Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming
Medicare pricing data for 5,367 providers across 48 states
This procedure has a 5.6x markup — hospitals charge $270.38 but Medicare allows only $48.40. Uninsured patients may face bills 5.6 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
Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming (HCPCS code 95972) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $48.40, but hospitals typically charge $270.38 — a 5.6x 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 $48.40, your out-of-pocket cost would be approximately $9.68. 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 5.6x more than what Medicare allows for this procedure. Medicare actually pays $37.24 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $57 | $406 | 267 | 1,920 | +16.8% |
| New Jersey | $56 | $444 | 205 | 1,319 | +14.7% |
| Puerto Rico | $55 | $92 | 4 | 24 | +14.5% |
| California | $53 | $279 | 402 | 3,495 | +8.8% |
| Connecticut | $51 | $309 | 48 | 133 | +6.0% |
| Illinois | $51 | $452 | 169 | 1,060 | +5.9% |
| Florida | $51 | $237 | 609 | 4,521 | +5.4% |
| Maryland | $50 | $213 | 82 | 524 | +3.3% |
| Virginia | $50 | $191 | 91 | 742 | +2.6% |
| Massachusetts | $49 | $300 | 96 | 607 | +1.9% |
| Michigan | $49 | $289 | 174 | 865 | +1.1% |
| New Hampshire | $49 | $315 | 14 | 83 | +0.5% |
| Oregon | $48 | $281 | 59 | 650 | -0.6% |
| Washington | $48 | $203 | 83 | 651 | -1.1% |
| Arizona | $48 | $150 | 163 | 1,338 | -1.2% |
| Texas | $48 | $242 | 507 | 3,728 | -1.3% |
| Oklahoma | $48 | $227 | 124 | 1,338 | -1.7% |
| Pennsylvania | $47 | $202 | 265 | 1,498 | -1.9% |
| South Carolina | $47 | $286 | 116 | 1,090 | -3.1% |
| Minnesota | $47 | $289 | 97 | 658 | -3.6% |
| Colorado | $46 | $215 | 90 | 650 | -4.3% |
| Kansas | $46 | $386 | 65 | 729 | -4.3% |
| Georgia | $46 | $296 | 165 | 724 | -4.4% |
| Idaho | $46 | $220 | 20 | 105 | -4.8% |
| New Mexico | $46 | $191 | 17 | 50 | -5.5% |
| Delaware | $46 | $289 | 20 | 112 | -5.7% |
| North Carolina | $45 | $256 | 158 | 785 | -7.2% |
| Ohio | $45 | $234 | 228 | 1,278 | -7.5% |
| Tennessee | $45 | $225 | 164 | 1,121 | -7.9% |
| Louisiana | $44 | $254 | 73 | 368 | -8.1% |
| Rhode Island | $44 | $349 | 15 | 87 | -8.2% |
| Nevada | $44 | $410 | 50 | 178 | -8.4% |
| Utah | $44 | $211 | 36 | 141 | -8.7% |
| Kentucky | $44 | $172 | 65 | 393 | -8.8% |
| Missouri | $44 | $248 | 96 | 776 | -9.2% |
| Mississippi | $44 | $262 | 51 | 827 | -9.4% |
| Alabama | $44 | $150 | 59 | 332 | -9.5% |
| West Virginia | $44 | $202 | 25 | 142 | -9.5% |
| District of Columbia | $44 | $184 | 7 | 17 | -10.1% |
| Iowa | $42 | $226 | 32 | 174 | -13.3% |
| Arkansas | $41 | $219 | 41 | 222 | -14.4% |
| Maine | $41 | $229 | 5 | 12 | -14.5% |
| Indiana | $41 | $279 | 107 | 845 | -15.9% |
| Nebraska | $40 | $259 | 60 | 325 | -16.5% |
| North Dakota | $39 | $229 | 8 | 67 | -19.0% |
| Montana | $38 | $221 | 5 | 16 | -20.5% |
| Wisconsin | $38 | $634 | 81 | 315 | -21.0% |
| South Dakota | $35 | $88 | 15 | 163 | -27.3% |
⚠️ 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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