External counterpulsation, per treatment session
Medicare pricing data for 339 providers across 17 states
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
External counterpulsation, per treatment session (HCPCS code G0166) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $107.89, but hospitals typically charge $507.87 — a 4.7x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $107.89, your out-of-pocket cost would be approximately $21.58. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $85.30 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $125 | $334 | 69 | 13,105 | +15.5% |
| New Jersey | $120 | $354 | 18 | 749 | +11.0% |
| New York | $118 | $444 | 9 | 794 | +9.6% |
| Illinois | $111 | $266 | 7 | 310 | +2.6% |
| Michigan | $104 | $262 | 7 | 788 | -4.0% |
| Pennsylvania | $103 | $323 | 16 | 512 | -4.6% |
| Nevada | $103 | $348 | 20 | 1,475 | -4.8% |
| Hawaii | $102 | $229 | 2 | 111 | -5.6% |
| Texas | $102 | $803 | 58 | 15,114 | -5.9% |
| Florida | $100 | $240 | 59 | 5,438 | -7.5% |
| Wisconsin | $99 | $654 | 3 | 319 | -7.9% |
| Arizona | $98 | $552 | 11 | 1,569 | -8.9% |
| Ohio | $97 | $237 | 11 | 479 | -10.3% |
| New Mexico | $96 | $322 | 1 | 432 | -11.1% |
| North Carolina | $96 | $713 | 11 | 2,599 | -11.5% |
| Oklahoma | $94 | $245 | 1 | 310 | -13.1% |
| Arkansas | $86 | $231 | 8 | 407 | -20.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber