Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance

Medicare Payment (avg)
$226.04
What Medicare actually pays
Billed Charge (avg)
$1,352.18
What providers submit
Markup
6.0x
498% above Medicare rate
74
Total Services
58
Beneficiaries
19
Providers
3
States with Data

Price Range Across States

Lowest State Avg
$193.47
North Carolina
Highest State Avg
$248.44
New York

What You Might Pay

Est. Commercial Insurance
$634.11
Range: $443.88 – $887.76
Est. Cash / Self-Pay
$584.16
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Cardiovascular Surgery procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Prices by State

State Medicare Payment Billed Charge
New York $248.44 $2,500.00
California $247.29 $735.35
North Carolina $193.47 $432.93

What the Data Says About Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance

Across 3 states with reporting providers, CPT code 36474 (Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance) shows a national average Medicare payment of $226.04 against an average billed charge of $1,352.18. That gap — a 6.0x markup, or 498% above the Medicare allowed amount — reflects chargemaster pricing, not what most insured patients actually pay. Medicare's negotiated rate is the statutory benchmark; commercial insurers typically settle between the two figures based on network contracts.

Cardiovascular Surgery procedures like this one saw 74 services billed to Medicare in 2023 by 19 distinct providers, serving 58 unique beneficiaries. State-level variation is significant: North Carolina reports the lowest average payment at $193.47, while New York reports the highest at $248.44. Geographic Practice Cost Indices (GPCIs) explain much of that spread — local malpractice premiums, practice expense, and physician work adjustments all shift the allowed amount even when the procedure is identical.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Cardiovascular Surgery category (2.24x), the estimated commercial insurance price lands near $634.11, with self-pay cash discounts commonly bringing the figure closer to $584.16. Uninsured patients facing the full billed charge have the strongest leverage to negotiate — the Hospital Price Transparency Rule (effective January 2021) requires providers to publish standard charges, cash rates, and payer-specific negotiated prices. This data is for educational reference; confirm coverage and out-of-pocket exposure with your insurer before any procedure.

Frequently Asked Questions

How much does Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance cost?

The national average Medicare payment for Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance (CPT 36474) is $226.04, while providers typically bill $1,352.18. Prices vary significantly by state, ranging from $193.47 to $248.44.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance cost with insurance?

With commercial insurance, Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance costs an estimated $634.11 on average (range: $443.88 – $887.76). Without insurance, the estimated cash price is $584.16. These estimates are based on RAND 2024 research on commercial-to-Medicare price ratios. Your actual cost depends on your insurer, plan, and provider.

Which state has the lowest cost for Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance?

North Carolina has the lowest average Medicare payment for Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance at $193.47, while New York has the highest at $248.44. This $54.97 difference reflects geographic variation in healthcare costs, local cost of living, and provider market dynamics.

How many providers perform Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance?

Nationally, 19 providers billed Medicare for Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance in 2023, performing 74 total services for 58 beneficiaries across 3 states and territories.

What is the billed-to-Medicare markup for Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance?

Providers bill 6.0x what Medicare pays for Mechanochemical Destruction Of Subsequent Incompetent Veins Of Arm Or Leg Using Imaging Guidance — a 498% markup. This gap between billed charges and actual payment is common across healthcare. Uninsured patients may face charges closer to the billed amount, while insured patients pay negotiated rates between the Medicare and billed figures.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial