95955

Measurement of brain wave activity (eeg) outside the brain during surgery

Medicare pricing data for 444 providers across 36 states

🤖AI Overview

This procedure has a 58.1x markup — hospitals charge $3,186 but Medicare allows only $54.86. Uninsured patients may face bills 58.1 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

Measurement of brain wave activity (eeg) outside the brain during surgery (HCPCS code 95955) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $54.86, but hospitals typically charge $3,186 — a 58.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $54.86, your out-of-pocket cost would be approximately $10.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$54.86
Average Hospital Charge
$3,186
Markup Ratio
58.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,186.41
Medicare Allowed$54.86
Medicare Payment$43.54

Hospitals charge 58.1x more than what Medicare allows for this procedure. Medicare actually pays $43.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Texas$62$4,690495,766+13.7%
District of Columbia$57$1,113235+4.8%
Maryland$56$1,6009534+2.6%
New York$56$8,172201,101+2.2%
Massachusetts$56$1,0709119+1.2%
Washington$55$2,43210869+0.9%
California$55$2,273444,785+0.5%
Utah$55$3,3846266+0.3%
Tennessee$55$1,42771,119-0.5%
Connecticut$54$1,5653142-1.2%
New Jersey$54$5,6708603-1.9%
Hawaii$54$1,870136-2.1%
Colorado$53$2,908131,344-3.4%
Florida$52$3,598342,036-4.6%
New Hampshire$52$4417117-5.2%
Nevada$52$1,61952,256-5.4%
Illinois$52$3,20219143-5.6%
Pennsylvania$52$5,14118803-6.0%
Arizona$51$1,748111,101-6.2%
Virginia$51$7,0909426-6.2%
Michigan$51$9227144-6.3%
Minnesota$51$1,11322206-6.6%
Georgia$51$4,18012151-6.8%
Vermont$51$265250-7.1%
North Carolina$51$2,41111587-7.1%
Ohio$50$5,76323658-8.1%
New Mexico$50$1,870139-8.6%
South Carolina$50$1,656464-8.8%
Wisconsin$50$4,4959537-8.9%
Louisiana$50$259101,908-9.2%
Alabama$50$14318147-9.6%
Indiana$50$231556-9.7%
Kentucky$50$104867-9.7%
Oklahoma$50$1002222-9.8%
Kansas$49$1,7674154-9.8%
Nebraska$49$152440-10.2%

⚠️ 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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