11980

Placement of hormone pellet under skin

Medicare pricing data for 2,235 providers across 44 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

Placement of hormone pellet under skin (HCPCS code 11980) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $88.80, but hospitals typically charge $275.82 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$17.76

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $88.80, your out-of-pocket cost would be approximately $17.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$88.80
Average Hospital Charge
$275.82
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$275.82
Medicare Allowed$88.80
Medicare Payment$66.60

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $66.60 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$103$56267553+15.9%
Alaska$103$6591141+15.8%
Massachusetts$101$29826630+14.1%
New York$99$2851531,450+11.3%
Maryland$96$21956732+7.9%
California$94$2991612,396+6.3%
Nevada$94$2361380+6.1%
Florida$93$2772213,879+4.7%
Rhode Island$93$260673+4.7%
Illinois$92$33564829+3.9%
Delaware$92$23812341+3.3%
New Hampshire$91$199733+2.6%
Virginia$91$25137357+2.4%
Texas$89$2611853,979+0.8%
Colorado$89$27688791+0.7%
Kansas$88$20315169-1.4%
Louisiana$87$30838589-2.2%
Georgia$86$30486629-2.6%
Oregon$86$30137210-3.2%
Alabama$86$25033212-3.6%
North Carolina$85$2531191,126-4.0%
Indiana$85$22354410-4.6%
Missouri$84$22229321-5.3%
Oklahoma$84$23228104-5.6%
Tennessee$83$232751,108-6.0%
Michigan$83$23543132-6.4%
Utah$83$22729302-6.4%
Washington$83$26438187-7.1%
Arizona$82$23058497-7.3%
New Mexico$82$222964-7.9%
Pennsylvania$82$25657372-8.0%
Mississippi$82$34521179-8.1%
Minnesota$81$30119149-8.9%
Ohio$79$27754426-10.7%
Kentucky$79$20418139-11.1%
South Carolina$78$248561,139-12.0%
Connecticut$78$481746-12.7%
Nebraska$77$27121131-13.1%
Iowa$76$324530-14.4%
Arkansas$74$25933488-17.0%
Wisconsin$73$51827136-18.3%
Idaho$71$17320185-19.8%
Montana$55$112731-37.9%
Vermont$53$233431-40.6%

⚠️ 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