75984

Review by radiologist of image for replacement of stomach or large bowel tube

Medicare pricing data for 3,872 providers across 50 states

🤖AI Overview

This procedure has a 5.2x markup — hospitals charge $198.68 but Medicare allows only $38.25. Uninsured patients may face bills 5.2 times higher than what insurance negotiates. 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

Review by radiologist of image for replacement of stomach or large bowel tube (HCPCS code 75984) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $38.25, but hospitals typically charge $198.68 — a 5.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.65

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $38.25, your out-of-pocket cost would be approximately $7.65. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$38.25
Average Hospital Charge
$198.68
Markup Ratio
5.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$198.68
Medicare Allowed$38.25
Medicare Payment$29.96

Hospitals charge 5.2x more than what Medicare allows for this procedure. Medicare actually pays $29.96 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Massachusetts$43$161140721+12.1%
New York$42$1822731,052+10.5%
Florida$42$2383011,446+9.5%
New Jersey$42$235113446+9.0%
Alaska$41$373823+7.7%
California$41$1873341,541+6.5%
District of Columbia$40$1471590+4.2%
Maryland$39$13266500+2.2%
Connecticut$39$16952215+1.1%
Illinois$38$2671721,003-0.2%
Rhode Island$38$14421143-0.3%
Oregon$38$10847194-1.0%
Delaware$38$1071575-1.1%
Texas$38$229252879-1.9%
Colorado$37$16285316-2.0%
Pennsylvania$37$1632351,715-2.1%
Montana$37$143712-2.3%
Virginia$37$157115549-2.3%
Michigan$37$176122655-2.6%
Nevada$37$25631119-3.0%
Louisiana$37$13521167-3.0%
Washington$37$11573302-3.6%
North Dakota$37$11817261-3.8%
Minnesota$37$189911,254-4.1%
New Hampshire$37$3821791-4.4%
Vermont$37$284826-4.4%
Ohio$36$213124595-4.7%
Alabama$36$1722494-5.2%
South Carolina$36$17749254-5.4%
South Dakota$36$12415291-5.4%
New Mexico$36$1512492-5.6%
Arizona$36$29576504-5.6%
Kansas$36$9726147-5.7%
Puerto Rico$36$128716-5.8%
Oklahoma$36$10330115-5.8%
Kentucky$36$1633389-6.0%
Idaho$36$13017127-6.1%
Tennessee$36$17977378-6.3%
Georgia$36$17564167-6.5%
Indiana$36$12875334-6.8%
Wisconsin$36$339113845-6.8%
Nebraska$35$1281690-7.4%
Missouri$35$19287747-7.5%
Mississippi$35$1302138-8.4%
Arkansas$35$88435176-8.4%
West Virginia$35$1392165-8.8%
North Carolina$35$173153616-9.3%
Utah$35$1761759-9.4%
Maine$34$1132294-11.0%
Iowa$33$13133540-13.2%

⚠️ 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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