Injection procedure to correct thickened penile tissue
Medicare pricing data for 932 providers across 34 states
This procedure has a 8.1x markup — hospitals charge $917.71 but Medicare allows only $113.93. Uninsured patients may face bills 8.1 times higher than what insurance negotiates. 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
Injection procedure to correct thickened penile tissue (HCPCS code 54200) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $113.93, but hospitals typically charge $917.71 — a 8.1x 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 $113.93, your out-of-pocket cost would be approximately $22.79. 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 8.1x more than what Medicare allows for this procedure. Medicare actually pays $85.93 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $129 | $4,041 | 83 | 1,261 | +12.9% |
| New York | $126 | $482 | 74 | 684 | +10.6% |
| New Jersey | $125 | $572 | 37 | 204 | +9.9% |
| Pennsylvania | $118 | $268 | 17 | 132 | +3.4% |
| Massachusetts | $118 | $417 | 25 | 135 | +3.2% |
| Virginia | $117 | $297 | 17 | 254 | +2.9% |
| Maryland | $117 | $249 | 17 | 160 | +2.6% |
| Colorado | $116 | $247 | 17 | 94 | +1.8% |
| Nevada | $115 | $314 | 6 | 111 | +1.0% |
| Washington | $114 | $287 | 15 | 101 | +0.2% |
| Texas | $113 | $276 | 67 | 503 | -0.7% |
| Florida | $112 | $339 | 101 | 709 | -2.0% |
| Illinois | $111 | $435 | 27 | 191 | -2.2% |
| Arizona | $111 | $266 | 27 | 144 | -2.6% |
| Missouri | $111 | $294 | 20 | 125 | -2.9% |
| Georgia | $110 | $274 | 51 | 395 | -3.1% |
| Wisconsin | $109 | $650 | 7 | 40 | -4.3% |
| Ohio | $107 | $316 | 34 | 261 | -5.9% |
| Oklahoma | $106 | $249 | 9 | 126 | -6.7% |
| Alabama | $106 | $194 | 17 | 83 | -7.0% |
| Minnesota | $105 | $516 | 10 | 98 | -7.4% |
| Delaware | $105 | $265 | 1 | 56 | -7.5% |
| Utah | $105 | $207 | 6 | 64 | -7.6% |
| Michigan | $105 | $224 | 27 | 157 | -7.6% |
| Connecticut | $105 | $506 | 10 | 61 | -8.2% |
| Kentucky | $105 | $214 | 10 | 127 | -8.2% |
| Tennessee | $104 | $259 | 24 | 205 | -9.1% |
| Louisiana | $103 | $263 | 17 | 150 | -9.2% |
| Indiana | $103 | $282 | 23 | 271 | -9.3% |
| Oregon | $103 | $367 | 20 | 191 | -9.5% |
| South Carolina | $102 | $278 | 27 | 220 | -10.6% |
| North Carolina | $101 | $273 | 30 | 240 | -11.1% |
| Kansas | $99 | $243 | 11 | 95 | -13.0% |
| Arkansas | $95 | $290 | 11 | 71 | -16.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber