94003

Follow-up inpatient or observation ventilation assistance and management

Medicare pricing data for 488 providers across 25 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

Follow-up inpatient or observation ventilation assistance and management (HCPCS code 94003) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $65.40, but hospitals typically charge $190.24 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.08

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $65.40, your out-of-pocket cost would be approximately $13.08. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$65.40
Average Hospital Charge
$190.24
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$190.24
Medicare Allowed$65.40
Medicare Payment$51.94

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $51.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$73$16623678+10.9%
District of Columbia$69$17661,018+6.0%
New Jersey$68$11113734+4.0%
Massachusetts$67$26612518+2.8%
Illinois$67$261425,454+2.5%
Maryland$67$1701374+2.5%
Florida$66$137351,272+0.2%
Michigan$65$125301,681-1.1%
Pennsylvania$64$111182,367-1.5%
California$64$22529111-2.5%
Arizona$64$251946-2.9%
Ohio$63$24937492-4.0%
West Virginia$62$300118-5.1%
Georgia$62$1791159-5.3%
Kentucky$62$1585156-5.6%
Texas$61$17124387-6.1%
North Dakota$61$243222-6.2%
South Carolina$61$17423383-6.3%
South Dakota$61$162216-6.5%
Alabama$61$906129-6.5%
Wisconsin$61$355828-7.1%
North Carolina$61$17931306-7.2%
Indiana$60$1641778-7.7%
Tennessee$60$178121,066-8.1%
Minnesota$58$29242391-11.1%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber