62368

Electronic analysis and reprogramming of spinal canal drug infusion pump

Medicare pricing data for 2,882 providers across 48 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $228.24 but Medicare allows only $39.20. Uninsured patients may face bills 5.8 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

Electronic analysis and reprogramming of spinal canal drug infusion pump (HCPCS code 62368) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $39.20, but hospitals typically charge $228.24 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.84

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $39.20, your out-of-pocket cost would be approximately $7.84. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$39.20
Average Hospital Charge
$228.24
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$228.24
Medicare Allowed$39.20
Medicare Payment$29.92

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $29.92 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$50$43914138+26.7%
New Jersey$45$36530226+15.3%
New Hampshire$45$104242+14.8%
Connecticut$44$20628171+12.1%
Wyoming$43$183345+10.7%
New York$43$258122946+10.6%
California$43$3102573,630+10.4%
Florida$42$1982852,560+7.9%
Nevada$42$32631383+6.6%
Maryland$41$18447245+5.3%
Oregon$41$13521200+4.2%
District of Columbia$41$143638+4.0%
Delaware$41$450556+3.7%
Virginia$41$17769513+3.3%
South Dakota$40$4613153+3.1%
Colorado$40$17334235+3.0%
Arizona$40$16836691+2.6%
Texas$40$2292692,980+2.4%
Oklahoma$40$17631406+1.4%
Pennsylvania$40$454140789+1.1%
Georgia$39$26352244-0.0%
Illinois$39$258106695-0.7%
Massachusetts$39$20364420-0.8%
South Carolina$39$16230364-1.7%
Louisiana$38$31062428-3.3%
Minnesota$38$197881,174-3.6%
Washington$38$15962457-4.3%
Michigan$37$20883459-5.1%
North Carolina$37$17953240-5.1%
Kentucky$37$211671,091-5.2%
Arkansas$37$15841951-5.9%
Kansas$36$18844447-7.1%
Missouri$36$22950729-7.2%
West Virginia$36$15822143-7.4%
Tennessee$36$17569689-7.5%
Iowa$36$1591230-7.6%
Ohio$36$1601361,226-8.0%
Indiana$36$2111041,569-8.8%
Montana$36$9216132-9.4%
Mississippi$35$15117130-11.2%
North Dakota$34$101848-12.0%
Alabama$34$1031059-12.2%
Utah$34$16430223-14.5%
Nebraska$33$14135254-15.2%
Wisconsin$33$39779501-15.9%
Rhode Island$31$122836-20.7%
Idaho$31$13735600-20.8%
Maine$29$113326-27.2%

⚠️ 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

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