93289

Evaluation of single, dual, or multiple lead implantable defibrillator system

Medicare pricing data for 6,553 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $35 in Vermont to $73 in Wyoming. 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

Evaluation of single, dual, or multiple lead implantable defibrillator system (HCPCS code 93289) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $56.61, but hospitals typically charge $167.31 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.32

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $56.61, your out-of-pocket cost would be approximately $11.32. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$56.61
Average Hospital Charge
$167.31
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$167.31
Medicare Allowed$56.61
Medicare Payment$41.38

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $41.38 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wyoming$73$669747+28.7%
Puerto Rico$71$7334231+25.4%
California$70$1886495,735+23.3%
Delaware$67$16137236+19.0%
New Jersey$67$1871801,467+18.2%
New York$66$2813862,520+16.8%
Nebraska$65$17420204+15.0%
Florida$62$1586675,266+10.0%
North Carolina$61$1691601,715+7.3%
Maryland$60$1441242,674+5.7%
Pennsylvania$59$1482621,772+5.0%
South Carolina$59$183110586+4.2%
Alabama$58$13581444+3.1%
District of Columbia$58$17217172+2.6%
Mississippi$58$15759738+2.3%
Virginia$58$1541571,420+2.0%
Nevada$58$16755375+1.9%
North Dakota$57$196730+1.5%
Massachusetts$56$2142201,994-0.4%
Illinois$56$1752212,263-1.2%
Arizona$54$1451561,399-3.9%
Texas$54$1764744,237-3.9%
Alaska$54$33113118-4.6%
Indiana$53$1351181,405-5.9%
Connecticut$53$20159177-6.3%
Michigan$53$1331781,246-6.4%
Minnesota$53$20779249-6.6%
Georgia$52$1711651,273-7.8%
Kansas$52$15090850-8.0%
Hawaii$52$13630356-8.3%
Louisiana$52$171111979-8.5%
Oklahoma$51$11988852-10.8%
Utah$50$13159764-11.0%
South Dakota$50$15812150-11.7%
Arkansas$50$130901,130-12.1%
Montana$50$12918117-12.3%
Washington$50$1301351,608-12.3%
New Hampshire$49$16343250-12.8%
Oregon$49$1583766-13.7%
Ohio$48$1292471,762-14.4%
Missouri$48$1441411,116-14.6%
Maine$48$1382487-14.7%
Tennessee$48$1321812,354-14.8%
Wisconsin$48$3501061,059-15.9%
Colorado$47$20693477-16.8%
New Mexico$47$14916148-17.4%
Rhode Island$46$1261458-19.3%
Kentucky$44$1101321,132-22.3%
West Virginia$44$116701,060-22.4%
Iowa$41$15068420-26.9%
Idaho$35$10528438-37.3%
Vermont$35$1581342-37.6%

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

Related from TheDataProject.ai

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