64645

Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity

Medicare pricing data for 1,095 providers across 42 states

🤖AI Overview

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

Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity (HCPCS code 64645) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $113.96, but hospitals typically charge $405.29 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$22.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $113.96, your out-of-pocket cost would be approximately $22.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$113.96
Average Hospital Charge
$405.29
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$405.29
Medicare Allowed$113.96
Medicare Payment$89.85

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $89.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$130$46437158+14.2%
Connecticut$128$49424324+12.4%
New York$127$64488422+11.4%
District of Columbia$126$341751+10.1%
Florida$124$39686400+8.9%
Maryland$122$2941749+7.0%
Colorado$121$37724120+6.1%
California$121$36099635+6.0%
Illinois$121$45640324+5.9%
Massachusetts$117$45425188+2.6%
Nevada$115$4461448+0.9%
Delaware$114$250261+0.2%
Missouri$113$51031458-0.5%
Arizona$112$2422592-1.3%
Utah$112$300837-1.4%
South Carolina$112$25325110-1.4%
Virginia$112$3942371-1.9%
Oklahoma$112$302745-2.1%
Oregon$111$3561233-2.3%
Pennsylvania$111$28045181-2.7%
South Dakota$111$320328-3.0%
Louisiana$110$29216104-3.2%
Ohio$110$31640257-3.6%
Kansas$109$43612142-4.1%
Iowa$109$3171267-4.7%
Minnesota$108$47529224-4.9%
Mississippi$107$316642-6.0%
Washington$107$27523117-6.3%
Idaho$106$236357-7.1%
Michigan$105$3142380-7.6%
Nebraska$104$293795-8.4%
Texas$104$32575413-8.5%
Tennessee$102$30928111-10.1%
Indiana$101$28631163-11.2%
North Carolina$101$3443194-11.2%
New Hampshire$100$472444-12.5%
Wisconsin$99$84923150-13.5%
Kentucky$98$2721134-14.4%
Georgia$96$38425103-15.6%
Alabama$93$2241253-18.6%
Vermont$86$495114-24.9%
North Dakota$76$152628-33.0%

⚠️ 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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