Maintenance of spinal canal or brain drug infusion pump by health care professional
Medicare pricing data for 465 providers across 34 states
Prices vary significantly by location — from $35 in Kansas to $130 in Alaska. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Maintenance of spinal canal or brain drug infusion pump by health care professional (HCPCS code 95991) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $99.08, but hospitals typically charge $405.61 — a 4.1x 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 $99.08, your out-of-pocket cost would be approximately $19.82. 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 4.1x more than what Medicare allows for this procedure. Medicare actually pays $75.04 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $130 | $592 | 2 | 37 | +31.0% |
| New York | $129 | $733 | 27 | 299 | +30.5% |
| New Jersey | $124 | $777 | 8 | 50 | +25.2% |
| Connecticut | $120 | $353 | 6 | 72 | +21.3% |
| Maryland | $118 | $414 | 19 | 243 | +19.0% |
| Texas | $107 | $332 | 21 | 190 | +7.5% |
| Minnesota | $104 | $372 | 7 | 78 | +4.5% |
| North Carolina | $102 | $308 | 10 | 141 | +3.2% |
| Florida | $102 | $377 | 90 | 1,962 | +2.8% |
| Illinois | $100 | $331 | 10 | 137 | +0.8% |
| Michigan | $99 | $468 | 25 | 223 | +0.3% |
| Oklahoma | $98 | $451 | 5 | 50 | -1.4% |
| Louisiana | $97 | $1,081 | 4 | 72 | -1.8% |
| California | $97 | $429 | 55 | 739 | -1.9% |
| South Carolina | $97 | $314 | 7 | 151 | -2.0% |
| Iowa | $95 | $272 | 4 | 28 | -4.1% |
| Kentucky | $93 | $495 | 10 | 64 | -6.0% |
| Alabama | $91 | $292 | 5 | 108 | -7.7% |
| Tennessee | $91 | $268 | 7 | 41 | -7.8% |
| Colorado | $91 | $944 | 8 | 74 | -7.9% |
| Georgia | $91 | $246 | 5 | 63 | -8.1% |
| Utah | $90 | $308 | 4 | 54 | -9.3% |
| Pennsylvania | $90 | $274 | 17 | 182 | -9.6% |
| Indiana | $88 | $281 | 9 | 54 | -11.0% |
| Virginia | $88 | $375 | 19 | 332 | -11.0% |
| Ohio | $83 | $280 | 15 | 266 | -16.7% |
| Wisconsin | $80 | $627 | 9 | 50 | -18.8% |
| Nebraska | $79 | $325 | 2 | 30 | -20.1% |
| Washington | $72 | $210 | 11 | 118 | -26.8% |
| Massachusetts | $43 | $314 | 11 | 67 | -56.4% |
| West Virginia | $39 | $101 | 6 | 45 | -60.8% |
| South Dakota | $38 | $254 | 4 | 13 | -61.8% |
| Missouri | $36 | $269 | 19 | 190 | -63.4% |
| Kansas | $35 | $341 | 15 | 138 | -65.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber