Other procedure on male genital system
Medicare pricing data for 651 providers across 31 states
This procedure has a 5.9x markup — hospitals charge $1,266 but Medicare allows only $213.58. Uninsured patients may face bills 5.9 times higher than what insurance negotiates. Prices vary significantly by location — from $72 in Louisiana to $512 in Tennessee. 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
Other procedure on male genital system (HCPCS code 55899) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $213.58, but hospitals typically charge $1,266 — a 5.9x 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 $213.58, your out-of-pocket cost would be approximately $42.72. 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 5.9x more than what Medicare allows for this procedure. Medicare actually pays $169.37 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Tennessee | $512 | $2,412 | 8 | 34 | +139.6% |
| California | $428 | $1,032 | 12 | 158 | +100.3% |
| New York | $326 | $1,603 | 66 | 3,763 | +52.4% |
| District of Columbia | $308 | $807 | 4 | 122 | +44.2% |
| Utah | $304 | $843 | 5 | 12 | +42.4% |
| Connecticut | $301 | $3,324 | 10 | 52 | +41.1% |
| Nebraska | $291 | $1,749 | 8 | 13 | +36.3% |
| Rhode Island | $288 | $479 | 6 | 91 | +34.7% |
| Indiana | $282 | $1,282 | 16 | 65 | +31.9% |
| Illinois | $281 | $1,134 | 60 | 902 | +31.8% |
| Minnesota | $271 | $1,194 | 26 | 133 | +27.0% |
| Missouri | $262 | $1,079 | 1 | 11 | +22.8% |
| Massachusetts | $258 | $914 | 6 | 195 | +21.0% |
| North Carolina | $246 | $1,247 | 8 | 38 | +15.1% |
| Ohio | $226 | $854 | 11 | 35 | +6.0% |
| New Hampshire | $219 | $225 | 1 | 30 | +2.3% |
| Florida | $195 | $1,790 | 58 | 1,201 | -8.8% |
| South Carolina | $189 | $1,250 | 5 | 21 | -11.3% |
| Georgia | $179 | $1,272 | 25 | 185 | -16.3% |
| Texas | $169 | $715 | 40 | 500 | -20.8% |
| Pennsylvania | $153 | $699 | 32 | 354 | -28.4% |
| Delaware | $150 | $598 | 4 | 50 | -29.5% |
| Virginia | $133 | $928 | 17 | 616 | -37.6% |
| Oklahoma | $132 | $948 | 2 | 12 | -38.0% |
| Arkansas | $124 | $760 | 8 | 82 | -42.1% |
| Colorado | $112 | $889 | 50 | 446 | -47.6% |
| Mississippi | $108 | $786 | 7 | 42 | -49.3% |
| New Mexico | $103 | $888 | 1 | 15 | -51.7% |
| New Jersey | $102 | $1,404 | 56 | 1,257 | -52.3% |
| Maryland | $92 | $862 | 87 | 1,599 | -56.9% |
| Louisiana | $72 | $753 | 24 | 302 | -66.1% |
⚠️ 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