31624

Irrigation and suction of lung airways to obtain cells using an endoscope

Medicare pricing data for 13,770 providers across 52 states

🤖AI Overview

This procedure has a 10.5x markup — hospitals charge $749.92 but Medicare allows only $71.76. Uninsured patients may face bills 10.5 times higher than what insurance negotiates. Prices vary significantly by location — from $52 in Tennessee to $148 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

Irrigation and suction of lung airways to obtain cells using an endoscope (HCPCS code 31624) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $71.76, but hospitals typically charge $749.92 — a 10.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $71.76, your out-of-pocket cost would be approximately $14.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$71.76
Average Hospital Charge
$749.92
Markup Ratio
10.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$749.92
Medicare Allowed$71.76
Medicare Payment$56.81

Hospitals charge 10.5x more than what Medicare allows for this procedure. Medicare actually pays $56.81 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$148$3,19724228+106.9%
Puerto Rico$113$3291227+56.8%
New Mexico$100$54553265+38.9%
Wyoming$93$506514+29.3%
New Jersey$90$8333631,905+26.1%
Utah$90$59298492+25.6%
Maine$90$36865254+25.2%
Idaho$89$49845201+24.2%
North Dakota$89$87636207+24.1%
South Dakota$87$45328253+21.3%
West Virginia$85$53694765+18.1%
Vermont$82$1,06529156+14.9%
Arizona$81$4753083,465+12.2%
Florida$80$5611,0698,794+11.2%
Oregon$79$645163897+10.4%
California$79$8321,25310,886+9.4%
Alabama$78$6961921,241+8.3%
Texas$77$6749657,911+7.5%
Minnesota$77$7862551,434+7.1%
Massachusetts$77$7194982,999+6.6%
New York$76$1,6007945,065+5.4%
South Carolina$76$6422302,343+5.3%
Louisiana$75$6341641,033+4.7%
Arkansas$75$5021051,039+4.2%
Montana$74$48346255+3.7%
New Hampshire$74$1,35476485+2.8%
Oklahoma$74$5271331,332+2.7%
Kansas$73$4721011,057+2.2%
Connecticut$73$878184859+1.9%
Mississippi$72$7681031,441+0.1%
Rhode Island$71$61350182-0.4%
Virginia$70$6743612,365-1.8%
Michigan$70$5104302,879-2.2%
North Carolina$69$7594223,194-3.7%
Washington$69$5203052,046-4.4%
Ohio$67$5636053,979-6.0%
Nebraska$67$59592739-6.0%
Illinois$67$9345174,696-6.6%
Colorado$66$1,2742591,513-8.4%
Missouri$65$6763442,557-9.0%
Indiana$65$6702912,820-9.4%
Maryland$65$7442591,666-9.6%
Nevada$64$513110906-11.3%
Pennsylvania$61$6227424,904-14.6%
District of Columbia$61$56659473-15.7%
Wisconsin$59$1,7472642,009-18.1%
Iowa$56$74697807-21.8%
Kentucky$55$4902282,765-23.5%
Hawaii$55$57432234-23.6%
Georgia$54$7034113,737-24.5%
Delaware$52$56727405-27.0%
Tennessee$52$6423132,678-27.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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