93285

Programming of cardiac rhythm monitor system

Medicare pricing data for 4,254 providers across 48 states

🤖AI Overview

Prices vary significantly by location — from $24 in Iowa to $66 in Maryland. 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

Programming of cardiac rhythm monitor system (HCPCS code 93285) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $52.99, but hospitals typically charge $151.24 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.60

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $52.99, your out-of-pocket cost would be approximately $10.60. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$52.99
Average Hospital Charge
$151.24
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$151.24
Medicare Allowed$52.99
Medicare Payment$40.06

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $40.06 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$66$13351832+24.7%
New Jersey$65$1841222,531+23.4%
New York$64$2663364,827+21.3%
Alaska$64$3855137+20.6%
California$60$1354444,819+14.0%
Montana$60$287632+13.4%
Puerto Rico$60$69968+13.3%
Nevada$59$1652049+11.9%
Delaware$59$9710187+10.9%
Arizona$54$1321662,638+2.5%
Arkansas$54$12817264+2.0%
District of Columbia$53$8119403+0.9%
New Mexico$52$125427-1.0%
Illinois$52$1421511,314-2.5%
Virginia$51$118112925-3.3%
Indiana$50$11646197-5.3%
Georgia$50$15594537-5.5%
Florida$50$1124924,152-5.9%
Pennsylvania$49$1472252,541-6.7%
Texas$49$1283244,050-6.9%
Utah$48$1221893-8.7%
Maine$48$113987-8.7%
Massachusetts$47$16298491-11.0%
Kansas$47$12030107-11.9%
Michigan$46$941421,075-12.5%
Washington$46$12070248-12.6%
Colorado$46$12057204-12.7%
Connecticut$46$15138165-12.9%
Kentucky$46$9560244-13.8%
Wisconsin$46$42290650-14.0%
Alabama$45$10436140-15.8%
South Carolina$44$11789708-16.5%
Tennessee$43$10373470-19.4%
Mississippi$43$108541,171-19.7%
Ohio$42$102111587-19.9%
North Carolina$42$118150819-21.0%
Minnesota$42$15837155-21.2%
Missouri$37$12166338-29.3%
West Virginia$37$952783-29.3%
Louisiana$37$10268203-29.5%
Oklahoma$36$8869264-31.4%
Oregon$35$11733102-33.1%
Rhode Island$34$981756-35.1%
Nebraska$31$10343208-40.9%
Idaho$29$7030256-45.3%
South Dakota$25$250549-53.1%
North Dakota$25$801058-53.3%
Iowa$24$92942-54.6%

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

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