Hospital Outpatient · C7540

Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac

What Medicare pays for C7540, what providers bill, and how the price varies across 0 states, drawn from CMS 2023 claims data.

C7540 · the short answer

For removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pac, Medicare pays about $7,317.77 while providers bill $22,758.03 on average, a 3.1× markup, one of the smaller markups in the catalog.

Medicare pays
$7,317.77
Providers bill
$22,758.03
Markup
3.1×
Markup percentile
18th

Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.

Medicare Payment (avg)
$7,317.77
What Medicare actually pays
Billed Charge (avg)
$22,758.03
What providers submit
Markup
3.1x
211% above Medicare rate
24
Total Services
24
Beneficiaries
11
Providers
0
States with Data

What You Might Pay

Est. Commercial Insurance
$20,573.40
Range: $14,401.38 – $28,802.76
Est. Cash / Self-Pay
$13,146.87
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: Hospital Outpatient 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.

Where this markup sits nationally

Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate

3 more affordable than 18% of 8,901 procedures

1–2: 466 procedures (5%). Below this entry. 2–3: 681 procedures (8%). Below this entry. 3–4: 845 procedures (9%). This entry sits in this band. 4–5: 1,308 procedures (15%). Above this entry. 5–6: 1,725 procedures (19%). Above this entry. 6–7: 1,217 procedures (14%). Above this entry. 7–8: 801 procedures (9%). Above this entry. 8–9: 541 procedures (6%). Above this entry. 9–10: 351 procedures (4%). Above this entry. 10–11: 246 procedures (3%). Above this entry. 11–12: 151 procedures (2%). Above this entry. 12–13: 175 procedures (2%). Above this entry. 13–14: 140 procedures (2%). Above this entry. 14–15: 40 procedures (0%). Above this entry. 15–16: 39 procedures (0%). Above this entry. 16–17: 26 procedures (0%). Above this entry. 17–18: 25 procedures (0%). Above this entry. 18–19: 21 procedures (0%). Above this entry. 19–20: 12 procedures (0%). Above this entry. 20–21: 16 procedures (0%). Above this entry. 21–22: 13 procedures (0%). Above this entry. 22–23: 8 procedures (0%). Above this entry. 23–24: 9 procedures (0%). Above this entry. 24–25: 4 procedures (0%). Above this entry. 25–26: 3 procedures (0%). Above this entry. 26–27: 3 procedures (0%). Above this entry. 27–28: 4 procedures (0%). Above this entry. 28–29: 3 procedures (0%). Above this entry. 29–30: 2 procedures (0%). Above this entry. 30–31: 26 procedures (0%). Above this entry. this procedure 1 31 × markup, bucketed by value

Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners · 2023

What the Data Says About Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac

Across 0 states with reporting providers, CPT code C7540 (Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac) shows a national average Medicare payment of $7,317.77 against an average billed charge of $22,758.03. That gap, a 3.1x markup, or 211% above the Medicare allowed amount, is among the tightest billed-to-paid spreads we track, this code's chargemaster rate tracks unusually close to the Medicare benchmark.

Hospital Outpatient procedures like this one saw 24 services billed to Medicare in 2023 by 11 distinct providers, serving 24 unique beneficiaries. Regional variation is limited in the underlying CMS file. Where state-level figures exist for removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pac, Geographic Practice Cost Indices (GPCIs), local malpractice premiums, and practice-expense adjustments are the usual drivers of any difference.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Hospital Outpatient category (2.24x), the estimated commercial insurance price lands near $20,573.40, with self-pay cash discounts commonly bringing the figure closer to $13,146.87. Within Hospital Outpatient, Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac ranks #10 of 60 tracked procedures by national average Medicare payment.

What to do with this

If you may have removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pac done, these steps turn the numbers above into a real-world cost estimate.

  • Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
  • Compare removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pac costs in your state, Medicare rates vary by locality. Browse states
  • Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
  • Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide

Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.

Frequently Asked Questions

How much does Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac cost?

The national average Medicare payment for Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac (CPT C7540) is $7,317.77, while providers typically bill $22,758.03.

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 Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac cost with insurance?

With commercial insurance, removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pac costs an estimated $20,573.40 on average (range: $14,401.38-$28,802.76), a moderate premium over Medicare's $7,317.77. Without insurance, the estimated cash price is $13,146.87.

How many providers perform Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac?

Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac is comparatively uncommon: only 11 providers nationally billed Medicare for it in 2023, serving 24 beneficiaries via 24 total services.

What is the billed-to-Medicare markup for Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac?

Providers bill 3.1x what Medicare pays for Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pulse Generator, Dual Lead System, With Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacing, At Time Of Insertion Of Implantable Defibrillator Or Pac - one of the smaller markups in the catalog at 211% above the Medicare rate.

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

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.