Indiana · 47780

Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel in Indiana

Indiana Medicare Avg
$1,195.83
19% below national avg
National Medicare Avg
$1,477.60
All states combined
Billed Charge (IN)
$4,058.60
What providers submit
Est. Commercial (IN)
$3,149.44
National avg: $4,148.77
Est. Cash / Self-Pay (IN)
$2,240.92
Typical self-pay discount

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

22
Services in IN
13
Providers
N/A
Min Payment
N/A
Max Payment

Indiana Pricing in Context

In Indiana, CPT code 47780 (Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel) carries an average Medicare payment of $1,195.83 — 19% below the national benchmark of $1,477.60. 13 providers across the state submitted claims for this procedure in 2023, performing 22 total services. Individual payments in IN ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Indiana is $4,058.60, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Indiana sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Digestive Surgery procedures, the estimated commercial insurance price in Indiana lands near $3,149.44, with self-pay cash prices typically around $2,240.92. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel cost in Indiana?

The average Medicare payment for Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel in Indiana is $1,195.83, which is 19% below the national average of $1,477.60. Providers in IN typically bill $4,058.60 for this procedure.

What does Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel cost with insurance in Indiana?

With commercial insurance in Indiana, Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel costs an estimated $3,149.44. Without insurance, the estimated cash price is $2,240.92. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel in Indiana?

13 providers in Indiana billed Medicare for Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel in 2023, performing 22 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel cheaper in Indiana than the national average?

Yes — Roux-En-Y Connection Of Bile Duct External To Liver To Small Bowel costs 19% below the national average in Indiana. The state average Medicare payment is $1,195.83 compared to $1,477.60 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

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