Refilling and maintenance of portable pump
Medicare pricing data for 1,035 providers across 34 states
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
Refilling and maintenance of portable pump (HCPCS code 96521) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $113.77, but hospitals typically charge $320.44 — a 2.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $113.77, your out-of-pocket cost would be approximately $22.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $90.31 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $151 | $521 | 65 | 529 | +32.4% |
| Maryland | $146 | $484 | 25 | 296 | +28.2% |
| California | $141 | $371 | 73 | 2,439 | +23.9% |
| Massachusetts | $139 | $483 | 7 | 110 | +22.2% |
| New Jersey | $129 | $373 | 12 | 1,647 | +13.1% |
| Wyoming | $128 | $862 | 4 | 645 | +12.4% |
| Virginia | $127 | $628 | 92 | 1,163 | +11.8% |
| West Virginia | $125 | $877 | 1 | 77 | +10.1% |
| Oregon | $121 | $430 | 24 | 1,414 | +6.5% |
| Texas | $120 | $353 | 126 | 8,428 | +5.6% |
| Delaware | $119 | $344 | 6 | 350 | +4.2% |
| Illinois | $117 | $317 | 30 | 1,918 | +3.1% |
| Nevada | $116 | $410 | 22 | 770 | +2.4% |
| Florida | $116 | $272 | 122 | 10,743 | +2.1% |
| North Carolina | $116 | $327 | 36 | 3,091 | +2.1% |
| Colorado | $116 | $307 | 70 | 2,466 | +2.0% |
| Pennsylvania | $116 | $282 | 4 | 907 | +1.8% |
| Ohio | $116 | $652 | 7 | 25 | +1.6% |
| Kansas | $115 | $437 | 14 | 164 | +1.5% |
| Washington | $115 | $390 | 19 | 439 | +1.5% |
| Arizona | $115 | $288 | 30 | 2,751 | +0.8% |
| Missouri | $114 | $413 | 23 | 1,630 | +0.2% |
| Indiana | $114 | $378 | 9 | 504 | -0.1% |
| Alabama | $111 | $195 | 11 | 251 | -2.2% |
| Michigan | $110 | $234 | 15 | 113 | -3.0% |
| Arkansas | $107 | $376 | 6 | 152 | -5.5% |
| Georgia | $103 | $311 | 55 | 7,663 | -9.9% |
| Louisiana | $101 | $213 | 22 | 6,431 | -10.9% |
| Tennessee | $101 | $259 | 12 | 1,871 | -10.9% |
| South Carolina | $101 | $338 | 18 | 1,707 | -11.1% |
| Nebraska | $101 | $189 | 9 | 1,055 | -11.6% |
| Utah | $100 | $314 | 16 | 1,414 | -11.8% |
| Iowa | $99 | $134 | 4 | 405 | -13.1% |
| Mississippi | $96 | $264 | 18 | 1,339 | -15.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber