77523

Intermediate proton beam radiation treatment

Medicare pricing data for 136 providers across 20 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

Intermediate proton beam radiation treatment (HCPCS code 77523) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,071, but hospitals typically charge $5,312 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$214.14

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,071, your out-of-pocket cost would be approximately $214.14. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,071
Average Hospital Charge
$5,312
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,312.49
Medicare Allowed$1,070.68
Medicare Payment$853.05

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $853.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
North Carolina$1,236$3,7731527+15.5%
Georgia$1,228$3,786205,216+14.7%
Massachusetts$1,228$3,7731118+14.7%
New Jersey$1,197$14,87061,947+11.8%
Alabama$1,151$5,926131,394+7.5%
Ohio$1,147$4,0292942+7.1%
California$1,136$6,31962,505+6.1%
Iowa$1,115$4,0801145+4.1%
Wisconsin$1,114$4,0912125+4.0%
Maryland$1,111$4,496136,269+3.8%
Pennsylvania$1,081$10,0725859+1.0%
New York$1,080$10,002162,798+0.8%
Washington$1,079$10,0001191+0.8%
Florida$1,053$5,0672013,177-1.6%
Tennessee$1,046$3,586714,562-2.3%
Texas$1,027$7,66032,927-4.1%
Illinois$950$5,91611,634-11.3%
Virginia$888$5,1113553-17.0%
Oklahoma$872$4,38952,760-18.6%
Arkansas$863$4,35761,232-19.4%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber