93656

Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation

Medicare pricing data for 2,869 providers across 52 states

🤖AI Overview

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

Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation (HCPCS code 93656) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $938.15, but hospitals typically charge $3,961 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$187.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $938.15, your out-of-pocket cost would be approximately $187.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$938.15
Average Hospital Charge
$3,961
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,961.06
Medicare Allowed$938.15
Medicare Payment$745.66

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $745.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,186$9,2014199+26.4%
New York$1,098$8,1561724,572+17.0%
District of Columbia$1,036$3,7738230+10.5%
Illinois$1,015$4,1851303,138+8.2%
New Jersey$1,000$3,548771,916+6.6%
Maryland$996$3,387471,341+6.2%
Florida$995$3,2002317,507+6.0%
Connecticut$977$4,02136508+4.1%
Massachusetts$973$4,114832,348+3.7%
Michigan$961$2,987931,735+2.4%
Delaware$953$2,54411223+1.5%
Washington$944$3,048531,511+0.6%
Rhode Island$943$3,0769236+0.5%
Pennsylvania$942$3,0621603,234+0.4%
Hawaii$940$2,775340+0.1%
New Hampshire$939$15,43311264+0.1%
New Mexico$939$2,5849329+0.1%
Nevada$939$3,43817453+0.1%
Puerto Rico$934$9811030-0.4%
Virginia$933$2,951823,058-0.6%
Colorado$931$4,209491,271-0.8%
Louisiana$929$3,14538780-1.0%
Ohio$922$4,5461202,714-1.8%
California$921$3,5902517,712-1.8%
Montana$919$3,73810337-2.0%
Georgia$918$4,248722,009-2.1%
Texas$914$3,7302096,178-2.6%
West Virginia$913$2,88918388-2.6%
Missouri$913$3,337481,178-2.7%
Arizona$911$3,621662,237-2.9%
Oregon$905$2,98731540-3.6%
Utah$893$2,93918649-4.8%
Kentucky$893$2,63941675-4.8%
Maine$889$2,94314203-5.2%
Vermont$887$4,3666136-5.4%
North Carolina$887$4,129902,310-5.5%
South Carolina$885$4,166421,801-5.7%
Oklahoma$879$2,91725923-6.3%
Minnesota$876$4,90367968-6.7%
Alabama$875$3,109421,362-6.8%
Wyoming$871$4,086211-7.1%
Kansas$864$2,98531901-8.0%
North Dakota$860$3,4347114-8.3%
Indiana$859$4,315701,827-8.4%
Wisconsin$859$9,746621,015-8.5%
South Dakota$857$1,108471-8.6%
Mississippi$857$4,43014418-8.7%
Tennessee$847$3,053692,330-9.7%
Arkansas$844$2,22417951-10.1%
Iowa$844$3,28331782-10.1%
Idaho$828$2,79313376-11.7%
Nebraska$828$2,96718460-11.8%

⚠️ 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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