11045

Removal of skin and tissue, each additional 20.0 sq cm or less

Medicare pricing data for 15,993 providers across 51 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

Removal of skin and tissue, each additional 20.0 sq cm or less (HCPCS code 11045) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.35, but hospitals typically charge $104.53 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.67

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.35, your out-of-pocket cost would be approximately $5.67. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.35
Average Hospital Charge
$104.53
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$104.53
Medicare Allowed$28.35
Medicare Payment$22.45

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $22.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$35$1061,17593,988+23.6%
District of Columbia$34$93491,443+20.5%
Connecticut$30$1591898,990+5.9%
Alaska$30$12818441+5.2%
New Jersey$30$12563017,250+4.8%
Maryland$30$11530410,819+4.8%
New Mexico$30$81821,263+4.4%
New York$30$14467925,036+4.2%
Florida$29$891,46467,084+3.6%
Illinois$29$12471018,954+1.3%
Massachusetts$28$13938315,366-0.3%
Louisiana$28$8131914,631-0.4%
Texas$28$971,17343,560-0.8%
Utah$28$971072,133-2.5%
Washington$28$972548,454-2.7%
Oregon$28$1421373,889-2.9%
Colorado$28$882196,232-2.9%
Nevada$27$1051506,599-3.1%
Hawaii$27$60533,383-4.3%
Rhode Island$27$85642,617-4.6%
Mississippi$27$7423114,191-4.7%
Georgia$27$9538010,725-4.9%
New Hampshire$27$193631,212-5.5%
Virginia$27$10141812,183-5.6%
Missouri$27$11436012,105-6.1%
Michigan$27$8952810,591-6.3%
Pennsylvania$26$8576317,180-6.6%
Oklahoma$26$8220210,824-7.6%
Alabama$26$812248,064-7.7%
Vermont$26$18024153-7.9%
Arizona$26$923339,615-7.9%
South Carolina$26$10728110,101-9.1%
West Virginia$26$1461182,875-9.2%
Delaware$25$92531,988-11.4%
Ohio$25$7682723,666-12.9%
Tennessee$25$9235314,103-13.2%
Montana$24$79742,153-14.0%
Kansas$24$12718210,470-14.6%
North Carolina$24$12951218,037-14.6%
Idaho$24$70801,548-14.8%
Kentucky$24$872858,581-15.3%
Maine$24$10058811-15.4%
Minnesota$24$1042165,711-16.2%
Indiana$24$11343614,501-16.7%
Arkansas$23$1181615,565-17.9%
North Dakota$23$21235259-18.7%
Wyoming$23$771283-19.5%
Wisconsin$23$1972805,452-19.6%
Iowa$23$1041646,595-20.1%
Nebraska$22$971032,500-21.7%
South Dakota$21$108511,110-25.6%

⚠️ 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