Revision of thigh bone prosthesis
Medicare pricing data for 4,018 providers across 48 states
This procedure has a 5.8x markup — hospitals charge $5,617 but Medicare allows only $962.78. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Revision of thigh bone prosthesis (HCPCS code 27138) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $962.78, but hospitals typically charge $5,617 — a 5.8x 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 $962.78, your out-of-pocket cost would be approximately $192.56. 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 5.8x more than what Medicare allows for this procedure. Medicare actually pays $766.66 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Virginia | $1,226 | $5,241 | 81 | 132 | +27.3% |
| New York | $1,190 | $8,816 | 196 | 299 | +23.6% |
| District of Columbia | $1,096 | $6,945 | 10 | 13 | +13.8% |
| California | $1,092 | $4,878 | 279 | 434 | +13.4% |
| Nevada | $1,048 | $5,682 | 33 | 50 | +8.8% |
| Maryland | $1,036 | $4,706 | 78 | 113 | +7.6% |
| Illinois | $1,031 | $9,909 | 141 | 212 | +7.1% |
| Michigan | $1,019 | $4,007 | 104 | 145 | +5.9% |
| Mississippi | $1,008 | $5,035 | 36 | 57 | +4.7% |
| New Jersey | $1,006 | $14,604 | 105 | 136 | +4.4% |
| Texas | $1,002 | $4,630 | 242 | 428 | +4.1% |
| Connecticut | $1,001 | $6,183 | 62 | 94 | +4.0% |
| Kentucky | $990 | $3,812 | 47 | 63 | +2.8% |
| Florida | $984 | $5,266 | 351 | 569 | +2.2% |
| New Mexico | $981 | $3,934 | 23 | 34 | +1.9% |
| Ohio | $976 | $4,054 | 145 | 218 | +1.3% |
| Missouri | $975 | $6,267 | 74 | 110 | +1.2% |
| Massachusetts | $969 | $6,677 | 80 | 130 | +0.6% |
| New Hampshire | $962 | $8,894 | 31 | 58 | -0.1% |
| West Virginia | $954 | $4,466 | 23 | 33 | -0.9% |
| Pennsylvania | $952 | $4,383 | 144 | 201 | -1.1% |
| Minnesota | $950 | $5,717 | 110 | 171 | -1.3% |
| Tennessee | $947 | $4,929 | 92 | 156 | -1.7% |
| Oklahoma | $942 | $3,201 | 60 | 109 | -2.2% |
| Indiana | $922 | $5,829 | 90 | 154 | -4.2% |
| North Carolina | $921 | $4,187 | 135 | 212 | -4.4% |
| Georgia | $917 | $6,366 | 96 | 153 | -4.8% |
| Washington | $908 | $3,456 | 110 | 162 | -5.7% |
| Wisconsin | $902 | $13,715 | 105 | 153 | -6.3% |
| Louisiana | $893 | $4,720 | 55 | 89 | -7.2% |
| South Carolina | $891 | $5,706 | 71 | 105 | -7.5% |
| Colorado | $871 | $4,741 | 118 | 168 | -9.5% |
| Montana | $865 | $4,012 | 33 | 59 | -10.2% |
| Arizona | $863 | $3,808 | 126 | 215 | -10.3% |
| Oregon | $862 | $3,903 | 57 | 75 | -10.5% |
| Delaware | $849 | $5,233 | 22 | 40 | -11.9% |
| North Dakota | $848 | $4,149 | 19 | 29 | -11.9% |
| Wyoming | $843 | $7,612 | 21 | 27 | -12.5% |
| Rhode Island | $836 | $5,238 | 20 | 27 | -13.1% |
| Iowa | $836 | $5,026 | 54 | 94 | -13.2% |
| Alabama | $811 | $4,615 | 60 | 89 | -15.7% |
| Utah | $802 | $2,688 | 35 | 57 | -16.8% |
| Maine | $797 | $2,451 | 17 | 24 | -17.3% |
| Kansas | $784 | $4,644 | 67 | 125 | -18.6% |
| South Dakota | $780 | $3,164 | 28 | 45 | -19.0% |
| Arkansas | $765 | $3,225 | 46 | 84 | -20.5% |
| Nebraska | $680 | $4,293 | 36 | 45 | -29.4% |
| Idaho | $622 | $4,010 | 29 | 49 | -35.4% |
⚠️ 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