53661

Subsequent dilation of urethra in female

Medicare pricing data for 1,172 providers across 36 states

🤖AI Overview

Prices vary significantly by location — from $34 in West Virginia to $83 in New Jersey. Where you get this procedure matters more than almost any other factor. 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

Subsequent dilation of urethra in female (HCPCS code 53661) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $71.75, but hospitals typically charge $201.31 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $71.75, your out-of-pocket cost would be approximately $14.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$71.75
Average Hospital Charge
$201.31
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$201.31
Medicare Allowed$71.75
Medicare Payment$52.16

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $52.16 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$83$28268375+15.2%
California$82$187121824+14.0%
New York$81$30763364+13.0%
Maryland$78$15933129+9.1%
Massachusetts$75$24419163+5.2%
Florida$74$209117666+3.0%
Oregon$74$185831+3.0%
Wyoming$74$149329+2.8%
Rhode Island$73$160439+1.7%
Washington$73$1741437+1.1%
Colorado$72$2361445+0.9%
Arizona$71$1742492-0.7%
Connecticut$71$3221693-0.8%
Texas$71$155781,304-1.3%
Virginia$70$18731105-2.1%
Missouri$70$19531137-2.4%
Minnesota$70$3021559-2.5%
Illinois$70$28851329-2.8%
Georgia$69$20637148-4.1%
Michigan$69$1871260-4.4%
Louisiana$68$1871749-5.6%
Pennsylvania$68$17467228-5.7%
Kentucky$66$19310199-8.6%
Oklahoma$65$12517157-9.2%
North Carolina$65$18841116-9.5%
Alabama$65$12819168-9.9%
South Dakota$64$210820-10.6%
Tennessee$63$19136205-11.7%
Utah$63$161839-12.2%
Indiana$61$20544216-15.0%
South Carolina$61$19720100-15.0%
Arkansas$60$1781228-16.9%
Ohio$58$18452211-18.6%
Mississippi$56$240962-21.3%
Montana$41$186130-43.5%
West Virginia$34$119862-51.9%

⚠️ 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