49593

Initial repair of sliding hernia of abdomen, 3-10 cm in length

Medicare pricing data for 8,685 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $343 in North Dakota to $749 in Alaska. 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

Initial repair of sliding hernia of abdomen, 3-10 cm in length (HCPCS code 49593) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $498.96, but hospitals typically charge $2,290 — a 4.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$99.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $498.96, your out-of-pocket cost would be approximately $99.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$498.96
Average Hospital Charge
$2,290
Markup Ratio
4.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,289.98
Medicare Allowed$498.96
Medicare Payment$394.75

Hospitals charge 4.6x more than what Medicare allows for this procedure. Medicare actually pays $394.75 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$749$7,8602339+50.1%
California$575$2,9607101,581+15.3%
Illinois$547$2,589311735+9.6%
Michigan$547$1,659267474+9.6%
Ohio$536$2,515345744+7.4%
Kansas$534$2,16194236+7.0%
Florida$532$2,2996141,668+6.6%
Indiana$531$2,509210469+6.4%
Virginia$530$1,522223517+6.2%
Maryland$530$1,755153397+6.1%
Texas$527$2,5615891,263+5.7%
Oregon$523$2,296116216+4.8%
Arkansas$518$1,40895219+3.9%
Tennessee$518$1,862189459+3.8%
Louisiana$515$1,837142275+3.3%
Mississippi$512$1,60890208+2.6%
Massachusetts$501$1,859184379+0.5%
Rhode Island$500$1,7162951+0.3%
South Carolina$500$2,199155363+0.1%
Puerto Rico$499$8381825-0.0%
Colorado$490$1,574159306-1.9%
Arizona$490$2,136192495-1.9%
New Jersey$478$6,483241596-4.2%
New York$476$2,8665381,132-4.6%
Georgia$476$1,736234541-4.7%
Montana$475$1,1854073-4.8%
District of Columbia$474$1,5372141-5.0%
Pennsylvania$473$1,445412921-5.1%
Delaware$472$1,5714283-5.4%
Oklahoma$469$1,313107282-6.1%
Hawaii$466$1,4381421-6.7%
Kentucky$465$1,351121228-6.9%
Alabama$458$1,462130316-8.2%
Iowa$454$1,58690179-9.1%
Vermont$453$2,1441627-9.2%
Nevada$452$2,01565152-9.4%
Missouri$450$1,511161325-9.8%
Connecticut$446$1,85089145-10.6%
North Carolina$445$1,970291688-10.9%
Wyoming$441$2,6392141-11.7%
Minnesota$436$2,487182292-12.5%
Utah$433$1,24185191-13.2%
Wisconsin$422$3,978173280-15.3%
New Hampshire$421$3,05770127-15.7%
New Mexico$418$1,5374065-16.3%
Washington$414$1,579188333-17.0%
Maine$389$1,3784275-22.1%
West Virginia$385$1,4774991-22.8%
Nebraska$381$1,96295255-23.6%
Idaho$375$1,3635793-24.8%
South Dakota$351$1,1054789-29.7%
North Dakota$343$1,6023273-31.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber

🏥 See Medicare hospital data on OpenMedicare