64643

Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity

Medicare pricing data for 3,174 providers across 49 states

🤖AI Overview

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

Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity (HCPCS code 64643) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $82.67, but hospitals typically charge $342.19 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$16.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $82.67, your out-of-pocket cost would be approximately $16.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$82.67
Average Hospital Charge
$342.19
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$342.19
Medicare Allowed$82.67
Medicare Payment$64.26

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $64.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$96$5011992,403+16.3%
District of Columbia$96$27923285+15.6%
Connecticut$96$354451,003+15.6%
Rhode Island$94$3268146+13.4%
Nevada$93$33819183+12.1%
Florida$92$2851861,847+11.0%
California$91$3092322,855+10.1%
Maryland$90$24257578+9.0%
New Jersey$86$38287827+4.2%
Illinois$86$3521271,439+4.1%
Arizona$86$23853502+3.9%
Colorado$85$26977691+2.8%
Oklahoma$84$22623263+2.2%
Massachusetts$84$3861131,371+1.5%
Pennsylvania$84$2521492,056+1.2%
Texas$83$3181792,240+0.8%
Wyoming$83$393933+0.6%
Oregon$83$28640255+0.1%
Missouri$82$299911,125-1.4%
Washington$81$23389952-1.9%
Michigan$81$279122838-2.3%
Alabama$81$30617170-2.4%
North Carolina$80$2941111,249-2.9%
South Carolina$80$25048507-3.7%
Virginia$80$29573650-3.7%
Indiana$79$24972637-3.9%
Utah$79$26723330-4.0%
Montana$79$17224235-4.6%
Georgia$78$34476494-5.2%
Louisiana$78$23754341-5.5%
Ohio$78$2951481,908-5.5%
Kansas$77$34927324-7.0%
Minnesota$77$3701051,680-7.1%
New Mexico$77$2132175-7.2%
Tennessee$77$29254465-7.2%
Delaware$75$21514167-9.5%
New Hampshire$75$37225283-9.6%
South Dakota$75$18416178-9.8%
Idaho$74$17919230-10.3%
Kentucky$71$21741348-13.8%
Iowa$71$27142787-14.1%
Nebraska$70$26927448-15.7%
West Virginia$70$21010101-15.8%
Wisconsin$69$1,011721,658-16.5%
Vermont$67$1821185-18.7%
North Dakota$65$13917233-20.9%
Mississippi$65$31116368-21.1%
Arkansas$65$25221235-21.8%
Maine$64$18522250-22.9%

⚠️ 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

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