10040

Acne surgery

Medicare pricing data for 5,313 providers across 44 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

Acne surgery (HCPCS code 10040) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $109.54, but hospitals typically charge $233.19 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.91

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $109.54, your out-of-pocket cost would be approximately $21.91. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$109.54
Average Hospital Charge
$233.19
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$233.19
Medicare Allowed$109.54
Medicare Payment$80.23

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $80.23 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Virginia$125$26246354+13.7%
Idaho$123$249128+11.9%
New York$122$26984110,286+11.5%
District of Columbia$122$17019141+11.4%
New Jersey$116$2283645,298+5.5%
Maryland$115$2261731,630+5.1%
Connecticut$115$27870302+5.0%
Massachusetts$113$25578479+3.0%
Colorado$112$262101533+2.6%
Rhode Island$112$25738193+2.1%
California$110$2622082-0.0%
Alabama$109$161793-0.6%
Illinois$109$2492822,039-0.7%
Delaware$109$15017192-0.8%
Florida$108$2128618,554-1.3%
Pennsylvania$108$2212431,145-1.5%
North Carolina$107$1891250-2.2%
Michigan$106$1972401,286-3.3%
Texas$105$2355204,278-3.8%
West Virginia$104$215575-5.5%
Louisiana$102$19595974-7.1%
New Hampshire$101$32945196-8.0%
Georgia$101$2001288-8.2%
Oregon$100$191419-8.5%
New Mexico$99$19621124-9.3%
South Carolina$98$268412-10.1%
Maine$98$2112487-10.3%
Oklahoma$97$18074817-11.3%
Kentucky$96$16785618-12.4%
Kansas$95$22485346-13.1%
Ohio$95$227480-13.5%
Mississippi$94$18259806-13.8%
Missouri$93$20684373-14.9%
Washington$93$244411-15.0%
Nebraska$93$25360491-15.2%
Wisconsin$92$323121449-15.7%
South Dakota$92$413753-16.2%
Iowa$91$229108989-17.1%
Indiana$89$224128534-18.6%
Minnesota$86$282181598-21.5%
North Dakota$85$301541-22.8%
Puerto Rico$82$14117223-25.4%
Vermont$82$215811-25.6%
Arkansas$80$14261497-27.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

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