Delaware · G0413

Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) in Delaware

Delaware Medicare Avg
$448.34
32% below national avg
National Medicare Avg
$660.28
All states combined
Billed Charge (DE)
$5,367.89
What providers submit
Est. Commercial (DE)
$1,268.20
National avg: $1,855.75
Est. Cash / Self-Pay (DE)
$1,898.90
Typical self-pay discount

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

71
Services in DE
7
Providers
N/A
Min Payment
N/A
Max Payment

Delaware Pricing in Context

In Delaware, CPT code G0413 (Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum)) carries an average Medicare payment of $448.34 — 32% below the national benchmark of $660.28. 7 providers across the state submitted claims for this procedure in 2023, performing 71 total services. Individual payments in DE 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 Delaware is $5,367.89, 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 Delaware 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 Temporary Procedures procedures, the estimated commercial insurance price in Delaware lands near $1,268.20, with self-pay cash prices typically around $1,898.90. 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 Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) cost in Delaware?

The average Medicare payment for Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) in Delaware is $448.34, which is 32% below the national average of $660.28. Providers in DE typically bill $5,367.89 for this procedure.

What does Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) cost with insurance in Delaware?

With commercial insurance in Delaware, Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) costs an estimated $1,268.20. Without insurance, the estimated cash price is $1,898.90. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) in Delaware?

7 providers in Delaware billed Medicare for Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) in 2023, performing 71 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) cheaper in Delaware than the national average?

Yes — Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/or Dislocation, For Fracture Patterns Which Disrupt The Pelvic Ring, Unilateral Or Bilateral, (includes Ilium, Sacroiliac Joint And/or Sacrum) costs 32% below the national average in Delaware. The state average Medicare payment is $448.34 compared to $660.28 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