97016

Application of blood vessel compression device

Medicare pricing data for 13,329 providers across 51 states

🤖AI Overview

This procedure has a 5.0x markup — hospitals charge $43.57 but Medicare allows only $8.71. Uninsured patients may face bills 5.0 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

Application of blood vessel compression device (HCPCS code 97016) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.71, but hospitals typically charge $43.57 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8.71, your out-of-pocket cost would be approximately $1.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$8.71
Average Hospital Charge
$43.57
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$43.57
Medicare Allowed$8.71
Medicare Payment$6.77

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $6.77 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$12$5024712+34.0%
District of Columbia$10$51401,465+14.5%
New Jersey$10$13444835,015+10.7%
Hawaii$9$51311,335+9.0%
Connecticut$9$58751,656+7.8%
California$9$371,191130,868+7.7%
New York$9$5523710,816+6.4%
Maryland$9$5257852,795+4.7%
Rhode Island$9$609418+4.6%
Massachusetts$9$431469,827+4.2%
Florida$9$3426030,589+2.8%
Colorado$9$4029812,270+2.4%
Pennsylvania$9$4672857,050+2.2%
Montana$9$261064,051+1.8%
New Hampshire$9$48813,552+1.8%
North Dakota$9$41451,247+0.3%
Vermont$9$3813282+0.3%
Virginia$9$4274257,640+0.3%
Delaware$9$4711913,366+0.2%
Illinois$9$5044219,834+0.2%
Maine$9$41851,948+0.2%
Nevada$9$26465,024+0.2%
Washington$9$3456624,2850.0%
Michigan$9$3933511,072-0.3%
Wyoming$9$361106,466-1.3%
South Dakota$9$47461,640-1.5%
Wisconsin$9$851384,365-1.5%
Oregon$9$381305,861-2.1%
North Carolina$9$3464049,177-2.3%
Arizona$9$3839041,601-2.3%
Georgia$9$4216610,358-2.4%
South Carolina$8$411617,389-2.5%
Ohio$8$5265943,220-3.0%
Kentucky$8$3815211,953-3.1%
Iowa$8$39611,859-3.4%
Texas$8$3754843,365-3.4%
Utah$8$331244,676-3.7%
Louisiana$8$3720817,032-3.9%
Kansas$8$331173,939-4.0%
Minnesota$8$492043,852-4.2%
Missouri$8$4018712,130-4.6%
Indiana$8$341537,666-4.9%
West Virginia$8$32752,928-4.9%
Nebraska$8$3423521,000-5.1%
Idaho$8$3021316,020-5.2%
Tennessee$8$4053238,724-5.3%
Arkansas$8$4317917,731-5.9%
New Mexico$8$45361,770-6.1%
Mississippi$8$3336240,626-6.5%
Alabama$8$3967960,484-6.7%
Oklahoma$8$331749,301-7.6%

⚠️ 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