Removal of muscle and/or tissue, 20.0 sq cm or less
Medicare pricing data for 23,711 providers across 52 states
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 muscle and/or tissue, 20.0 sq cm or less (HCPCS code 11043) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $192.90, but hospitals typically charge $547.39 — a 2.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $192.90, your out-of-pocket cost would be approximately $38.58. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $152.85 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $212 | $591 | 2,208 | 123,334 | +10.0% |
| New York | $206 | $695 | 1,290 | 21,643 | +6.7% |
| Pennsylvania | $200 | $520 | 1,185 | 12,361 | +3.6% |
| Delaware | $199 | $442 | 94 | 629 | +3.4% |
| Rhode Island | $199 | $510 | 67 | 853 | +3.3% |
| Maryland | $198 | $515 | 500 | 9,469 | +2.9% |
| Illinois | $197 | $550 | 916 | 10,389 | +1.9% |
| Florida | $195 | $498 | 2,130 | 129,720 | +1.0% |
| District of Columbia | $191 | $605 | 89 | 1,340 | -0.9% |
| Colorado | $190 | $498 | 342 | 3,996 | -1.3% |
| Oregon | $189 | $495 | 216 | 2,242 | -1.9% |
| Hawaii | $188 | $554 | 66 | 410 | -2.3% |
| New Jersey | $188 | $703 | 906 | 13,661 | -2.4% |
| New Mexico | $188 | $574 | 136 | 2,325 | -2.5% |
| Texas | $187 | $523 | 1,798 | 40,884 | -2.9% |
| Massachusetts | $186 | $607 | 556 | 7,360 | -3.3% |
| Washington | $185 | $623 | 419 | 5,504 | -3.9% |
| Connecticut | $184 | $697 | 261 | 4,018 | -4.9% |
| Virginia | $183 | $574 | 557 | 5,036 | -5.4% |
| Nevada | $180 | $496 | 214 | 3,408 | -6.8% |
| Tennessee | $178 | $534 | 574 | 8,170 | -7.5% |
| Arizona | $178 | $452 | 495 | 4,944 | -7.9% |
| West Virginia | $177 | $564 | 151 | 1,875 | -8.0% |
| Oklahoma | $176 | $525 | 339 | 6,521 | -9.0% |
| Idaho | $172 | $495 | 114 | 526 | -10.6% |
| Georgia | $172 | $446 | 637 | 6,130 | -10.6% |
| Wisconsin | $172 | $815 | 373 | 2,488 | -10.8% |
| Mississippi | $172 | $410 | 330 | 8,607 | -10.9% |
| Utah | $171 | $504 | 198 | 2,170 | -11.5% |
| North Carolina | $170 | $516 | 719 | 8,357 | -11.8% |
| Ohio | $170 | $487 | 1,020 | 11,763 | -12.0% |
| Michigan | $170 | $523 | 652 | 4,671 | -12.1% |
| Indiana | $169 | $585 | 458 | 4,777 | -12.6% |
| Kentucky | $168 | $516 | 381 | 4,929 | -13.0% |
| South Carolina | $166 | $554 | 416 | 5,693 | -14.1% |
| Alaska | $165 | $1,544 | 39 | 75 | -14.2% |
| Minnesota | $165 | $585 | 352 | 1,968 | -14.7% |
| Montana | $164 | $526 | 97 | 779 | -15.1% |
| Louisiana | $162 | $426 | 443 | 6,337 | -15.8% |
| Alabama | $162 | $460 | 339 | 4,602 | -16.0% |
| Maine | $156 | $401 | 87 | 527 | -19.0% |
| North Dakota | $156 | $603 | 76 | 198 | -19.0% |
| New Hampshire | $155 | $704 | 100 | 381 | -19.9% |
| Iowa | $148 | $631 | 187 | 1,391 | -23.3% |
| Vermont | $146 | $705 | 33 | 65 | -24.3% |
| Arkansas | $146 | $599 | 243 | 1,639 | -24.5% |
| Missouri | $144 | $574 | 408 | 1,809 | -25.1% |
| Wyoming | $141 | $817 | 31 | 63 | -26.8% |
| Nebraska | $141 | $516 | 128 | 772 | -26.9% |
| South Dakota | $138 | $552 | 67 | 284 | -28.6% |
| Kansas | $133 | $496 | 204 | 1,183 | -31.1% |
| Puerto Rico | $125 | $222 | 22 | 32 | -35.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber