92563

Test to assess defects in adaption to sounds

Medicare pricing data for 207 providers across 14 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Test to assess defects in adaption to sounds (HCPCS code 92563) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.92, but hospitals typically charge $64.68 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $36.92, your out-of-pocket cost would be approximately $7.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$36.92
Average Hospital Charge
$64.68
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$64.68
Medicare Allowed$36.92
Medicare Payment$27.57

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $27.57 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$39$77602,841+6.8%
New Jersey$38$4714835+3.1%
Hawaii$37$601164+1.5%
California$37$63322,080+0.6%
Rhode Island$34$401210-6.7%
Maryland$33$611182-9.5%
Pennsylvania$33$6810147-10.2%
Puerto Rico$33$34378-10.4%
Illinois$33$436277-10.9%
Tennessee$33$452254-11.3%
Virginia$33$49373-11.5%
Oregon$32$65162-13.8%
Florida$31$6823578-15.5%
Ohio$30$45380-18.1%

⚠️ 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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