27245

Treatment of broken neck of thigh bone with bone implant

Medicare pricing data for 17,654 providers across 52 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

Treatment of broken neck of thigh bone with bone implant (HCPCS code 27245) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $974.26, but hospitals typically charge $4,333 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$194.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $974.26, your out-of-pocket cost would be approximately $194.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$974.26
Average Hospital Charge
$4,333
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,332.98
Medicare Allowed$974.26
Medicare Payment$773.88

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $773.88 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$1,166$1,7243259+19.7%
Hawaii$1,165$3,62343167+19.5%
New York$1,121$7,0769884,933+15.0%
Massachusetts$1,105$5,1173872,081+13.4%
California$1,103$3,7801,2257,124+13.2%
Maryland$1,090$3,9353261,866+11.9%
Virginia$1,087$3,9444182,500+11.6%
Nevada$1,086$5,300108759+11.4%
Michigan$1,066$3,3105112,450+9.5%
New Jersey$1,056$11,3655062,693+8.4%
Rhode Island$1,044$3,94767316+7.2%
Alaska$1,037$7,89473238+6.4%
Connecticut$1,035$4,8652651,086+6.3%
New Mexico$1,015$3,543107606+4.1%
District of Columbia$1,013$4,09034119+4.0%
Illinois$1,012$5,4987133,933+3.9%
Kentucky$1,008$3,4382531,518+3.5%
Tennessee$1,000$3,8553792,139+2.7%
Ohio$991$3,3796673,356+1.8%
Vermont$987$3,92154220+1.3%
Texas$987$3,7549576,484+1.3%
North Carolina$972$3,6246553,194-0.2%
Pennsylvania$971$3,7868664,046-0.3%
Georgia$967$4,2525572,652-0.8%
Missouri$964$4,3863602,229-1.1%
Oklahoma$957$2,7041871,431-1.8%
West Virginia$951$3,285118590-2.4%
Washington$950$3,1954641,920-2.5%
Florida$947$4,3821,2199,310-2.8%
Mississippi$946$3,8591611,141-2.9%
New Hampshire$943$5,091127581-3.2%
Arkansas$930$2,5961601,124-4.6%
South Carolina$922$3,6313341,994-5.3%
Oregon$918$3,756233886-5.8%
Indiana$912$3,8893772,152-6.4%
Wyoming$900$3,87063241-7.6%
Louisiana$891$3,7012731,442-8.6%
Utah$874$2,746166571-10.3%
Colorado$863$3,3563981,517-11.4%
Arizona$853$3,3093412,482-12.5%
Minnesota$851$4,5434021,651-12.6%
North Dakota$837$4,89164463-14.1%
Wisconsin$837$8,2574671,612-14.1%
Iowa$829$3,5642411,106-14.9%
Delaware$811$4,53177569-16.7%
Montana$802$2,829137543-17.7%
Kansas$793$2,9282001,217-18.6%
Alabama$787$3,1373731,970-19.2%
Idaho$770$3,493114545-21.0%
Maine$760$2,432117524-22.0%
South Dakota$696$2,21886618-28.5%
Nebraska$656$3,372164796-32.7%

⚠️ 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

🏥 See Medicare hospital data on OpenMedicare