Connecticut | $307 | $1,307 | 39 | 71 | +4.3% |
| New Mexico | $306 | $1,008 | 19 | 41 | +3.8% |
| Texas | $306 | $1,445 | 254 | 561 | +3.7% |
| Iowa | $303 | $1,320 | 31 | 37 | +2.7% |
| Utah | $300 | $815 | 19 | 22 | +1.8% |
| Mississippi | $300 | $1,270 | 39 | 80 | +1.8% |
| Georgia | $299 | $1,145 | 114 | 209 | +1.4% |
| Washington | $288 | $959 | 97 | 156 | -2.1% |
| Indiana | $288 | $890 | 53 | 102 | -2.1% |
| Minnesota | $286 | $1,925 | 69 | 98 | -2.9% |
| California | $284 | $1,117 | 347 | 727 | -3.5% |
| North Dakota | $281 | $1,005 | 9 | 13 | -4.6% |
| Colorado | $281 | $1,052 | 83 | 184 | -4.7% |
| Florida | $279 | $1,044 | 258 | 767 | -5.2% |
| Oklahoma | $279 | $777 | 57 | 93 | -5.4% |
| Missouri | $277 | $1,153 | 63 | 97 | -6.0% |
| Wisconsin | $276 | $2,391 | 74 | 119 | -6.3% |
| New Jersey | $275 | $2,168 | 126 | 480 | -6.5% |
| Kansas | $273 | $909 | 20 | 49 | -7.2% |
| South Carolina | $273 | $1,012 | 77 | 201 | -7.3% |
| North Carolina | $273 | $965 | 116 | 234 | -7.3% |
| Tennessee | $271 | $1,527 | 110 | 250 | -8.0% |
| Louisiana | $268 | $906 | 48 | 82 | -9.0% |
| Arkansas | $264 | $787 | 65 | 170 | -10.3% |
| Nevada | $261 | $919 | 45 | 109 | -11.3% |
| Nebraska | $259 | $1,127 | 15 | 22 | -12.0% |
| Arizona | $258 | $840 | 63 | 103 | -12.4% |
| Oregon | $257 | $954 | 56 | 84 | -12.7% |
| Alabama | $254 | $1,515 | 72 | 151 | -13.9% |
| South Dakota | $245 | $542 | 11 | 15 | -16.7% |
| Hawaii | $227 | $699 | 8 | 13 | -23.0% |
| Idaho | $226 | $951 | 13 | 17 | -23.2% |
| Delaware | $219 | $542 | 18 | 102 | -25.6% |
| Maine | $215 | $655 | 19 | 27 | -26.9% |
| Montana | $187 | $628 | 17 | 40 | -36.4% |
⚠️ 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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