95984

Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional

Medicare pricing data for 1,525 providers across 48 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

Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional (HCPCS code 95984) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $41.67, but hospitals typically charge $169.71 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.33

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $41.67, your out-of-pocket cost would be approximately $8.33. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$41.67
Average Hospital Charge
$169.71
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$169.71
Medicare Allowed$41.67
Medicare Payment$32.03

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $32.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$47$231721,653+13.5%
District of Columbia$47$1458430+13.3%
Connecticut$45$16015202+8.4%
New Jersey$45$23526985+8.4%
Maryland$45$12731500+8.2%
Hawaii$45$108560+7.2%
Illinois$44$175361,237+5.9%
California$44$1491745,993+5.9%
Delaware$44$119473+4.6%
Florida$43$2591094,285+3.9%
Massachusetts$43$17840874+3.5%
Puerto Rico$43$443187+3.2%
Virginia$43$13134718+2.9%
Pennsylvania$43$129772,188+2.4%
Colorado$43$165591,213+2.0%
Maine$42$95739+1.7%
New Hampshire$42$10114133+1.7%
Michigan$42$14550686+1.4%
Washington$42$114431,508+1.2%
Texas$42$1611428,522+1.1%
Arizona$42$216623,429+0.5%
Minnesota$42$494281,292+0.4%
West Virginia$42$17817861+0.1%
New Mexico$41$28310611-0.5%
Vermont$41$48161-0.6%
South Dakota$41$594159-0.7%
Louisiana$41$12916569-0.8%
Arkansas$41$1548323-1.3%
Kansas$41$17115371-1.4%
South Carolina$41$15117685-1.4%
Rhode Island$41$108445-1.5%
Idaho$41$9610225-2.4%
North Carolina$40$16032769-2.9%
Indiana$40$12413491-3.1%
Oregon$40$12231544-3.5%
Montana$40$10312254-3.5%
Georgia$39$158241,149-5.2%
Tennessee$39$13225548-5.5%
Nebraska$39$11117583-5.7%
Iowa$39$22211556-7.2%
Utah$39$7616250-7.3%
Wisconsin$39$36930343-7.4%
Missouri$38$153471,953-7.7%
Oklahoma$38$1439321-7.7%
Kentucky$38$11814533-9.0%
Ohio$37$247461,608-10.2%
Alabama$37$9714423-10.2%
Nevada$37$57145,170-11.0%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber

🏥 See Medicare hospital data on OpenMedicare