11056

Removal of noncancer thickened skin growth, 2-4 growths

Medicare pricing data for 14,048 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.8 million services annually. Even small pricing inefficiencies here affect millions of patients. 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 noncancer thickened skin growth, 2-4 growths (HCPCS code 11056) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $81.74, but hospitals typically charge $127.76 — a 1.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$16.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $81.74, your out-of-pocket cost would be approximately $16.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$81.74
Average Hospital Charge
$127.76
Markup Ratio
1.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$127.76
Medicare Allowed$81.74
Medicare Payment$60.42

Hospitals charge 1.6x more than what Medicare allows for this procedure. Medicare actually pays $60.42 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$97$172242,686+18.2%
New York$91$1311,234206,996+11.0%
New Jersey$89$134794142,200+9.5%
Hawaii$89$128311,241+9.2%
Maryland$88$12432672,086+7.2%
California$87$1401,622268,228+6.9%
Connecticut$87$12019130,786+6.1%
Rhode Island$83$1297914,799+2.1%
Delaware$83$1195011,815+1.7%
Wyoming$83$13892,287+1.6%
Massachusetts$83$12934675,877+1.5%
Washington$82$13933526,495+0.3%
Vermont$81$117111,072-1.4%
Puerto Rico$81$88540-1.5%
New Hampshire$80$126432,984-1.8%
Alaska$80$21621585-1.8%
Virginia$80$13134238,912-2.6%
Nevada$79$11910112,401-3.0%
Pennsylvania$79$112966170,264-3.0%
Colorado$79$13615511,557-3.1%
Oregon$79$15616013,864-3.3%
Minnesota$78$13018511,487-4.2%
Arizona$78$13137134,618-4.9%
Illinois$77$120687116,170-5.5%
Michigan$77$11948938,947-5.5%
Florida$77$121840130,937-5.6%
Maine$76$104314,201-6.6%
Montana$76$137735,428-6.8%
Georgia$76$13933424,353-7.6%
Texas$75$13266447,263-7.8%
Utah$75$13316614,971-7.9%
North Carolina$74$13834833,003-9.1%
Wisconsin$74$15020714,451-9.1%
Ohio$74$11160539,719-9.4%
South Carolina$74$11618814,307-9.5%
New Mexico$73$139684,662-10.9%
Indiana$73$11124522,484-11.0%
Missouri$73$11822626,055-11.2%
Oklahoma$72$1101238,883-11.6%
Alabama$72$1101077,810-12.1%
Tennessee$72$13423015,804-12.4%
Kentucky$71$10614612,764-13.2%
Arkansas$70$115664,520-13.8%
Iowa$70$15615914,821-14.0%
West Virginia$70$103643,894-14.2%
Kansas$69$1058413,814-15.6%
Louisiana$67$1251476,521-17.5%
Nebraska$67$120894,978-17.7%
Idaho$65$137865,287-20.7%
Mississippi$64$127472,546-21.5%
South Dakota$60$129512,952-27.2%
North Dakota$50$126611,771-39.1%

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

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