93286

Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery

Medicare pricing data for 2,049 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $12 in Utah to $46 in Delaware. 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 single, dual, or multiple lead or leadless pacemaker system before or after surgery (HCPCS code 93286) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.94, but hospitals typically charge $91.30 — a 4.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.94, your out-of-pocket cost would be approximately $3.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.94
Average Hospital Charge
$91.30
Markup Ratio
4.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$91.30
Medicare Allowed$19.94
Medicare Payment$15.58

Hospitals charge 4.6x more than what Medicare allows for this procedure. Medicare actually pays $15.58 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$46$1055109+129.3%
Texas$35$1651472,753+75.4%
North Carolina$26$11750533+28.0%
Massachusetts$24$104962,004+19.8%
California$24$921461,761+19.0%
Minnesota$23$85792,382+13.8%
Alaska$22$15510218+12.7%
Florida$21$1031191,849+7.4%
Indiana$20$5034123+1.5%
Pennsylvania$20$631302,089-1.4%
New Jersey$20$9131198-1.9%
Missouri$20$5840210-2.0%
Arizona$19$126561,728-2.9%
Maryland$19$5719351-4.0%
New York$19$961132,031-5.8%
Iowa$19$592488-6.0%
Georgia$17$6961749-17.2%
New Hampshire$17$14121272-17.2%
Washington$15$4256588-23.5%
District of Columbia$15$54556-24.0%
South Carolina$15$6030345-24.4%
Wisconsin$15$187861,348-24.4%
Colorado$15$5826222-26.6%
Michigan$15$6357878-26.7%
Montana$14$4220370-27.4%
Ohio$14$56951,117-27.5%
Nevada$14$54619-27.7%
North Dakota$14$488439-28.1%
Kentucky$14$4034232-28.4%
Vermont$14$93859-28.8%
South Dakota$14$37742-29.1%
Maine$14$4120240-29.1%
Rhode Island$14$38171-29.1%
New Mexico$14$51523-29.2%
Louisiana$14$541128-29.3%
Virginia$14$36631,430-29.8%
Kansas$14$9226575-29.9%
Alabama$14$261571-30.1%
Mississippi$14$64440-30.4%
Connecticut$14$7023221-30.7%
Oklahoma$14$481351-30.8%
Tennessee$14$3940210-30.8%
Nebraska$14$89423-31.0%
Arkansas$14$446168-31.7%
Illinois$14$8468997-31.9%
Oregon$14$4130374-32.3%
Wyoming$13$92579-32.9%
Idaho$13$53976-33.2%
West Virginia$12$41737-37.6%
Utah$12$3424865-37.8%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber

🏥 See Medicare hospital data on OpenMedicare