92612

Evaluation and recording of swallowing using an endoscope

Medicare pricing data for 618 providers across 34 states

🤖AI Overview

Prices vary significantly by location — from $64 in Louisiana to $227 in New York. Where you get this procedure matters more than almost any other factor. 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

Evaluation and recording of swallowing using an endoscope (HCPCS code 92612) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $203.56, but hospitals typically charge $631.05 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$40.71

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $203.56, your out-of-pocket cost would be approximately $40.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$203.56
Average Hospital Charge
$631.05
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$631.05
Medicare Allowed$203.56
Medicare Payment$158.90

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $158.90 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$227$843781,143+11.7%
Maryland$224$5191049+10.0%
California$223$890692,104+9.7%
New Jersey$221$54818239+8.5%
Colorado$204$3406560.0%
Massachusetts$203$55722147-0.1%
Illinois$202$48312189-0.8%
Pennsylvania$200$45723300-1.6%
Minnesota$200$95621173-1.8%
Nevada$194$5377712-4.9%
Virginia$192$40118168-5.4%
Wisconsin$191$430833-6.4%
Arizona$190$497836-6.6%
Washington$190$438852-6.7%
Florida$190$41785697-6.7%
Texas$189$37333454-7.1%
Missouri$189$4758112-7.1%
Georgia$188$6261888-7.7%
Indiana$182$340484-10.8%
Ohio$181$38831220-10.8%
Utah$181$39613100-10.9%
Kansas$181$3431282-11.2%
North Carolina$181$4981582-11.3%
Tennessee$180$370732-11.6%
Oklahoma$179$300285-12.3%
Iowa$178$5231038-12.6%
South Carolina$176$4261042-13.4%
Alabama$173$2231573-15.1%
Idaho$171$295224-16.0%
Arkansas$162$323641-20.2%
New Mexico$119$341322-41.6%
Michigan$88$3657134-56.8%
Maine$66$186415-67.5%
Louisiana$64$2674144-68.5%

⚠️ 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