C9290

Injection, bupivacaine liposome, 1 mg

Medicare pricing data for 862 providers across 46 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 5.6 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

Injection, bupivacaine liposome, 1 mg (HCPCS code C9290) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1.37, but hospitals typically charge $5.27 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.27

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1.37, your out-of-pocket cost would be approximately $0.27. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1.37
Average Hospital Charge
$5.27
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5.27
Medicare Allowed$1.37
Medicare Payment$1.09

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $1.09 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Kentucky$1$541,477+1.5%
Maine$1$212,793+1.5%
Montana$1$3676,280+1.5%
Nebraska$1$4927,694+1.5%
Nevada$1$4827,001+1.5%
New Hampshire$1$51194,092+1.5%
North Dakota$1$4335,645+1.5%
Wyoming$1$586,393+1.5%
Delaware$1$4119,950+0.7%
Iowa$1$4893,418+0.7%
Kansas$1$4827,037+0.7%
Michigan$1$41252,376+0.7%
Missouri$1$31294,503+0.7%
Ohio$1$722306,279+0.7%
Tennessee$1$513164,009+0.7%
Utah$1$61481,711+0.7%
Washington$1$314120,769+0.7%
Wisconsin$1$31269,125+0.7%
Arkansas$1$6425,010+0.7%
California$1$492452,957+0.7%
Florida$1$8102987,2800.0%
Illinois$1$520103,5320.0%
Indiana$1$623221,9390.0%
Louisiana$1$61653,9510.0%
Minnesota$1$417191,6950.0%
Mississippi$1$1665,7050.0%
North Carolina$1$431294,7230.0%
Virginia$1$41687,3770.0%
West Virginia$1$7225,2710.0%
Arizona$1$427163,2630.0%
Colorado$1$429113,0810.0%
Georgia$1$336179,630-0.7%
Idaho$1$5527,282-0.7%
Oklahoma$1$3417,955-0.7%
Oregon$1$1517136,393-0.7%
Pennsylvania$1$52678,468-0.7%
Alabama$1$2328,863-0.7%
Alaska$1$5645,021-0.7%
Connecticut$1$315113,789-0.7%
District of Columbia$1$113,724-1.5%
Maryland$1$434141,747-1.5%
Texas$1$599470,756-1.5%
New Jersey$1$339162,765-2.2%
New York$1$51439,092-2.2%
Rhode Island$1$6214,326-5.1%
South Carolina$1$2888,251-5.8%

⚠️ 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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