Surgical removal of prostate and surrounding lymph nodes using an endoscope
Medicare pricing data for 3,643 providers across 52 states
This procedure has a 6.0x markup — hospitals charge $5,440 but Medicare allows only $913.06. Uninsured patients may face bills 6.0 times higher than what insurance negotiates. 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
Surgical removal of prostate and surrounding lymph nodes using an endoscope (HCPCS code 55866) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $913.06, but hospitals typically charge $5,440 — a 6.0x 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 $913.06, your out-of-pocket cost would be approximately $182.61. 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 6.0x more than what Medicare allows for this procedure. Medicare actually pays $724.80 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Virginia | $1,119 | $4,896 | 64 | 455 | +22.5% |
| District of Columbia | $1,110 | $5,336 | 15 | 156 | +21.6% |
| Georgia | $1,056 | $6,288 | 94 | 559 | +15.6% |
| Maryland | $1,048 | $5,189 | 61 | 504 | +14.8% |
| Illinois | $1,045 | $7,497 | 134 | 737 | +14.4% |
| Hawaii | $1,037 | $3,792 | 10 | 44 | +13.6% |
| Maine | $1,034 | $4,339 | 9 | 32 | +13.2% |
| Ohio | $1,027 | $6,360 | 121 | 910 | +12.5% |
| Pennsylvania | $991 | $5,257 | 192 | 1,071 | +8.5% |
| Arizona | $985 | $6,372 | 84 | 563 | +7.9% |
| Alaska | $977 | $7,314 | 12 | 70 | +7.0% |
| Kentucky | $974 | $3,924 | 36 | 192 | +6.7% |
| West Virginia | $973 | $4,439 | 14 | 78 | +6.6% |
| Mississippi | $973 | $5,378 | 23 | 188 | +6.6% |
| Texas | $968 | $5,431 | 219 | 1,532 | +6.1% |
| New Hampshire | $968 | $11,139 | 12 | 91 | +6.0% |
| Arkansas | $959 | $4,408 | 26 | 211 | +5.1% |
| Michigan | $950 | $5,932 | 126 | 591 | +4.1% |
| New York | $936 | $8,555 | 237 | 1,491 | +2.5% |
| California | $936 | $5,683 | 322 | 2,368 | +2.5% |
| New Mexico | $931 | $3,733 | 9 | 34 | +2.0% |
| Tennessee | $930 | $4,342 | 76 | 673 | +1.9% |
| Indiana | $926 | $4,818 | 85 | 465 | +1.4% |
| New Jersey | $921 | $8,371 | 88 | 409 | +0.9% |
| Massachusetts | $920 | $5,071 | 106 | 616 | +0.7% |
| South Carolina | $912 | $4,221 | 59 | 442 | -0.1% |
| Oklahoma | $894 | $3,560 | 35 | 274 | -2.0% |
| Florida | $889 | $4,015 | 209 | 1,789 | -2.7% |
| Missouri | $881 | $4,270 | 77 | 452 | -3.5% |
| Vermont | $881 | $6,792 | 5 | 49 | -3.5% |
| Wisconsin | $875 | $12,534 | 86 | 479 | -4.2% |
| Louisiana | $874 | $3,613 | 61 | 316 | -4.2% |
| North Carolina | $871 | $4,256 | 124 | 644 | -4.6% |
| Nevada | $851 | $4,516 | 20 | 163 | -6.8% |
| Colorado | $847 | $5,220 | 79 | 468 | -7.3% |
| North Dakota | $834 | $4,321 | 9 | 80 | -8.7% |
| Minnesota | $833 | $6,268 | 93 | 701 | -8.8% |
| Puerto Rico | $822 | $1,593 | 4 | 19 | -10.0% |
| Oregon | $816 | $3,551 | 60 | 430 | -10.6% |
| Montana | $814 | $3,875 | 30 | 233 | -10.8% |
| Kansas | $801 | $4,109 | 49 | 335 | -12.3% |
| Alabama | $793 | $3,533 | 51 | 320 | -13.2% |
| Washington | $785 | $3,343 | 118 | 691 | -14.1% |
| Iowa | $756 | $3,695 | 54 | 371 | -17.2% |
| Rhode Island | $755 | $4,720 | 15 | 68 | -17.3% |
| Delaware | $750 | $4,026 | 7 | 52 | -17.9% |
| Utah | $691 | $4,122 | 33 | 201 | -24.3% |
| Connecticut | $675 | $5,830 | 51 | 284 | -26.1% |
| Nebraska | $673 | $3,951 | 40 | 367 | -26.3% |
| Idaho | $632 | $2,663 | 34 | 183 | -30.8% |
| South Dakota | $620 | $3,985 | 25 | 278 | -32.1% |
| Wyoming | $606 | $2,944 | 7 | 34 | -33.6% |
⚠️ 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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