94727

Test to determine lung volumes using gas dilution or washout

Medicare pricing data for 6,880 providers across 51 states

🤖AI Overview

Prices vary significantly by location — from $11 in Wyoming to $51 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

Test to determine lung volumes using gas dilution or washout (HCPCS code 94727) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.82, but hospitals typically charge $100.33 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.96

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.82, your out-of-pocket cost would be approximately $6.96. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.82
Average Hospital Charge
$100.33
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$100.33
Medicare Allowed$34.82
Medicare Payment$26.85

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $26.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$51$347346+45.7%
New York$45$14363935,293+30.1%
Puerto Rico$42$87631,725+21.8%
Montana$41$8910122+18.8%
Virginia$41$1132088,350+17.2%
California$40$11440917,631+15.9%
Nevada$40$119521,679+14.0%
Michigan$40$891094,553+13.8%
New Jersey$39$13741920,789+13.1%
North Dakota$39$119139+12.3%
Florida$38$7772834,699+8.0%
Arizona$36$811015,178+3.3%
Maryland$36$10316713,978+3.3%
Washington$36$1121281,757+3.2%
Colorado$36$74992,873+2.9%
Georgia$34$1171699,900-3.0%
North Carolina$34$1241705,497-3.1%
Oregon$34$9246649-3.6%
Connecticut$33$1202096,722-5.4%
Alabama$32$8324310,073-7.5%
Texas$32$993319,766-8.5%
Tennessee$31$942638,529-9.7%
Pennsylvania$31$7839310,939-10.5%
Arkansas$31$78392,754-10.9%
South Carolina$31$69751,941-11.5%
West Virginia$30$11337847-15.2%
Mississippi$29$77632,952-16.2%
Iowa$29$94581,488-18.2%
Indiana$26$611636,049-25.3%
Kentucky$26$721002,012-26.4%
Illinois$25$1061842,909-28.2%
District of Columbia$24$6927648-31.5%
New Mexico$23$6229290-34.4%
Oklahoma$23$58622,334-35.4%
Rhode Island$21$107371,063-38.7%
Ohio$21$612836,066-39.7%
Minnesota$21$7752719-39.7%
Massachusetts$20$662249,270-42.5%
Missouri$20$571102,170-43.4%
Kansas$19$7238801-45.4%
Louisiana$19$67893,185-46.8%
Utah$18$57442,298-47.0%
Delaware$18$4816402-48.2%
Maine$16$5922256-53.6%
Wisconsin$16$9655426-53.7%
Nebraska$15$4815226-58.2%
Hawaii$14$6023137-59.8%
New Hampshire$12$5344644-64.8%
Idaho$12$37789-65.6%
South Dakota$12$748210-66.4%
Wyoming$11$391354-67.1%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber