92626

Evaluation of hearing function related to surgically implanted hearing device, first hour

Medicare pricing data for 1,556 providers across 50 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

Evaluation of hearing function related to surgically implanted hearing device, first hour (HCPCS code 92626) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $85.74, but hospitals typically charge $242.56 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$17.15

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $85.74, your out-of-pocket cost would be approximately $17.15. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$85.74
Average Hospital Charge
$242.56
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$242.56
Medicare Allowed$85.74
Medicare Payment$62.46

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $62.46 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$99$2298115+15.6%
New York$95$339601,178+10.5%
California$94$332961,554+10.0%
New Jersey$93$25413177+8.9%
Connecticut$92$25616189+7.8%
Maryland$92$23633496+7.7%
Hawaii$92$212420+7.1%
Alaska$91$127492+6.2%
Washington$91$24547500+5.9%
Rhode Island$89$144441+4.0%
Colorado$88$20850462+3.2%
Massachusetts$88$22329144+3.1%
Montana$87$21410125+1.2%
Delaware$87$153579+1.2%
Oregon$87$27027244+0.9%
Wyoming$86$230329+0.5%
Georgia$86$21240599+0.2%
Texas$86$2051121,749+0.0%
Missouri$86$27444906-0.2%
Nevada$85$1971188-0.5%
Virginia$85$23840354-0.7%
Florida$85$2281181,375-0.8%
Minnesota$85$31542620-1.1%
Arizona$85$22650871-1.2%
New Hampshire$85$2877106-1.3%
Illinois$84$30447571-1.8%
Michigan$84$17751327-1.9%
North Carolina$84$20055616-2.5%
Utah$83$21019249-3.2%
Indiana$83$18534373-3.4%
New Mexico$83$21114158-3.7%
Pennsylvania$82$20360424-4.0%
Nebraska$82$22617246-4.0%
Louisiana$82$1801896-4.1%
Kansas$82$2218208-4.2%
Iowa$82$22313195-4.3%
Oklahoma$82$15839861-4.3%
South Carolina$82$23224723-4.7%
Kentucky$82$19732412-4.7%
South Dakota$82$19617154-4.9%
Tennessee$81$29736420-5.4%
Maine$81$2021069-5.5%
Alabama$81$13527506-6.1%
Mississippi$80$169589-6.4%
Arkansas$80$20417121-6.5%
West Virginia$80$171459-6.8%
Wisconsin$80$31130420-7.2%
Ohio$77$35258492-10.5%
Idaho$77$17914110-10.6%
North Dakota$77$22013111-10.8%

⚠️ 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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