61781

Computer-assisted procedure inside brain

Medicare pricing data for 3,070 providers across 50 states

🤖AI Overview

This procedure has a 5.9x markup — hospitals charge $1,350 but Medicare allows only $230.60. Uninsured patients may face bills 5.9 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

Computer-assisted procedure inside brain (HCPCS code 61781) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $230.60, but hospitals typically charge $1,350 — a 5.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$46.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $230.60, your out-of-pocket cost would be approximately $46.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$230.60
Average Hospital Charge
$1,350
Markup Ratio
5.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,349.73
Medicare Allowed$230.60
Medicare Payment$184.17

Hospitals charge 5.9x more than what Medicare allows for this procedure. Medicare actually pays $184.17 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$284$3,0971831,107+23.1%
District of Columbia$263$8811365+14.0%
Illinois$257$1,724119731+11.5%
Michigan$253$1,78187308+9.6%
Florida$252$1,2412621,380+9.4%
Connecticut$249$1,16730209+8.2%
Maryland$249$1,03264495+7.8%
Massachusetts$245$1,22077615+6.2%
New Jersey$243$3,40871381+5.4%
New Mexico$242$6511341+4.9%
Delaware$237$1,230969+2.9%
Pennsylvania$237$1,161145781+2.9%
Montana$237$7701959+2.6%
New Hampshire$234$2,5821541+1.6%
West Virginia$233$6681441+1.1%
Ohio$232$966114661+0.7%
Virginia$232$95289474+0.6%
Georgia$231$1,06772340+0.2%
Louisiana$231$1,13948231+0.1%
Texas$230$1,1142461,326-0.3%
Rhode Island$229$9871145-0.7%
Colorado$221$86150239-4.2%
Mississippi$220$8162191-4.5%
Kentucky$219$82045243-5.0%
Maine$218$731631-5.3%
Nevada$218$2,2492793-5.6%
Oklahoma$218$72434242-5.6%
Utah$216$1,3682498-6.4%
California$216$9752941,681-6.4%
Missouri$215$79369234-6.9%
Arizona$214$1,03781512-7.1%
North Dakota$214$694534-7.3%
North Carolina$213$86396447-7.6%
Vermont$212$1,107641-8.0%
Alabama$211$76244214-8.6%
South Carolina$210$88749284-8.8%
Washington$210$63672320-8.8%
Oregon$210$78831118-9.0%
Wisconsin$208$2,93558370-10.0%
Minnesota$207$2,22362357-10.1%
Arkansas$202$83326165-12.5%
Tennessee$199$99375356-13.6%
Iowa$199$1,4592291-13.8%
Idaho$198$3,8941342-14.3%
Alaska$195$3,4161262-15.3%
Kansas$192$67425134-16.6%
South Dakota$189$8661233-18.2%
Hawaii$170$4941145-26.1%
Indiana$166$77149235-27.9%
Nebraska$164$68735149-28.8%

⚠️ 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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