92504

Exam of ear using a microscope

Medicare pricing data for 6,318 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $9 in Vermont to $34 in New York. 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

Exam of ear using a microscope (HCPCS code 92504) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $27.10, but hospitals typically charge $83.16 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.42

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $27.10, your out-of-pocket cost would be approximately $5.42. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$27.10
Average Hospital Charge
$83.16
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$83.16
Medicare Allowed$27.10
Medicare Payment$19.97

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $19.97 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$34$9734917,654+24.1%
New Jersey$33$9212110,014+22.4%
Connecticut$31$78561,167+13.3%
California$31$10464040,321+12.6%
Alaska$30$14122477+11.5%
Rhode Island$30$949504+10.7%
Maryland$30$811187,035+10.4%
Hawaii$30$7315330+9.2%
Puerto Rico$29$48635+7.5%
District of Columbia$29$78222,253+7.5%
Colorado$29$621347,047+6.2%
Nevada$28$6330558+4.8%
Wyoming$28$11713284+4.5%
Washington$28$751805,213+3.7%
Virginia$28$711698,510+2.8%
Pennsylvania$27$732246,831-0.3%
Florida$27$6941622,441-0.4%
Texas$27$8048416,909-0.8%
Delaware$26$708270-2.9%
North Carolina$26$702175,094-4.3%
Arkansas$26$6335943-4.8%
Alabama$26$66702,098-5.8%
Oklahoma$25$68711,933-6.1%
Indiana$25$68842,339-6.1%
Arizona$25$531355,603-6.9%
South Carolina$25$801466,137-7.5%
Minnesota$25$951543,426-7.8%
Georgia$25$1021805,206-7.9%
Mississippi$25$92451,247-8.1%
Massachusetts$25$851704,978-9.4%
Kentucky$25$571163,145-9.5%
Kansas$24$71704,369-10.3%
Tennessee$24$841325,268-10.5%
Missouri$24$781665,179-11.1%
Nebraska$24$89822,439-11.5%
Oregon$24$89953,905-11.9%
Illinois$23$832437,319-13.3%
Michigan$23$561613,298-14.9%
South Dakota$23$93411,208-16.9%
Louisiana$22$85841,532-17.0%
Utah$22$85801,590-17.0%
Idaho$22$6729717-18.4%
West Virginia$22$69421,554-19.4%
Iowa$22$911073,906-20.3%
Montana$21$6037613-21.1%
Wisconsin$20$1471483,519-25.8%
Ohio$20$671945,450-27.9%
New Hampshire$16$52331,116-42.7%
New Mexico$14$8532716-48.1%
Maine$13$5030834-53.7%
North Dakota$10$2632591-61.6%
Vermont$9$3217641-66.6%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber