49406

Drainage of fluid collection of abdominal cavity by tube using imaging guidance

Medicare pricing data for 6,043 providers across 52 states

🤖AI Overview

This procedure has a 8.7x markup — hospitals charge $1,616 but Medicare allows only $184.75. Uninsured patients may face bills 8.7 times higher than what insurance negotiates. 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

Drainage of fluid collection of abdominal cavity by tube using imaging guidance (HCPCS code 49406) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $184.75, but hospitals typically charge $1,616 — a 8.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$36.95

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $184.75, your out-of-pocket cost would be approximately $36.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$184.75
Average Hospital Charge
$1,616
Markup Ratio
8.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,616.35
Medicare Allowed$184.75
Medicare Payment$146.12

Hospitals charge 8.7x more than what Medicare allows for this procedure. Medicare actually pays $146.12 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$240$3,2351348+29.8%
New York$207$2,2853361,635+12.1%
District of Columbia$198$1,20923123+7.0%
New Jersey$197$1,249149766+6.8%
Maryland$191$91392621+3.6%
California$191$1,8305432,547+3.5%
Illinois$191$1,7372401,234+3.3%
Connecticut$190$1,96776271+2.6%
Florida$188$2,0044181,871+2.0%
Delaware$187$57923130+1.4%
Massachusetts$187$1,107159929+1.0%
Montana$186$1,0472481+0.4%
Wyoming$185$8281244+0.1%
Pennsylvania$185$1,3642891,606-0.1%
Nevada$184$1,98752225-0.2%
Colorado$184$1,341118523-0.6%
Michigan$184$982194738-0.6%
Virginia$183$1,111175776-1.0%
Washington$183$915119600-1.1%
New Mexico$182$1,40933163-1.2%
Puerto Rico$182$8381237-1.3%
Texas$182$1,9234442,094-1.4%
Hawaii$182$9221433-1.4%
Vermont$182$4,2341577-1.7%
New Hampshire$181$2,51627172-2.1%
Georgia$180$1,842172633-2.4%
Louisiana$180$1,48785367-2.5%
Rhode Island$180$2,04333121-2.6%
Oregon$179$95284359-3.0%
West Virginia$179$84036213-3.1%
Ohio$178$1,3242351,019-3.5%
Missouri$178$1,305127664-3.6%
Minnesota$178$1,777144574-3.7%
South Carolina$178$1,28689486-3.7%
Utah$178$80053249-3.8%
Arizona$177$2,353118581-4.1%
Alabama$177$1,42494321-4.3%
North Carolina$175$1,477231884-5.3%
Indiana$175$1,582127544-5.4%
Kansas$175$1,02652309-5.4%
Kentucky$174$1,44179351-5.8%
Tennessee$174$1,306139660-5.9%
Mississippi$173$1,38048255-6.1%
Oklahoma$173$1,08266409-6.2%
North Dakota$173$2,1691896-6.5%
Idaho$172$1,21135166-6.9%
Maine$172$8333398-6.9%
Iowa$171$1,61950282-7.4%
Wisconsin$170$3,258143651-8.2%
South Dakota$169$1,42217160-8.4%
Nebraska$168$1,84434293-9.1%
Arkansas$167$1,85157297-9.6%

⚠️ 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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