C7513

Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis a

Medicare pricing data for 98 providers across 25 states

🤖AI Overview

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

Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis a (HCPCS code C7513) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,191, but hospitals typically charge $5,145 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$238.22

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,191, your out-of-pocket cost would be approximately $238.22. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,191
Average Hospital Charge
$5,145
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,145.46
Medicare Allowed$1,191.09
Medicare Payment$947.10

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $947.10 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nevada$1,341$5,4633427+12.6%
California$1,328$5,92310899+11.5%
New York$1,326$5,7992370+11.3%
Arizona$1,302$7,931453+9.3%
Washington$1,269$4,701182+6.6%
New Jersey$1,260$5,3835578+5.8%
Utah$1,230$4,929140+3.3%
Indiana$1,228$4,8124188+3.1%
Pennsylvania$1,201$5,0556328+0.8%
Maryland$1,195$4,6164172+0.3%
Virginia$1,170$4,9983460-1.7%
North Carolina$1,154$4,9222347-3.1%
Rhode Island$1,154$5,1271113-3.1%
Illinois$1,149$5,1983695-3.5%
Kansas$1,140$2,700227-4.3%
Texas$1,118$4,95910429-6.1%
Ohio$1,105$4,4116344-7.2%
Mississippi$1,104$4,657167-7.3%
Georgia$1,102$4,8367226-7.5%
Alabama$1,084$4,4633120-9.0%
Missouri$1,064$5,165248-10.7%
South Carolina$1,058$4,598155-11.2%
Florida$1,057$4,7017611-11.3%
Tennessee$996$4,6181101-16.4%
Louisiana$975$4,5181101-18.2%

⚠️ 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

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