64999

Other procedure on nervous system

Medicare pricing data for 10,389 providers across 51 states

🤖AI Overview

This procedure has a 16.1x markup — hospitals charge $1,308 but Medicare allows only $81.15. Uninsured patients may face bills 16.1 times higher than what insurance negotiates. Prices vary significantly by location — from $30 in Rhode Island to $356 in Delaware. 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

Other procedure on nervous system (HCPCS code 64999) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $81.15, but hospitals typically charge $1,308 — a 16.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$16.23

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $81.15, your out-of-pocket cost would be approximately $16.23. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$81.15
Average Hospital Charge
$1,308
Markup Ratio
16.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,308.22
Medicare Allowed$81.15
Medicare Payment$64.70

Hospitals charge 16.1x more than what Medicare allows for this procedure. Medicare actually pays $64.70 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$356$2,19542121+338.9%
South Carolina$245$6391481,226+201.4%
Pennsylvania$195$1,4265602,735+140.2%
Minnesota$191$2,060155421+135.8%
North Dakota$180$1,9171124+121.2%
Washington$147$2,18277234+81.0%
Massachusetts$136$1,7712771,103+67.5%
Oregon$132$1,56438146+62.7%
California$122$1,3984421,834+50.1%
Arizona$110$1,67775206+34.9%
West Virginia$106$1,07736102+30.8%
Illinois$102$2,0883161,450+26.2%
Indiana$100$1,060185453+23.5%
Alaska$91$7582137+12.4%
Montana$90$7651118+11.3%
Maryland$87$1,4493612,348+6.7%
Florida$86$1,0926733,134+5.6%
South Dakota$85$6652352+4.6%
North Carolina$83$1,7383101,207+2.3%
Hawaii$81$9871237-0.2%
Louisiana$79$920112506-3.3%
Michigan$76$1,3163731,702-5.8%
Oklahoma$75$1,0662621,125-7.3%
Mississippi$72$871126588-11.3%
Colorado$72$1,3203561,672-11.6%
Kentucky$71$1,0862561,252-12.5%
Utah$68$75467220-16.3%
Georgia$67$1,213149436-18.0%
Virginia$65$1,0462341,230-20.4%
Wisconsin$63$1,7072221,050-21.8%
Iowa$61$88590230-24.8%
Texas$61$1,1721,5199,744-25.3%
New Mexico$60$1,408106329-25.5%
Kansas$60$1,029152756-26.6%
Ohio$57$1,1125954,210-29.2%
New Jersey$57$1,7462601,881-29.9%
Connecticut$57$1,3851341,087-30.3%
New York$56$1,8914804,801-31.4%
Missouri$55$1,0092581,653-31.8%
Tennessee$55$1,0582441,334-32.6%
Nevada$53$1,1072067-34.2%
Alabama$52$63754341-36.0%
Arkansas$50$1,270136842-38.2%
Wyoming$49$824915-39.2%
New Hampshire$44$1,38979359-45.8%
Vermont$43$883835-47.1%
District of Columbia$40$91244181-50.9%
Nebraska$38$6421241,226-53.1%
Idaho$37$50512141-54.5%
Maine$36$7573482-55.3%
Rhode Island$30$1,24029144-63.6%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber