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
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
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.
What Hospitals Charge vs. What Medicare Pays
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
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $27 | $101 | 491 | 382,257 | +16.7% |
| California | $27 | $101 | 683 | 80,126 | +15.8% |
| New Jersey | $26 | $100 | 289 | 48,767 | +10.8% |
| Massachusetts | $25 | $120 | 174 | 37,991 | +9.9% |
| Hawaii | $25 | $75 | 15 | 601 | +9.4% |
| Colorado | $25 | $69 | 80 | 34,551 | +9.3% |
| Alaska | $25 | $329 | 7 | 7,223 | +7.5% |
| Maryland | $25 | $83 | 124 | 27,441 | +7.0% |
| Connecticut | $24 | $111 | 123 | 15,457 | +6.0% |
| New Hampshire | $24 | $113 | 11 | 1,046 | +5.6% |
| District of Columbia | $24 | $77 | 14 | 2,296 | +4.3% |
| Rhode Island | $24 | $81 | 16 | 2,324 | +2.0% |
| Washington | $24 | $74 | 172 | 35,640 | +2.0% |
| Virginia | $23 | $78 | 145 | 27,762 | +1.4% |
| Oregon | $23 | $80 | 57 | 8,589 | +0.4% |
| Delaware | $23 | $98 | 39 | 8,160 | -1.0% |
| Montana | $23 | $93 | 16 | 4,434 | -1.3% |
| Vermont | $23 | $80 | 3 | 1,321 | -1.6% |
| Minnesota | $23 | $111 | 73 | 38,157 | -1.9% |
| Nevada | $22 | $67 | 57 | 3,890 | -3.1% |
| Wyoming | $22 | $250 | 8 | 823 | -3.6% |
| Texas | $22 | $95 | 647 | 138,849 | -3.8% |
| Illinois | $22 | $104 | 232 | 59,622 | -3.8% |
| Pennsylvania | $22 | $97 | 392 | 89,298 | -3.8% |
| Florida | $22 | $68 | 806 | 132,709 | -5.7% |
| Arizona | $22 | $82 | 216 | 39,547 | -6.7% |
| Michigan | $21 | $61 | 187 | 24,726 | -7.5% |
| South Dakota | $21 | $49 | 9 | 739 | -8.1% |
| Wisconsin | $21 | $242 | 82 | 11,513 | -8.4% |
| Georgia | $21 | $106 | 158 | 44,328 | -8.9% |
| New Mexico | $21 | $71 | 16 | 1,365 | -9.4% |
| North Carolina | $21 | $106 | 215 | 61,961 | -9.5% |
| Missouri | $21 | $88 | 209 | 47,250 | -10.0% |
| Utah | $21 | $83 | 44 | 10,805 | -10.3% |
| Ohio | $21 | $58 | 177 | 73,990 | -10.7% |
| Indiana | $21 | $89 | 129 | 47,206 | -11.0% |
| South Carolina | $21 | $84 | 204 | 37,250 | -11.0% |
| West Virginia | $21 | $59 | 27 | 8,339 | -11.1% |
| North Dakota | $20 | $96 | 4 | 235 | -11.4% |
| Nebraska | $20 | $59 | 49 | 23,031 | -11.9% |
| Kansas | $20 | $80 | 104 | 30,742 | -12.0% |
| Idaho | $20 | $62 | 34 | 4,026 | -12.1% |
| Iowa | $20 | $93 | 58 | 18,325 | -12.4% |
| Oklahoma | $20 | $74 | 71 | 16,784 | -13.3% |
| Tennessee | $20 | $71 | 186 | 47,177 | -13.7% |
| Louisiana | $20 | $80 | 152 | 22,960 | -14.2% |
| Alabama | $20 | $65 | 138 | 29,530 | -14.4% |
| Kentucky | $20 | $56 | 144 | 28,180 | -14.5% |
| Mississippi | $19 | $88 | 73 | 17,839 | -16.9% |
| Arkansas | $19 | $64 | 61 | 14,129 | -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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