69433

Incision of eardrum with insertion of eardrum tube under local or topical anesthesia

Medicare pricing data for 5,844 providers across 51 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

Incision of eardrum with insertion of eardrum tube under local or topical anesthesia (HCPCS code 69433) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $207.66, but hospitals typically charge $620.73 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$41.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $207.66, your out-of-pocket cost would be approximately $41.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$207.66
Average Hospital Charge
$620.73
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$620.73
Medicare Allowed$207.66
Medicare Payment$157.09

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $157.09 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$245$1,2331559+18.0%
District of Columbia$244$580856+17.3%
New York$237$1,0613131,571+14.4%
California$234$6544212,109+12.5%
New Jersey$233$1,219162991+12.1%
Maryland$231$577109911+11.0%
Connecticut$230$57971352+10.8%
Colorado$222$604107353+6.8%
Delaware$220$56316251+6.1%
Massachusetts$219$730150837+5.3%
Hawaii$218$5401250+5.0%
Nevada$217$64425124+4.3%
Washington$216$582149865+4.2%
Wyoming$216$8641162+4.0%
Rhode Island$214$6301149+3.1%
Florida$213$5203702,662+2.8%
Virginia$211$5001691,216+1.7%
Texas$208$5374412,728+0.4%
Oregon$208$64792452+0.2%
Illinois$208$7051981,423+0.1%
Pennsylvania$206$6322621,824-0.6%
Georgia$206$623201971-0.7%
Utah$206$51860250-1.0%
North Carolina$204$5752111,263-1.6%
Arizona$204$446100603-1.8%
Michigan$203$4571861,228-2.1%
Oklahoma$201$50256471-3.0%
Indiana$201$545132758-3.4%
Minnesota$200$767133676-3.7%
South Carolina$199$4791341,230-4.2%
Kansas$198$65167735-4.7%
Ohio$196$5432371,335-5.8%
Kentucky$195$487103680-6.1%
Louisiana$194$612103418-6.6%
Alabama$193$351104643-6.8%
Mississippi$192$53854591-7.5%
Missouri$192$5201291,010-7.6%
Nebraska$191$52965330-7.9%
New Hampshire$191$55428146-8.0%
Iowa$190$57178524-8.4%
Montana$190$47633186-8.6%
Tennessee$188$668132955-9.5%
Arkansas$185$45053443-10.8%
Idaho$182$50231168-12.1%
Wisconsin$182$1,264130669-12.2%
South Dakota$181$50231137-12.9%
Maine$180$4392392-13.2%
West Virginia$176$50734216-15.1%
New Mexico$171$4741954-17.5%
North Dakota$163$45823122-21.5%
Vermont$132$2271031-36.6%

⚠️ 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