93798

Outpatient heart rehabilitation with electrocardiogram (ecg) monitoring, quality health care professional services

Medicare pricing data for 585 providers across 39 states

🤖AI Overview

This procedure has a 7.3x markup — hospitals charge $149.43 but Medicare allows only $20.53. Uninsured patients may face bills 7.3 times higher than what insurance negotiates. Prices vary significantly by location — from $13 in Mississippi to $29 in California. 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

Outpatient heart rehabilitation with electrocardiogram (ecg) monitoring, quality health care professional services (HCPCS code 93798) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $20.53, but hospitals typically charge $149.43 — a 7.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.11

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $20.53, your out-of-pocket cost would be approximately $4.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$20.53
Average Hospital Charge
$149.43
Markup Ratio
7.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$149.43
Medicare Allowed$20.53
Medicare Payment$15.69

Hospitals charge 7.3x more than what Medicare allows for this procedure. Medicare actually pays $15.69 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$29$94349,667+39.9%
New Jersey$28$60131,031+34.9%
Rhode Island$26$617789+27.6%
Colorado$26$63341,396+27.3%
North Dakota$26$56135+26.8%
Maryland$26$6471,554+26.5%
Washington$26$643658+24.6%
Delaware$25$9511,483+24.2%
Montana$25$1081120+22.7%
Kansas$25$873133+20.2%
North Carolina$25$387596+19.3%
Iowa$24$1523392+19.2%
Missouri$24$8616972+18.6%
New Mexico$24$3232,684+16.6%
Florida$24$84323,881+16.4%
Idaho$24$1382121+16.4%
Massachusetts$24$1793101+16.0%
Wisconsin$24$184342,524+15.9%
Oklahoma$24$124252+15.6%
Arkansas$24$2157771+15.4%
West Virginia$23$618278+13.9%
New York$22$2646817,622+7.1%
Minnesota$22$105292,437+6.8%
Indiana$22$116201,874+6.2%
Michigan$22$1135416+5.4%
Utah$20$65226-2.5%
Pennsylvania$19$64111,757-9.4%
Arizona$19$125183,712-9.8%
Illinois$18$138394,902-11.8%
Ohio$17$595174-14.8%
Virginia$17$12351,280-17.5%
Louisiana$14$62271,017-29.6%
Connecticut$14$186162,056-29.6%
Oregon$14$76543-33.4%
Texas$14$695910,883-34.0%
Georgia$13$657662-36.3%
South Carolina$13$382186,326-36.3%
Alabama$13$382998-36.7%
Mississippi$13$4651,486-37.0%

⚠️ 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