93455

Insertion of tube in bypass graft for diagnosis with review by radiologist

Medicare pricing data for 5,295 providers across 50 states

🤖AI Overview

This procedure has a 5.9x markup — hospitals charge $1,358 but Medicare allows only $231.59. Uninsured patients may face bills 5.9 times higher than what insurance negotiates. 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

Insertion of tube in bypass graft for diagnosis with review by radiologist (HCPCS code 93455) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $231.59, but hospitals typically charge $1,358 — a 5.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$46.32

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $231.59, your out-of-pocket cost would be approximately $46.32. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$231.59
Average Hospital Charge
$1,358
Markup Ratio
5.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,358.38
Medicare Allowed$231.59
Medicare Payment$182.59

Hospitals charge 5.9x more than what Medicare allows for this procedure. Medicare actually pays $182.59 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Louisiana$279$1,815140387+20.3%
Oregon$272$98162195+17.6%
Arizona$269$1,413138458+16.3%
Texas$264$1,8024051,118+13.9%
Oklahoma$261$95191295+12.9%
Alaska$261$8,1051361+12.8%
New York$261$1,5392571,000+12.7%
Nevada$260$1,78448109+12.2%
Florida$257$1,1103841,258+11.1%
Kansas$254$2,22166408+9.7%
Nebraska$252$90944150+8.9%
District of Columbia$242$1,0121399+4.5%
Illinois$238$1,468244906+3.0%
Connecticut$237$1,75657161+2.4%
Vermont$236$1,3821068+1.9%
Massachusetts$233$1,063122674+0.8%
Maryland$233$94565354+0.5%
New Hampshire$232$1,99329174+0.4%
New Jersey$231$1,238117349-0.2%
Delaware$228$8121868-1.4%
Hawaii$225$706711-2.9%
Montana$225$1,02228125-3.0%
Georgia$224$1,341123335-3.2%
Pennsylvania$224$1,3302341,022-3.3%
Rhode Island$223$1,297914-3.7%
Michigan$223$1,021186482-3.9%
Colorado$220$86376240-4.8%
California$220$1,3823651,198-4.9%
Virginia$218$951142510-5.7%
Ohio$217$1,573217854-6.2%
South Dakota$217$1,71824151-6.5%
New Mexico$216$1,1971829-6.5%
Washington$216$764120375-6.9%
Utah$215$97339109-7.4%
Maine$214$1,29624137-7.6%
West Virginia$213$1,09340134-7.9%
North Carolina$213$1,062152488-7.9%
Missouri$212$1,003118388-8.5%
Alabama$211$1,27185291-9.1%
Mississippi$210$1,58168227-9.3%
South Carolina$210$1,50984231-9.3%
Indiana$209$1,023134502-9.9%
North Dakota$209$1,13521113-9.9%
Wisconsin$207$3,382104453-10.4%
Iowa$207$88456273-10.7%
Kentucky$206$711101312-10.9%
Arkansas$205$84985286-11.3%
Idaho$202$7373098-12.6%
Tennessee$199$861142419-14.0%
Minnesota$197$1,260101574-14.8%

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

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