99292

Critical care, each additional 30 minutes

Medicare pricing data for 45,612 providers across 52 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

Critical care, each additional 30 minutes (HCPCS code 99292) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $104.26, but hospitals typically charge $448.95 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$20.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $104.26, your out-of-pocket cost would be approximately $20.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$104.26
Average Hospital Charge
$448.95
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$448.95
Medicare Allowed$104.26
Medicare Payment$83.63

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $83.63 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$138$75384605+32.4%
New York$115$5302,97726,659+9.9%
District of Columbia$112$3892732,206+7.5%
New Jersey$112$5671,04610,023+7.4%
California$111$4604,19453,894+6.1%
Florida$110$4542,58533,257+5.3%
Rhode Island$108$4011851,195+3.7%
Illinois$108$4621,83613,378+3.4%
Maryland$108$4011,20913,276+3.3%
Puerto Rico$107$54247185+2.4%
Delaware$107$525128705+2.4%
Washington$106$4321,1467,932+2.0%
Pennsylvania$106$3862,25014,624+1.3%
Virginia$106$4001,1818,764+1.3%
Nevada$105$4062962,580+0.9%
Colorado$105$4108426,053+0.9%
West Virginia$105$4282601,600+0.8%
Connecticut$105$4718498,192+0.5%
Wyoming$105$66162241+0.5%
New Mexico$104$4602491,327+0.2%
Texas$104$4652,66020,964+0.2%
Michigan$104$4431,79810,870+0.1%
Massachusetts$104$3851,88222,256-0.1%
Montana$104$3231801,357-0.7%
South Dakota$103$531105643-1.0%
Hawaii$103$2962023,007-1.3%
Louisiana$103$5995362,952-1.4%
Ohio$103$4721,6078,367-1.4%
Arizona$103$3957648,105-1.4%
North Dakota$102$394119985-2.1%
Maine$102$3972301,022-2.2%
Oregon$102$3917426,017-2.5%
Vermont$101$35296748-2.9%
New Hampshire$101$4322731,598-3.0%
Minnesota$101$4679965,508-3.2%
Mississippi$100$6093031,916-4.2%
Indiana$100$3898734,778-4.4%
Oklahoma$100$5004653,079-4.5%
Kentucky$99$3206004,528-4.8%
Arkansas$99$4713061,627-4.8%
South Carolina$99$4596443,590-5.1%
Idaho$99$335198944-5.3%
Utah$98$4643183,192-6.3%
Wisconsin$97$8079316,718-6.7%
Nebraska$97$3222981,379-6.9%
Iowa$97$4393422,278-7.2%
North Carolina$96$4091,77813,123-7.7%
Tennessee$96$3939478,110-7.7%
Kansas$95$3404845,420-9.2%
Missouri$94$52199318,574-9.7%
Georgia$93$4241,51526,823-10.9%
Alabama$92$3176437,943-11.7%

⚠️ 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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