35371

Removal of blood clot and portion of upper thigh artery

Medicare pricing data for 3,155 providers across 48 states

🤖AI Overview

This procedure has a 5.0x markup — hospitals charge $2,735 but Medicare allows only $543.78. Uninsured patients may face bills 5.0 times higher than what insurance negotiates. Prices vary significantly by location — from $341 in Montana to $715 in Vermont. Where you get this procedure matters more than almost any other factor. 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

Removal of blood clot and portion of upper thigh artery (HCPCS code 35371) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $543.78, but hospitals typically charge $2,735 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$108.76

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $543.78, your out-of-pocket cost would be approximately $108.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$543.78
Average Hospital Charge
$2,735
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,734.59
Medicare Allowed$543.78
Medicare Payment$432.82

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $432.82 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Vermont$715$3,912417+31.6%
Delaware$691$2,8691018+27.0%
Illinois$683$4,551105270+25.6%
Ohio$663$2,45791203+21.9%
Michigan$623$2,08197224+14.5%
South Carolina$619$3,30363190+13.9%
Massachusetts$616$2,88477190+13.3%
Pennsylvania$613$3,017161384+12.7%
Connecticut$609$2,85555126+12.0%
Virginia$594$2,17778174+9.3%
Rhode Island$590$3,274822+8.5%
Tennessee$588$2,17177207+8.1%
New Jersey$576$3,31893178+5.9%
Oklahoma$573$2,02133115+5.3%
Georgia$571$2,40992184+5.0%
Iowa$568$2,5413477+4.5%
Maryland$562$1,97557126+3.4%
Louisiana$561$2,0094486+3.2%
Florida$559$2,337253634+2.8%
New York$556$3,126173402+2.2%
Texas$553$2,699222552+1.6%
South Dakota$534$3,1281839-1.8%
New Hampshire$532$3,7643394-2.1%
Idaho$531$1,9742477-2.3%
Maine$530$2,2322356-2.5%
Kentucky$525$2,00861161-3.4%
Missouri$520$2,67969162-4.3%
Mississippi$520$2,5052574-4.4%
Minnesota$515$3,89757196-5.3%
California$511$2,461230484-6.1%
Arizona$505$2,42655115-7.1%
North Dakota$505$4,2751427-7.2%
Alabama$504$2,47056130-7.4%
Colorado$503$2,2804898-7.4%
Indiana$502$2,32563138-7.7%
Kansas$482$2,1182031-11.4%
Wisconsin$478$5,95184222-12.0%
North Carolina$458$2,792127325-15.7%
Washington$446$1,88869206-18.0%
Arkansas$443$2,0083082-18.4%
New Mexico$436$2,2601231-19.8%
Nevada$432$2,3642861-20.5%
West Virginia$431$2,0222771-20.7%
Oregon$411$1,98455158-24.4%
Utah$385$1,7112144-29.2%
Hawaii$363$1,910612-33.3%
Nebraska$360$2,09838123-33.8%
Montana$341$1,5851648-37.3%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber