G0422

Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session

Medicare pricing data for 147 providers across 20 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

Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session (HCPCS code G0422) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $118.34, but hospitals typically charge $295.76 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$23.67

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $118.34, your out-of-pocket cost would be approximately $23.67. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$118.34
Average Hospital Charge
$295.76
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$295.76
Medicare Allowed$118.34
Medicare Payment$94.06

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $94.06 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$132$810102,473+11.7%
Massachusetts$132$3641428+11.5%
California$126$3382910,984+6.1%
New York$124$276393,048+5.1%
Colorado$123$323234,770+3.7%
Hawaii$122$2342408+2.7%
Illinois$121$3231113+2.3%
Florida$119$18333,832+0.4%
Nevada$119$307310,413+0.2%
Georgia$118$6011406-0.0%
Michigan$116$2323145-1.7%
Arizona$116$22541,764-2.0%
Missouri$116$12483,182-2.1%
North Carolina$116$34716,480-2.1%
Texas$115$31772,636-2.7%
Pennsylvania$114$32213,646-3.3%
South Carolina$113$2244676-4.4%
Louisiana$112$15525,540-5.4%
Idaho$111$2501878-6.1%
Arkansas$111$23348,943-6.5%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber