94640

Inhalation treatment for airway obstruction or sputum production

Medicare pricing data for 45,069 providers across 52 states

🤖AI Overview

This procedure has a 6.0x markup — hospitals charge $51.51 but Medicare allows only $8.54. Uninsured patients may face bills 6.0 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

Inhalation treatment for airway obstruction or sputum production (HCPCS code 94640) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.54, but hospitals typically charge $51.51 — a 6.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.71

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8.54, your out-of-pocket cost would be approximately $1.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$8.54
Average Hospital Charge
$51.51
Markup Ratio
6.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$51.51
Medicare Allowed$8.54
Medicare Payment$6.20

Hospitals charge 6.0x more than what Medicare allows for this procedure. Medicare actually pays $6.20 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$10$582,13213,423+22.8%
New Jersey$10$651,0986,957+18.3%
California$10$603,73224,356+17.0%
Hawaii$9$6194326+9.1%
Maryland$9$561,0977,180+9.1%
District of Columbia$9$5580287+8.2%
Connecticut$9$574091,103+6.6%
Puerto Rico$9$1840524+4.4%
Massachusetts$9$561,0764,553+3.7%
Rhode Island$9$35144583+2.8%
Alaska$9$84178791+2.8%
Illinois$9$401,57117,176+0.8%
Nevada$9$554703,047+0.4%
Virginia$9$471,3715,942-0.1%
Florida$8$413,24923,329-0.8%
Washington$8$499383,026-0.9%
Delaware$8$411541,110-1.1%
Colorado$8$428852,574-1.6%
Michigan$8$421,4326,279-2.5%
Pennsylvania$8$501,7336,920-2.8%
Minnesota$8$616321,787-3.2%
New Hampshire$8$572781,389-4.8%
Arizona$8$491,0956,631-4.8%
Texas$8$553,43414,767-5.2%
South Dakota$8$4497247-5.4%
Montana$8$68161552-6.1%
North Dakota$8$7486231-6.3%
Oregon$8$434601,255-6.6%
Wyoming$8$62158628-7.1%
Georgia$8$631,8157,909-7.7%
Vermont$8$4272228-8.8%
Ohio$8$481,4594,140-10.3%
Missouri$8$485672,252-10.5%
Wisconsin$8$1317782,364-10.7%
Maine$8$57120574-11.2%
North Carolina$8$502,1197,223-11.9%
South Carolina$8$629384,540-11.9%
Utah$8$403971,218-11.9%
Indiana$7$469923,122-13.5%
Nebraska$7$43319723-13.8%
Louisiana$7$637532,982-13.9%
Kansas$7$444221,336-14.4%
Iowa$7$49341998-14.5%
Alabama$7$389943,891-14.6%
Tennessee$7$451,4185,783-14.8%
New Mexico$7$442971,174-14.9%
West Virginia$7$44177580-15.0%
Kentucky$7$446672,169-15.3%
Oklahoma$7$376862,307-15.9%
Idaho$7$37254675-16.5%
Arkansas$7$365672,164-18.3%
Mississippi$7$435812,252-19.0%

⚠️ 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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