33418

Repair of mitral valve through the skin, initial prosthesis

Medicare pricing data for 1,302 providers across 49 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

Repair of mitral valve through the skin, initial prosthesis (HCPCS code 33418) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,378, but hospitals typically charge $5,781 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$275.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,378, your out-of-pocket cost would be approximately $275.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,378
Average Hospital Charge
$5,781
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,780.66
Medicare Allowed$1,378.07
Medicare Payment$1,100.08

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $1,100 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$1,716$8,649731+24.5%
Vermont$1,647$8,677315+19.5%
Oregon$1,645$5,20212117+19.4%
Arizona$1,641$4,54631272+19.1%
North Dakota$1,608$5,068432+16.7%
New York$1,580$9,16579709+14.6%
Utah$1,542$4,6741165+11.9%
Ohio$1,531$6,59938266+11.1%
West Virginia$1,497$6,005628+8.6%
Michigan$1,491$6,00432229+8.2%
Washington$1,481$4,87624265+7.5%
Illinois$1,475$8,04658424+7.0%
North Carolina$1,442$6,46632203+4.7%
Minnesota$1,432$8,88138282+3.9%
Rhode Island$1,427$6,231544+3.5%
California$1,416$5,5001441,286+2.7%
Delaware$1,401$4,354513+1.7%
Alaska$1,399$13,382226+1.5%
Florida$1,385$5,372140874+0.5%
Wisconsin$1,383$15,9631987+0.4%
South Carolina$1,379$5,53019199+0.0%
Oklahoma$1,373$4,57615150-0.3%
District of Columbia$1,371$4,617421-0.5%
Virginia$1,367$4,42233422-0.8%
Alabama$1,366$3,24520181-0.9%
Louisiana$1,361$4,81417116-1.2%
Texas$1,349$5,57983544-2.1%
Massachusetts$1,338$6,45528259-2.9%
Maryland$1,318$4,33322123-4.3%
Nevada$1,307$4,32315116-5.2%
Georgia$1,301$5,47834258-5.6%
Missouri$1,290$5,29138241-6.4%
Tennessee$1,287$5,00926339-6.6%
New Jersey$1,280$5,35537262-7.1%
Kentucky$1,260$4,4491765-8.6%
Pennsylvania$1,257$5,14255287-8.8%
Colorado$1,238$4,35027240-10.2%
Indiana$1,232$4,13917175-10.6%
Iowa$1,224$4,7601176-11.2%
Mississippi$1,208$5,1491558-12.3%
Montana$1,205$3,494965-12.5%
New Mexico$1,167$4,476945-15.3%
New Hampshire$1,165$9,309963-15.4%
Arkansas$1,158$2,84310104-16.0%
Maine$1,116$5,136736-19.0%
South Dakota$1,085$2,707575-21.3%
Idaho$1,041$5,158444-24.5%
Kansas$1,012$4,30015259-26.6%
Nebraska$1,009$3,712988-26.8%

⚠️ 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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