11047

Removal of bone, each additional 20.0 sq cm or less

Medicare pricing data for 5,356 providers across 46 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 bone, each additional 20.0 sq cm or less (HCPCS code 11047) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $103.81, but hospitals typically charge $327.40 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$20.76

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $103.81, your out-of-pocket cost would be approximately $20.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$103.81
Average Hospital Charge
$327.40
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$327.40
Medicare Allowed$103.81
Medicare Payment$82.84

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $82.84 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$123$3222476,669+18.0%
Maryland$122$2311164,618+17.3%
California$110$60855915,169+6.3%
New Jersey$109$4851463,081+4.7%
Illinois$107$3761891,268+3.3%
District of Columbia$107$310321,455+2.8%
Pennsylvania$106$2632162,086+2.4%
Arizona$106$206921,265+2.3%
Delaware$106$28623135+2.3%
New Mexico$105$22735398+1.2%
Mississippi$104$1551175,295+0.4%
Connecticut$104$26555750+0.3%
Texas$102$2714435,406-1.8%
Hawaii$101$20021134-2.3%
Washington$101$26766691-2.9%
Virginia$100$3021211,638-3.3%
Florida$100$26558416,489-3.4%
Colorado$99$33781816-4.4%
Massachusetts$99$3741371,027-4.5%
Alabama$99$188781,906-4.5%
Oregon$99$28937340-4.5%
Utah$99$21719177-4.6%
Georgia$99$2181515,770-4.7%
Montana$99$2751169-5.0%
Michigan$98$258143935-5.4%
Nevada$98$28742175-6.1%
West Virginia$96$34225289-7.8%
Ohio$95$2781891,344-8.6%
Louisiana$94$2391382,675-9.2%
Maine$94$2291135-9.6%
Kentucky$92$303951,579-11.1%
Idaho$92$3171239-11.5%
Missouri$91$27494928-12.0%
Oklahoma$90$29177736-13.4%
South Dakota$90$2881670-13.5%
Indiana$90$316106662-13.5%
North Carolina$89$2571952,859-14.1%
Tennessee$88$2671281,053-14.8%
Minnesota$88$38074526-15.3%
South Carolina$88$2961211,584-15.4%
New Hampshire$88$5392060-15.5%
Kansas$88$28646445-15.7%
Iowa$87$31831143-15.7%
Arkansas$86$25760523-16.9%
Wisconsin$86$67171292-17.3%
Nebraska$81$37618178-21.8%

⚠️ 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