62369

Electronic analysis reprogramming and refill of spinal canal drug infusion pump

Medicare pricing data for 878 providers across 40 states

🤖AI Overview

This procedure has a 5.3x markup — hospitals charge $410.97 but Medicare allows only $77.60. Uninsured patients may face bills 5.3 times higher than what insurance negotiates. Prices vary significantly by location — from $27 in Mississippi to $109 in Alaska. 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

Electronic analysis reprogramming and refill of spinal canal drug infusion pump (HCPCS code 62369) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $77.60, but hospitals typically charge $410.97 — a 5.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.52

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $77.60, your out-of-pocket cost would be approximately $15.52. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$77.60
Average Hospital Charge
$410.97
Markup Ratio
5.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$410.97
Medicare Allowed$77.60
Medicare Payment$58.15

Hospitals charge 5.3x more than what Medicare allows for this procedure. Medicare actually pays $58.15 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$109$7574127+40.4%
Washington$98$24712311+26.9%
New Jersey$97$234397+25.4%
Massachusetts$96$29411285+23.3%
California$88$61163837+13.8%
Arizona$87$2944372+11.7%
Nevada$86$36911776+11.2%
Connecticut$86$378218+11.2%
New York$85$86842493+10.0%
Florida$85$26743653+9.7%
Texas$83$441741,658+7.4%
Oklahoma$83$25511852+6.5%
Kansas$83$32410150+6.5%
Virginia$82$264531+5.6%
Minnesota$81$448712,771+4.3%
Indiana$80$31831846+3.3%
Nebraska$79$405548+1.7%
Utah$79$3753114+1.5%
Tennessee$78$3401277+0.4%
Louisiana$78$51025578+0.1%
South Carolina$77$46111338-0.2%
Kentucky$77$39314973-0.3%
Missouri$77$77910987-0.5%
Arkansas$76$25924806-2.2%
Oregon$75$29611171-2.8%
Georgia$73$29828213-5.9%
Pennsylvania$72$46955515-7.4%
Alabama$72$13912360-7.4%
North Carolina$71$35823285-8.6%
District of Columbia$71$287580-8.7%
Michigan$70$280451,148-9.4%
Illinois$67$62437427-14.3%
Idaho$66$290333-14.9%
Ohio$60$23634613-23.1%
Wisconsin$55$62615271-29.2%
Maryland$50$22511219-35.6%
Colorado$45$28012134-42.1%
Iowa$45$169869-42.5%
South Dakota$43$16810110-45.2%
Mississippi$27$1501168-64.7%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber