97605

Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less

Medicare pricing data for 12,506 providers across 51 states

🤖AI Overview

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

Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less (HCPCS code 97605) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.17, but hospitals typically charge $140.39 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.17, your out-of-pocket cost would be approximately $5.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.17
Average Hospital Charge
$140.39
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$140.39
Medicare Allowed$28.17
Medicare Payment$22.30

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $22.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wyoming$38$11337240+36.2%
Alaska$33$2762886+18.8%
Hawaii$33$9445212+18.3%
New Mexico$33$16798426+16.2%
California$32$1588653,134+15.2%
Colorado$32$116266731+12.1%
Utah$31$10184218+11.1%
Oregon$31$124146347+8.9%
Washington$31$92180533+8.8%
New Jersey$30$2174761,848+6.0%
Nevada$29$14182250+4.3%
Connecticut$29$150160470+2.6%
Arizona$29$98238961+2.3%
Florida$29$1039943,296+2.1%
Maryland$29$99204678+1.9%
New York$29$2156862,229+1.9%
Georgia$28$1463291,135+0.8%
Kansas$28$159131486+0.2%
Indiana$28$104186561-0.6%
Iowa$28$11297245-1.0%
Texas$28$1399523,320-1.5%
Virginia$28$147323803-2.0%
Alabama$28$90169475-2.3%
Pennsylvania$27$1046611,716-2.8%
Oklahoma$27$100178487-3.6%
Illinois$27$1704311,534-3.7%
Arkansas$27$134115337-3.9%
South Carolina$27$91219599-4.2%
Montana$27$9355265-4.5%
Mississippi$27$10995221-4.9%
Tennessee$27$943391,267-5.0%
Louisiana$27$102242624-5.1%
Massachusetts$27$1193811,114-5.8%
District of Columbia$26$8043218-6.1%
Ohio$26$974331,094-6.2%
Wisconsin$26$454317936-6.3%
Michigan$26$101371935-7.2%
Missouri$26$106249709-7.5%
South Dakota$26$7650198-8.0%
Kentucky$26$92181551-8.2%
Nebraska$26$12194337-8.3%
Idaho$26$9361330-8.5%
North Carolina$25$1344401,044-11.0%
Rhode Island$25$1194382-12.9%
New Hampshire$24$214107366-14.3%
Maine$24$9457132-14.9%
Minnesota$24$147326853-16.3%
West Virginia$23$7875206-17.3%
Delaware$23$903797-17.7%
Vermont$23$1563477-18.0%
North Dakota$22$13148160-20.3%

⚠️ 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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