Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft
Medicare pricing data for 2,469 providers across 47 states
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
Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft (HCPCS code 92943) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $621.43, but hospitals typically charge $2,331 — a 3.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $621.43, your out-of-pocket cost would be approximately $124.29. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $493.16 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $773 | $5,429 | 9 | 26 | +24.4% |
| New York | $744 | $3,363 | 121 | 429 | +19.7% |
| District of Columbia | $681 | $2,575 | 6 | 34 | +9.6% |
| Illinois | $675 | $2,705 | 116 | 289 | +8.7% |
| Florida | $667 | $1,928 | 170 | 332 | +7.3% |
| Maryland | $663 | $1,749 | 28 | 82 | +6.7% |
| Connecticut | $654 | $3,109 | 16 | 43 | +5.3% |
| Washington | $650 | $1,950 | 66 | 294 | +4.7% |
| New Jersey | $649 | $2,562 | 73 | 157 | +4.4% |
| Massachusetts | $643 | $2,830 | 44 | 172 | +3.5% |
| Nevada | $639 | $2,121 | 28 | 65 | +2.9% |
| New Mexico | $637 | $1,896 | 16 | 44 | +2.6% |
| Virginia | $637 | $1,952 | 65 | 159 | +2.5% |
| Pennsylvania | $634 | $1,865 | 85 | 247 | +2.0% |
| Oregon | $633 | $2,609 | 22 | 89 | +1.9% |
| California | $631 | $2,580 | 229 | 773 | +1.5% |
| Louisiana | $628 | $1,977 | 48 | 135 | +1.0% |
| Rhode Island | $625 | $1,904 | 4 | 16 | +0.6% |
| New Hampshire | $625 | $6,485 | 12 | 38 | +0.6% |
| Utah | $624 | $1,784 | 24 | 56 | +0.3% |
| Georgia | $621 | $2,609 | 70 | 291 | -0.0% |
| Montana | $616 | $1,906 | 11 | 24 | -0.8% |
| Maine | $616 | $2,432 | 10 | 22 | -0.9% |
| West Virginia | $613 | $1,867 | 16 | 39 | -1.3% |
| Michigan | $612 | $1,768 | 84 | 349 | -1.5% |
| Colorado | $609 | $1,638 | 42 | 163 | -2.0% |
| Arizona | $608 | $1,702 | 74 | 183 | -2.2% |
| Alabama | $603 | $2,010 | 34 | 61 | -2.9% |
| Missouri | $598 | $2,215 | 69 | 223 | -3.7% |
| Texas | $594 | $2,223 | 216 | 589 | -4.4% |
| Hawaii | $590 | $1,512 | 6 | 34 | -5.0% |
| Mississippi | $586 | $3,078 | 25 | 51 | -5.7% |
| South Carolina | $586 | $2,793 | 41 | 79 | -5.8% |
| Ohio | $583 | $2,161 | 89 | 202 | -6.3% |
| North Carolina | $577 | $2,454 | 66 | 163 | -7.2% |
| South Dakota | $572 | $1,879 | 10 | 52 | -7.9% |
| Minnesota | $568 | $2,664 | 45 | 128 | -8.5% |
| Kentucky | $566 | $1,487 | 44 | 74 | -8.9% |
| Idaho | $561 | $1,658 | 10 | 16 | -9.7% |
| Indiana | $558 | $2,199 | 58 | 187 | -10.2% |
| Arkansas | $557 | $1,410 | 41 | 127 | -10.4% |
| Iowa | $555 | $1,927 | 23 | 74 | -10.7% |
| Wisconsin | $550 | $6,116 | 34 | 64 | -11.5% |
| Kansas | $548 | $1,914 | 23 | 74 | -11.9% |
| Oklahoma | $548 | $1,795 | 42 | 111 | -11.9% |
| Tennessee | $536 | $1,802 | 73 | 164 | -13.7% |
| Nebraska | $494 | $1,726 | 13 | 33 | -20.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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