Creation of brain fluid drainage shunt, ventriculo-peritoneal, -pleural, other terminus
Medicare pricing data for 3,516 providers across 47 states
This procedure has a 7.1x markup — hospitals charge $4,898 but Medicare allows only $691.47. Uninsured patients may face bills 7.1 times higher than what insurance negotiates. Prices vary significantly by location — from $437 in Idaho to $930 in Rhode Island. 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
Creation of brain fluid drainage shunt, ventriculo-peritoneal, -pleural, other terminus (HCPCS code 62223) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $691.47, but hospitals typically charge $4,898 — a 7.1x 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 $691.47, your out-of-pocket cost would be approximately $138.29. 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 7.1x more than what Medicare allows for this procedure. Medicare actually pays $550.93 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Rhode Island | $930 | $4,126 | 17 | 45 | +34.5% |
| District of Columbia | $830 | $2,445 | 15 | 27 | +20.1% |
| New York | $822 | $10,156 | 207 | 553 | +18.9% |
| Illinois | $773 | $5,570 | 145 | 295 | +11.8% |
| Connecticut | $764 | $4,678 | 39 | 163 | +10.5% |
| Alaska | $761 | $12,692 | 11 | 16 | +10.0% |
| Massachusetts | $760 | $6,051 | 92 | 273 | +9.9% |
| Pennsylvania | $753 | $5,293 | 164 | 367 | +9.0% |
| Montana | $749 | $2,984 | 20 | 31 | +8.3% |
| Florida | $734 | $3,841 | 283 | 736 | +6.1% |
| New Jersey | $731 | $16,592 | 100 | 202 | +5.8% |
| Mississippi | $730 | $3,069 | 23 | 51 | +5.5% |
| Texas | $722 | $4,186 | 256 | 603 | +4.4% |
| Maryland | $715 | $3,844 | 70 | 221 | +3.4% |
| New Mexico | $712 | $2,655 | 17 | 23 | +2.9% |
| Michigan | $702 | $5,710 | 108 | 189 | +1.5% |
| Virginia | $701 | $3,735 | 80 | 211 | +1.4% |
| California | $692 | $4,261 | 303 | 943 | +0.1% |
| Louisiana | $688 | $3,354 | 59 | 131 | -0.5% |
| Missouri | $687 | $3,548 | 85 | 166 | -0.7% |
| Georgia | $686 | $3,724 | 99 | 201 | -0.7% |
| Washington | $669 | $2,242 | 99 | 203 | -3.2% |
| Nevada | $669 | $7,916 | 33 | 78 | -3.3% |
| Arkansas | $666 | $2,971 | 36 | 62 | -3.6% |
| Colorado | $660 | $3,809 | 54 | 85 | -4.5% |
| Indiana | $659 | $3,573 | 63 | 131 | -4.7% |
| New Hampshire | $652 | $6,820 | 14 | 35 | -5.7% |
| Ohio | $644 | $3,325 | 141 | 352 | -6.8% |
| Oregon | $636 | $2,728 | 48 | 85 | -8.0% |
| Delaware | $636 | $3,702 | 21 | 57 | -8.1% |
| Oklahoma | $634 | $2,518 | 40 | 110 | -8.3% |
| Arizona | $626 | $2,425 | 70 | 259 | -9.5% |
| Vermont | $626 | $5,315 | 8 | 18 | -9.5% |
| Kentucky | $606 | $3,001 | 51 | 96 | -12.4% |
| North Carolina | $606 | $3,504 | 90 | 182 | -12.4% |
| South Carolina | $603 | $4,350 | 67 | 154 | -12.8% |
| Utah | $603 | $3,263 | 20 | 37 | -12.9% |
| West Virginia | $592 | $2,623 | 9 | 17 | -14.3% |
| Iowa | $585 | $4,764 | 25 | 62 | -15.4% |
| Minnesota | $582 | $5,280 | 81 | 253 | -15.8% |
| Kansas | $582 | $2,685 | 35 | 85 | -15.8% |
| Alabama | $573 | $3,502 | 53 | 119 | -17.1% |
| Wisconsin | $567 | $12,284 | 75 | 138 | -18.1% |
| Tennessee | $562 | $3,144 | 95 | 200 | -18.7% |
| Nebraska | $560 | $3,288 | 28 | 55 | -19.0% |
| South Dakota | $529 | $2,870 | 20 | 34 | -23.6% |
| Idaho | $437 | $2,537 | 21 | 30 | -36.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber