64555

Insertion of peripheral nerve neurostimulator electrode through skin

Medicare pricing data for 2,599 providers across 39 states

🤖AI Overview

Prices vary significantly by location — from $283 in West Virginia to $3,286 in California. 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

Insertion of peripheral nerve neurostimulator electrode through skin (HCPCS code 64555) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2,323, but hospitals typically charge $10,186 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$464.70

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2,323, your out-of-pocket cost would be approximately $464.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2,323
Average Hospital Charge
$10,186
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$10,185.63
Medicare Allowed$2,323.48
Medicare Payment$1,849.81

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $1,850 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$3,286$13,2692672,580+41.4%
Nebraska$3,132$10,67825210+34.8%
Maryland$3,059$13,77649230+31.7%
New Jersey$2,876$16,74290574+23.8%
Colorado$2,750$16,21434294+18.4%
Oregon$2,734$9,27165459+17.7%
Indiana$2,734$10,52454738+17.7%
Kentucky$2,732$7,1921250+17.6%
New Mexico$2,667$7,604978+14.8%
Kansas$2,650$13,11321213+14.0%
Nevada$2,538$7,79732145+9.2%
Florida$2,457$12,7462801,590+5.7%
Arizona$2,444$5,65081806+5.2%
Georgia$2,431$10,927104638+4.6%
Texas$2,402$12,2522823,151+3.4%
Washington$2,282$6,90644422-1.8%
Utah$2,268$10,68444234-2.4%
Tennessee$2,180$7,49251310-6.2%
South Carolina$2,113$5,62645482-9.1%
Idaho$2,089$5,14029236-10.1%
Wisconsin$2,071$10,10244506-10.8%
New York$2,045$9,187121630-12.0%
Michigan$1,945$11,28060509-16.3%
Oklahoma$1,882$5,50062666-19.0%
Louisiana$1,777$9,89031252-23.5%
Alabama$1,768$2,90213106-23.9%
Minnesota$1,737$8,89733202-25.2%
Missouri$1,713$13,62737366-26.3%
Arkansas$1,681$6,19226134-27.6%
Pennsylvania$1,639$5,13390422-29.5%
Illinois$1,594$6,91684684-31.4%
Connecticut$1,534$8,5732191-34.0%
Virginia$1,486$4,1152358-36.1%
North Carolina$1,422$9,36090671-38.8%
Iowa$1,282$3,7781278-44.8%
Ohio$1,250$3,864104546-46.2%
New Hampshire$1,001$4,141622-56.9%
Massachusetts$816$5,11651316-64.9%
West Virginia$283$990419-87.8%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber