33405

Replacement of aortic valve on heart-lung machine

Medicare pricing data for 3,848 providers across 51 states

🤖AI Overview

This procedure has a 5.6x markup — hospitals charge $7,203 but Medicare allows only $1,286. Uninsured patients may face bills 5.6 times higher than what insurance negotiates. Prices vary significantly by location — from $521 in Alaska to $1,985 in District of Columbia. 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

Replacement of aortic valve on heart-lung machine (HCPCS code 33405) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,286, but hospitals typically charge $7,203 — a 5.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$257.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,286, your out-of-pocket cost would be approximately $257.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,286
Average Hospital Charge
$7,203
Markup Ratio
5.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$7,203.38
Medicare Allowed$1,286.32
Medicare Payment$1,026.42

Hospitals charge 5.6x more than what Medicare allows for this procedure. Medicare actually pays $1,026 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$1,985$6,076758+54.3%
New Mexico$1,551$4,884824+20.6%
Oklahoma$1,537$5,81333176+19.5%
Hawaii$1,498$5,6291038+16.5%
New York$1,494$10,9232051,066+16.2%
New Jersey$1,486$8,96880517+15.5%
Maryland$1,474$5,44246185+14.6%
Missouri$1,470$6,78386425+14.3%
Massachusetts$1,431$7,02392597+11.2%
Georgia$1,424$7,84580316+10.7%
Kansas$1,422$4,87739191+10.5%
Illinois$1,411$10,592140691+9.7%
Arkansas$1,385$4,43830182+7.7%
Pennsylvania$1,384$6,3372361,244+7.6%
Florida$1,362$6,2183071,567+5.9%
Mississippi$1,342$6,12427109+4.3%
Rhode Island$1,334$8,0321184+3.7%
Ohio$1,330$8,625170896+3.4%
South Carolina$1,330$6,90773301+3.4%
Tennessee$1,311$5,25583312+1.9%
Virginia$1,308$5,80991438+1.7%
Texas$1,302$6,851240974+1.2%
Kentucky$1,294$4,20962295+0.6%
Colorado$1,293$6,79653197+0.5%
South Dakota$1,280$3,1681279-0.5%
Louisiana$1,279$6,46360250-0.6%
Michigan$1,269$6,175144537-1.4%
New Hampshire$1,263$12,00932265-1.8%
Minnesota$1,248$9,33177376-3.0%
Nevada$1,223$4,93331127-4.9%
Utah$1,198$4,66838122-6.9%
Connecticut$1,173$7,28743253-8.8%
California$1,172$5,8603431,706-8.9%
North Carolina$1,152$6,726126637-10.4%
Montana$1,138$6,46622114-11.5%
Indiana$1,129$6,908107460-12.2%
Alabama$1,129$5,86670370-12.2%
Arizona$1,128$5,09369492-12.3%
Wyoming$1,123$5,015214-12.7%
Washington$1,097$4,50998419-14.7%
Oregon$1,068$4,65875379-17.0%
Delaware$1,057$6,3911790-17.9%
Iowa$1,052$5,25346225-18.2%
Idaho$1,034$4,62824100-19.6%
North Dakota$1,031$6,8011895-19.8%
West Virginia$1,027$4,27026102-20.2%
Wisconsin$998$21,99990430-22.4%
Nebraska$987$4,90435191-23.3%
Maine$980$3,6471992-23.8%
Vermont$924$9,973751-28.1%
Alaska$521$7,020411-59.5%

⚠️ 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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