44213

Partial release of large bowel and partial removal of large bowel using an endoscope

Medicare pricing data for 4,128 providers across 51 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

Partial release of large bowel and partial removal of large bowel using an endoscope (HCPCS code 44213) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $147.73, but hospitals typically charge $632.07 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.55

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $147.73, your out-of-pocket cost would be approximately $29.55. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$147.73
Average Hospital Charge
$632.07
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$632.07
Medicare Allowed$147.73
Medicare Payment$117.95

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $117.95 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$182$1,9531633+23.4%
Puerto Rico$180$732819+21.6%
Maryland$170$55275180+14.9%
New Mexico$169$566922+14.1%
Illinois$166$742166400+12.7%
Virginia$165$60992254+11.8%
Ohio$165$701136326+11.4%
New York$164$913271783+11.3%
Michigan$162$49797191+9.7%
Connecticut$160$7504396+8.5%
Massachusetts$160$658112360+8.2%
Pennsylvania$158$521169442+6.7%
California$156$600346912+5.8%
Georgia$156$543107278+5.7%
Montana$155$4761745+4.9%
Louisiana$153$53266134+3.9%
Florida$151$518347977+2.1%
Texas$151$763274744+2.1%
Tennessee$150$54077197+1.6%
Nevada$150$7361849+1.5%
Rhode Island$150$596921+1.3%
New Jersey$148$1,306116358+0.4%
Missouri$146$47193243-1.0%
Hawaii$144$446817-2.3%
Kentucky$144$39774171-2.7%
Oklahoma$142$37738124-3.9%
District of Columbia$141$4611455-4.7%
Kansas$140$43863176-5.3%
Alabama$137$66155108-7.3%
Arizona$136$54291245-7.8%
Iowa$135$5624084-8.5%
Minnesota$134$67994204-9.4%
Indiana$134$45488221-9.5%
South Dakota$133$5292763-9.7%
South Carolina$131$57487219-11.1%
Wisconsin$129$1,30791167-12.8%
Mississippi$128$5423791-13.0%
Arkansas$128$38044107-13.6%
Washington$127$451110307-13.9%
Oregon$126$50788179-14.7%
Colorado$125$52076143-15.5%
North Carolina$123$488140422-16.6%
New Hampshire$123$7252981-16.7%
Delaware$120$3651375-18.5%
Utah$120$4312445-18.8%
North Dakota$119$4241733-19.3%
West Virginia$118$4212646-19.9%
Maine$113$3552041-23.5%
Nebraska$107$44031104-27.5%
Wyoming$105$360623-28.6%
Idaho$102$4032955-31.1%

⚠️ 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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