Compounded drug, not otherwise classified
Medicare pricing data for 2,540 providers across 46 states
Prices vary significantly by location — from $49 in Louisiana to $407 in Nevada. Where you get this procedure matters more than almost any other factor. 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
Compounded drug, not otherwise classified (HCPCS code J7999) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $116.13, but hospitals typically charge $396.89 — a 3.4x 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 $116.13, your out-of-pocket cost would be approximately $23.23. 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 3.4x more than what Medicare allows for this procedure. Medicare actually pays $90.71 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Nevada | $407 | $460 | 11 | 117 | +250.7% |
| North Carolina | $376 | $684 | 32 | 710 | +224.1% |
| Wisconsin | $307 | $722 | 28 | 1,051 | +164.1% |
| Minnesota | $248 | $375 | 46 | 2,617 | +113.9% |
| Mississippi | $198 | $497 | 20 | 5,510 | +70.3% |
| South Carolina | $193 | $374 | 7 | 121 | +66.3% |
| Massachusetts | $185 | $263 | 11 | 945 | +59.5% |
| Arkansas | $176 | $1,825 | 63 | 5,604 | +51.8% |
| California | $174 | $764 | 488 | 63,703 | +50.2% |
| Michigan | $156 | $196 | 24 | 958 | +33.9% |
| Pennsylvania | $152 | $637 | 160 | 30,604 | +30.6% |
| Illinois | $139 | $387 | 40 | 1,000 | +19.9% |
| New York | $122 | $340 | 37 | 2,036 | +4.9% |
| Georgia | $121 | $220 | 10 | 88 | +3.9% |
| Connecticut | $117 | $172 | 12 | 417 | +0.4% |
| West Virginia | $113 | $540 | 4 | 174 | -2.4% |
| Texas | $99 | $242 | 294 | 27,589 | -14.8% |
| Alaska | $99 | $185 | 7 | 677 | -14.8% |
| Alabama | $95 | $341 | 3 | 679 | -17.9% |
| Nebraska | $94 | $146 | 1 | 78 | -18.7% |
| Ohio | $94 | $253 | 29 | 1,460 | -18.8% |
| Arizona | $94 | $211 | 59 | 30,125 | -19.4% |
| Utah | $93 | $347 | 37 | 5,180 | -20.2% |
| North Dakota | $92 | $133 | 9 | 416 | -20.4% |
| South Dakota | $92 | $123 | 13 | 6,166 | -20.5% |
| Montana | $92 | $193 | 13 | 6,654 | -20.9% |
| Washington | $92 | $149 | 116 | 15,263 | -21.0% |
| Oklahoma | $92 | $152 | 19 | 3,254 | -21.0% |
| Oregon | $92 | $172 | 77 | 17,405 | -21.1% |
| Colorado | $91 | $190 | 77 | 14,088 | -21.9% |
| Idaho | $89 | $130 | 24 | 5,727 | -23.6% |
| Maryland | $89 | $418 | 81 | 6,206 | -23.6% |
| New Jersey | $88 | $305 | 68 | 11,169 | -24.6% |
| Tennessee | $87 | $271 | 13 | 889 | -24.7% |
| Florida | $86 | $266 | 361 | 49,495 | -26.2% |
| New Mexico | $84 | $289 | 13 | 3,229 | -28.0% |
| Kentucky | $83 | $260 | 6 | 572 | -28.6% |
| District of Columbia | $79 | $220 | 3 | 451 | -32.0% |
| Virginia | $76 | $476 | 43 | 1,450 | -34.6% |
| Puerto Rico | $72 | $110 | 15 | 480 | -37.7% |
| Iowa | $72 | $109 | 16 | 471 | -37.8% |
| Hawaii | $71 | $169 | 27 | 3,096 | -39.0% |
| Missouri | $69 | $283 | 19 | 2,240 | -40.3% |
| Kansas | $59 | $168 | 19 | 3,753 | -49.5% |
| Indiana | $51 | $182 | 25 | 449 | -55.9% |
| Louisiana | $49 | $158 | 36 | 10,296 | -58.0% |
⚠️ 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