G0268

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing

Medicare pricing data for 5,047 providers across 49 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

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing (HCPCS code G0268) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $50.88, but hospitals typically charge $128.54 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $50.88, your out-of-pocket cost would be approximately $10.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$50.88
Average Hospital Charge
$128.54
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$128.54
Medicare Allowed$50.88
Medicare Payment$37.52

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $37.52 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$58$161732,771+14.9%
New York$56$15937633,219+9.5%
New Jersey$56$12719511,192+9.3%
Maryland$54$124863,399+6.7%
California$54$1283359,216+5.6%
Illinois$53$1291644,273+3.2%
Massachusetts$52$1821524,620+2.6%
Washington$52$125711,398+2.6%
District of Columbia$52$776300+2.2%
Nevada$51$12731637-0.2%
Wyoming$51$15912183-0.3%
Delaware$51$119311,008-0.5%
Rhode Island$51$11817570-0.5%
Colorado$49$130841,196-2.9%
Pennsylvania$49$10723511,683-3.0%
Texas$49$1314379,992-3.2%
Idaho$49$102568-4.3%
Georgia$49$1381552,702-4.7%
Virginia$48$1061062,609-4.7%
Oregon$48$13436366-5.1%
Florida$48$11043519,652-5.5%
North Dakota$48$126622-5.7%
Arizona$48$1021126,319-6.0%
North Carolina$48$1222193,598-6.2%
Missouri$48$1121021,368-6.4%
Michigan$47$1011733,059-6.7%
South Carolina$47$1171053,425-7.0%
Kentucky$47$101561,412-7.4%
South Dakota$47$10215153-7.4%
Ohio$46$1012242,241-9.0%
New Mexico$46$9511606-9.4%
Utah$46$9926107-9.5%
Louisiana$46$141931,807-9.5%
Oklahoma$46$104471,839-9.7%
Alabama$46$691173,118-10.1%
Nebraska$46$12130370-10.5%
Tennessee$45$1321513,191-11.8%
Iowa$45$126681,239-11.9%
Arkansas$45$12040645-12.4%
Indiana$44$113931,265-14.4%
Mississippi$42$13538750-17.4%
Wisconsin$41$19065401-18.7%
Kansas$41$10536428-18.8%
Minnesota$40$12049224-20.4%
Hawaii$39$132878-22.7%
Maine$38$9321145-26.0%
Montana$37$1371034-26.4%
New Hampshire$36$16039382-28.8%
Vermont$29$9713112-42.1%

⚠️ 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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