93296

Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days

Medicare pricing data for 7,434 providers across 50 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.9 million services annually. Even small pricing inefficiencies here affect millions of patients. 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, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days (HCPCS code 93296) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $23.07, but hospitals typically charge $91.01 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $23.07, your out-of-pocket cost would be approximately $4.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$23.07
Average Hospital Charge
$91.01
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$91.01
Medicare Allowed$23.07
Medicare Payment$16.64

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $16.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$27$101491382,257+16.7%
California$27$10168380,126+15.8%
New Jersey$26$10028948,767+10.8%
Massachusetts$25$12017437,991+9.9%
Hawaii$25$7515601+9.4%
Colorado$25$698034,551+9.3%
Alaska$25$32977,223+7.5%
Maryland$25$8312427,441+7.0%
Connecticut$24$11112315,457+6.0%
New Hampshire$24$113111,046+5.6%
District of Columbia$24$77142,296+4.3%
Rhode Island$24$81162,324+2.0%
Washington$24$7417235,640+2.0%
Virginia$23$7814527,762+1.4%
Oregon$23$80578,589+0.4%
Delaware$23$98398,160-1.0%
Montana$23$93164,434-1.3%
Vermont$23$8031,321-1.6%
Minnesota$23$1117338,157-1.9%
Nevada$22$67573,890-3.1%
Wyoming$22$2508823-3.6%
Texas$22$95647138,849-3.8%
Illinois$22$10423259,622-3.8%
Pennsylvania$22$9739289,298-3.8%
Florida$22$68806132,709-5.7%
Arizona$22$8221639,547-6.7%
Michigan$21$6118724,726-7.5%
South Dakota$21$499739-8.1%
Wisconsin$21$2428211,513-8.4%
Georgia$21$10615844,328-8.9%
New Mexico$21$71161,365-9.4%
North Carolina$21$10621561,961-9.5%
Missouri$21$8820947,250-10.0%
Utah$21$834410,805-10.3%
Ohio$21$5817773,990-10.7%
Indiana$21$8912947,206-11.0%
South Carolina$21$8420437,250-11.0%
West Virginia$21$59278,339-11.1%
North Dakota$20$964235-11.4%
Nebraska$20$594923,031-11.9%
Kansas$20$8010430,742-12.0%
Idaho$20$62344,026-12.1%
Iowa$20$935818,325-12.4%
Oklahoma$20$747116,784-13.3%
Tennessee$20$7118647,177-13.7%
Louisiana$20$8015222,960-14.2%
Alabama$20$6513829,530-14.4%
Kentucky$20$5614428,180-14.5%
Mississippi$19$887317,839-16.9%
Arkansas$19$646114,129-17.3%

⚠️ 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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