11000

Removal of inflamed or infected skin, up to 10% of body surface

Medicare pricing data for 2,640 providers across 46 states

🤖AI Overview

Prices vary significantly by location — from $21 in Maine to $65 in Alaska. Where you get this procedure matters more than almost any other factor. 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

Removal of inflamed or infected skin, up to 10% of body surface (HCPCS code 11000) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $49.88, but hospitals typically charge $126.17 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.98

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $49.88, your out-of-pocket cost would be approximately $9.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$49.88
Average Hospital Charge
$126.17
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$126.17
Medicare Allowed$49.88
Medicare Payment$38.01

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $38.01 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$65$188839+29.6%
Massachusetts$61$12629189+23.3%
Hawaii$61$102861+21.3%
Connecticut$60$27012132+20.8%
Oklahoma$60$13522615+20.6%
New York$59$1221974,274+18.3%
Minnesota$56$17421288+12.9%
Maryland$55$9056259+10.0%
Puerto Rico$53$1121260+6.2%
Pennsylvania$52$14863324+4.8%
Kansas$52$118940+4.1%
California$52$10445214,592+4.0%
West Virginia$52$1105256+3.9%
Alabama$52$65301,482+3.6%
Florida$52$12739812,748+3.5%
Arkansas$51$9817100+3.2%
Mississippi$51$7816221+2.8%
Nebraska$51$1201530+2.7%
Delaware$51$153913+2.2%
Illinois$50$94912,966+1.2%
Kentucky$50$98575+0.9%
Michigan$50$82841,282+0.3%
New Hampshire$50$170928+0.1%
Rhode Island$49$1851123-0.9%
Montana$49$97739-1.6%
Washington$49$23135158-1.9%
South Carolina$49$12649481-2.2%
Louisiana$49$8029547-2.3%
North Carolina$49$12768228-2.7%
Oregon$48$1291321-2.9%
Texas$47$1882016,105-5.8%
Virginia$47$11550238-6.3%
Utah$45$13041503-9.3%
Missouri$45$1281872-9.3%
Arizona$44$175612,776-11.7%
Ohio$44$9314117-12.5%
Indiana$44$10618259-12.7%
Nevada$42$132352,245-16.5%
New Jersey$42$91801,842-16.5%
Idaho$41$12811285-16.8%
Wisconsin$41$17312134-17.3%
Georgia$40$97521,141-19.2%
Tennessee$39$10357604-21.5%
Colorado$39$30127793-22.3%
New Mexico$38$117937-24.7%
Maine$21$107834-57.2%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber