Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less
Medicare pricing data for 67,478 providers across 52 states
This procedure has a 6.8x markup — hospitals charge $367.10 but Medicare allows only $53.85. Uninsured patients may face bills 6.8 times higher than what insurance negotiates. 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
Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less (HCPCS code 12001) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $53.85, but hospitals typically charge $367.10 — a 6.8x 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 $53.85, your out-of-pocket cost would be approximately $10.77. 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 6.8x more than what Medicare allows for this procedure. Medicare actually pays $39.58 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $70 | $499 | 203 | 416 | +29.1% |
| Maryland | $65 | $332 | 1,300 | 3,514 | +20.5% |
| Delaware | $64 | $275 | 280 | 784 | +18.8% |
| New York | $62 | $484 | 4,152 | 8,749 | +14.5% |
| New Jersey | $61 | $413 | 1,742 | 4,368 | +13.3% |
| California | $60 | $347 | 5,409 | 12,462 | +12.1% |
| Hawaii | $59 | $324 | 214 | 484 | +10.4% |
| Utah | $59 | $254 | 694 | 1,380 | +9.4% |
| Washington | $58 | $317 | 1,279 | 2,684 | +7.9% |
| Wyoming | $58 | $304 | 155 | 335 | +6.9% |
| Rhode Island | $57 | $416 | 303 | 732 | +6.7% |
| Massachusetts | $56 | $317 | 1,805 | 4,458 | +4.1% |
| Colorado | $56 | $331 | 1,224 | 2,410 | +4.1% |
| Montana | $56 | $258 | 295 | 629 | +3.1% |
| New Hampshire | $55 | $363 | 452 | 1,020 | +3.0% |
| Florida | $55 | $406 | 4,146 | 10,147 | +2.1% |
| Pennsylvania | $54 | $330 | 3,374 | 7,574 | +0.6% |
| Illinois | $54 | $410 | 2,863 | 6,454 | +0.5% |
| Virginia | $54 | $325 | 1,876 | 4,404 | +0.3% |
| Oregon | $54 | $281 | 758 | 1,500 | +0.3% |
| Georgia | $54 | $366 | 1,859 | 3,605 | -0.6% |
| Michigan | $53 | $350 | 2,591 | 5,500 | -1.3% |
| Idaho | $53 | $217 | 429 | 887 | -1.7% |
| District of Columbia | $52 | $326 | 170 | 357 | -3.0% |
| Connecticut | $52 | $382 | 833 | 1,826 | -3.1% |
| Arizona | $52 | $361 | 1,328 | 3,146 | -3.1% |
| Louisiana | $52 | $454 | 1,065 | 2,003 | -3.3% |
| North Dakota | $52 | $337 | 190 | 401 | -3.8% |
| Nevada | $52 | $432 | 509 | 1,023 | -4.3% |
| South Carolina | $51 | $349 | 1,349 | 3,292 | -4.4% |
| Nebraska | $51 | $299 | 493 | 1,046 | -4.7% |
| North Carolina | $51 | $320 | 2,230 | 4,464 | -6.0% |
| West Virginia | $51 | $315 | 450 | 950 | -6.0% |
| Iowa | $51 | $337 | 770 | 1,680 | -6.2% |
| Alabama | $50 | $305 | 925 | 1,775 | -7.1% |
| Texas | $50 | $437 | 4,326 | 8,943 | -8.0% |
| Mississippi | $49 | $384 | 748 | 1,633 | -8.1% |
| Oklahoma | $49 | $294 | 971 | 2,251 | -8.4% |
| Wisconsin | $49 | $536 | 1,362 | 2,661 | -8.8% |
| Maine | $49 | $301 | 385 | 758 | -9.0% |
| New Mexico | $49 | $342 | 406 | 808 | -9.5% |
| Arkansas | $48 | $310 | 735 | 1,646 | -10.2% |
| Indiana | $48 | $342 | 1,516 | 3,379 | -10.5% |
| Missouri | $48 | $330 | 1,352 | 3,000 | -10.9% |
| Minnesota | $48 | $445 | 1,261 | 2,290 | -11.3% |
| Tennessee | $48 | $339 | 1,501 | 3,225 | -11.8% |
| Ohio | $47 | $344 | 2,858 | 6,337 | -12.1% |
| Kentucky | $47 | $330 | 1,073 | 2,288 | -12.3% |
| Kansas | $47 | $342 | 711 | 1,680 | -13.0% |
| Vermont | $47 | $314 | 165 | 341 | -13.1% |
| South Dakota | $46 | $290 | 269 | 541 | -15.0% |
| Puerto Rico | $45 | $316 | 65 | 112 | -16.7% |
⚠️ 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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