37229

Removal of plaque in artery of leg, initial vessel

Medicare pricing data for 3,503 providers across 46 states

🤖AI Overview

Prices vary significantly by location — from $543 in Puerto Rico to $9,667 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

Removal of plaque in artery of leg, initial vessel (HCPCS code 37229) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7,073, but hospitals typically charge $22,212 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1,415

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7,073, your out-of-pocket cost would be approximately $1,415. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7,073
Average Hospital Charge
$22,212
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$22,212.36
Medicare Allowed$7,073.15
Medicare Payment$5,640.22

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $5,640 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$9,667$20,42411181+36.7%
Alaska$9,235$59,926317+30.6%
Maryland$9,031$20,437742,002+27.7%
New York$8,441$25,7851923,406+19.3%
California$8,240$23,1733407,697+16.5%
New Jersey$8,033$25,5371412,043+13.6%
Virginia$7,556$24,02086524+6.8%
Arizona$7,504$21,3681341,611+6.1%
Utah$7,388$24,85010200+4.4%
Connecticut$7,303$33,78231243+3.3%
Michigan$7,263$20,3111161,258+2.7%
Florida$7,230$21,8834244,819+2.2%
Massachusetts$7,071$31,32435306-0.0%
Hawaii$6,693$23,1621082-5.4%
Wisconsin$6,673$23,02225164-5.7%
Colorado$6,629$25,69134156-6.3%
Nevada$6,345$17,46425213-10.3%
Texas$6,287$22,4554674,168-11.1%
Minnesota$6,195$28,2421878-12.4%
Tennessee$6,004$19,610100930-15.1%
Ohio$5,959$15,67761410-15.7%
Kentucky$5,927$20,19526166-16.2%
Washington$5,897$20,56132141-16.6%
Delaware$5,833$23,9541162-17.5%
Mississippi$5,633$28,43355677-20.4%
Pennsylvania$5,592$17,53962463-20.9%
South Dakota$5,458$22,41522224-22.8%
North Carolina$5,447$19,28882623-23.0%
Georgia$5,381$26,009107564-23.9%
South Carolina$5,375$20,02747288-24.0%
Louisiana$5,300$20,809106571-25.1%
Oregon$5,196$19,2152681-26.5%
Alabama$5,178$13,95773428-26.8%
Arkansas$4,966$13,95850596-29.8%
Kansas$4,907$17,27729337-30.6%
Iowa$4,431$23,2612599-37.4%
Idaho$4,271$15,5401350-39.6%
Oklahoma$4,219$23,34150557-40.3%
Illinois$4,219$17,477131773-40.4%
Nebraska$4,198$19,18921198-40.7%
Missouri$4,047$16,45358272-42.8%
Indiana$3,930$16,62570384-44.4%
West Virginia$3,375$13,5021337-52.3%
New Mexico$1,926$11,52913160-72.8%
Montana$615$4,2311128-91.3%
Puerto Rico$543$684213-92.3%

⚠️ 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