99239

Hospital discharge day management, more than 30 minutes

Medicare pricing data for 119,705 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 5.2 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Hospital discharge day management, more than 30 minutes (HCPCS code 99239) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $112.17, but hospitals typically charge $337.76 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$22.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $112.17, your out-of-pocket cost would be approximately $22.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$112.17
Average Hospital Charge
$337.76
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$337.76
Medicare Allowed$112.17
Medicare Payment$88.54

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $88.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$145$6042627,115+29.3%
District of Columbia$121$37545019,563+7.8%
California$120$3789,240453,600+7.2%
New York$120$3977,038269,115+7.1%
New Jersey$120$3783,170176,505+6.7%
Connecticut$117$3101,60458,814+4.4%
Massachusetts$116$3304,336164,796+3.6%
Maryland$116$4002,371122,278+3.2%
Illinois$115$3014,502247,459+2.7%
Rhode Island$114$31857516,000+2.0%
Hawaii$114$28832113,531+1.9%
Florida$114$3396,907452,273+1.3%
Washington$114$3642,55284,454+1.3%
Nevada$113$37482765,069+0.6%
Delaware$113$25738621,681+0.4%
Colorado$113$3212,18463,872+0.3%
Virginia$112$3333,059158,178+0.1%
New Hampshire$112$37772031,639-0.3%
Michigan$112$3184,619154,558-0.3%
Oregon$111$3471,64147,806-1.0%
Pennsylvania$111$2916,454255,466-1.4%
Puerto Rico$110$383972,413-1.5%
Montana$110$34753017,895-1.6%
Maine$110$29886023,708-1.8%
Arizona$110$3002,075121,615-1.8%
Texas$110$3587,573388,955-2.0%
North Dakota$110$32841218,020-2.1%
Georgia$109$3383,886150,933-2.6%
Vermont$109$3212949,253-3.0%
West Virginia$109$31371231,190-3.0%
Missouri$109$2902,436118,734-3.1%
Wyoming$109$4281827,369-3.2%
Louisiana$109$3371,78376,365-3.2%
New Mexico$109$35863921,406-3.2%
Ohio$108$3175,359206,595-3.4%
South Dakota$108$27145614,533-3.7%
Oklahoma$108$3421,33071,339-4.1%
Minnesota$107$3873,21877,156-4.2%
North Carolina$107$3424,766164,250-4.4%
Utah$107$29992921,181-4.4%
South Carolina$107$2991,99291,673-4.7%
Wisconsin$107$4482,71984,379-4.9%
Alabama$107$2701,49560,827-4.9%
Kentucky$107$2831,92887,913-5.0%
Indiana$107$2672,487117,416-5.0%
Kansas$106$3571,10747,013-5.5%
Idaho$106$31164220,186-5.9%
Tennessee$105$3282,242109,175-6.1%
Iowa$105$3271,33344,316-6.4%
Nebraska$105$27096232,169-6.5%
Mississippi$105$31595161,590-6.8%
Arkansas$104$23398853,624-7.1%

⚠️ 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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