77263

Complex radiation therapy planning

Medicare pricing data for 6,989 providers across 52 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

Complex radiation therapy planning (HCPCS code 77263) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $168.10, but hospitals typically charge $783.20 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$33.62

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $168.10, your out-of-pocket cost would be approximately $33.62. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$168.10
Average Hospital Charge
$783.20
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$783.20
Medicare Allowed$168.10
Medicare Payment$132.30

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $132.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$222$3,25018682+31.9%
New York$185$90446416,892+10.0%
District of Columbia$183$528251,109+8.6%
California$180$85265527,425+7.1%
New Jersey$179$7411647,536+6.3%
Connecticut$177$713902,805+5.5%
Massachusetts$177$6552119,304+5.2%
Maryland$176$5301386,699+4.7%
Illinois$173$1,20824310,711+2.8%
Washington$172$6001976,660+2.3%
Rhode Island$170$55427770+1.4%
Hawaii$170$57226759+1.1%
Montana$169$651251,233+0.6%
Delaware$169$760221,283+0.4%
Virginia$169$7301268,449+0.3%
Florida$169$66956225,094+0.3%
New Hampshire$168$1,136311,718+0.2%
Nevada$168$755441,697-0.1%
Oregon$167$631952,914-0.6%
Puerto Rico$167$27518117-0.7%
Pennsylvania$166$69837613,665-1.4%
Wyoming$166$8095306-1.4%
Colorado$165$6221254,638-1.6%
North Dakota$165$76819966-1.7%
Arizona$165$6241527,767-1.7%
Michigan$165$6772187,339-1.8%
Utah$164$612481,743-2.4%
Vermont$164$92215596-2.6%
Minnesota$163$9761665,172-2.8%
Maine$163$49529862-2.8%
New Mexico$163$55128852-3.0%
Missouri$163$6491426,239-3.2%
South Dakota$163$472191,075-3.2%
Ohio$162$94232110,551-3.6%
Texas$162$1,17345118,910-3.6%
Georgia$162$6302167,494-3.6%
Wisconsin$161$2,0041755,303-4.2%
North Carolina$161$6472229,494-4.5%
West Virginia$161$670301,358-4.5%
Louisiana$160$5261003,281-4.6%
Kentucky$160$564913,545-5.1%
Oklahoma$159$636612,933-5.2%
Iowa$159$592622,814-5.7%
Idaho$158$484331,614-5.8%
Alabama$158$5881054,035-5.8%
Kansas$158$515503,471-5.8%
South Carolina$158$7471035,452-5.9%
Indiana$158$5991496,417-6.1%
Tennessee$158$5221567,301-6.3%
Nebraska$156$595382,144-6.9%
Mississippi$155$554462,365-8.0%
Arkansas$154$556552,578-8.2%

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

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