00530

Anesthesia for insertion of permanent heart pacemaker

Medicare pricing data for 26,713 providers across 52 states

🤖AI Overview

This procedure has a 11.1x markup — hospitals charge $1,762 but Medicare allows only $158.27. Uninsured patients may face bills 11.1 times higher than what insurance negotiates. Prices vary significantly by location — from $107 in South Dakota to $301 in Alaska. 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

Anesthesia for insertion of permanent heart pacemaker (HCPCS code 00530) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $158.27, but hospitals typically charge $1,762 — a 11.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$31.65

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $158.27, your out-of-pocket cost would be approximately $31.65. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$158.27
Average Hospital Charge
$1,762
Markup Ratio
11.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,761.86
Medicare Allowed$158.27
Medicare Payment$124.90

Hospitals charge 11.1x more than what Medicare allows for this procedure. Medicare actually pays $124.90 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$301$1,84529206+90.2%
Wyoming$274$1,791954+72.9%
Utah$233$1,545169408+47.1%
Montana$222$1,21363212+40.5%
California$222$1,7541,8825,713+40.1%
Oregon$213$1,452295783+34.4%
Puerto Rico$209$1,07442157+32.1%
Idaho$197$1,5633981+24.6%
Nevada$194$2,212134382+22.3%
Colorado$191$1,736344736+20.8%
New York$191$2,8281,7187,766+20.5%
Indiana$189$1,7943651,006+19.4%
Illinois$183$2,2118791,965+15.9%
Maryland$180$1,6674091,904+13.7%
Arkansas$180$952151593+13.6%
Hawaii$179$1,3754495+13.2%
Oklahoma$178$1,222126927+12.8%
Washington$177$1,4624911,275+11.8%
Louisiana$176$1,373278664+11.5%
Minnesota$173$1,4944001,300+9.3%
New Mexico$172$1,60950153+8.5%
Delaware$172$1,636131669+8.4%
Arizona$170$1,6733771,448+7.6%
Florida$163$1,9182,5079,423+2.8%
Nebraska$162$1,011191596+2.6%
Massachusetts$162$1,5257022,292+2.4%
Missouri$161$1,4996502,239+1.9%
District of Columbia$161$1,319149666+1.8%
Iowa$159$1,228180742+0.7%
New Hampshire$157$2,683157436-0.8%
Kentucky$157$1,552384944-1.0%
Texas$157$2,1311,8256,253-1.0%
Mississippi$156$1,191189640-1.4%
Connecticut$156$2,0194981,456-1.5%
Vermont$155$1,2364282-2.2%
Ohio$154$1,3739632,648-2.9%
New Jersey$152$1,5998234,283-3.7%
Wisconsin$152$2,1635451,364-4.1%
Tennessee$145$1,7727593,719-8.4%
Rhode Island$145$1,23682251-8.4%
Virginia$141$1,8088063,890-11.0%
North Carolina$137$1,6438643,144-13.4%
Kansas$131$958221644-17.2%
Michigan$128$1,9861,1253,454-19.3%
West Virginia$128$1,057135442-19.4%
Maine$127$1,702170481-19.9%
Pennsylvania$127$1,3952,1418,280-20.0%
North Dakota$123$1,491117304-22.1%
Georgia$120$1,3248983,585-24.4%
South Carolina$113$1,7256713,745-28.8%
Alabama$110$1,0313981,871-30.3%
South Dakota$107$83973278-32.6%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber