Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm
Medicare pricing data for 15,702 providers across 52 states
This procedure has a 7.4x markup — hospitals charge $556.10 but Medicare allows only $75.18. Uninsured patients may face bills 7.4 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, 7.6-12.5 cm (HCPCS code 12004) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $75.18, but hospitals typically charge $556.10 — a 7.4x 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 $75.18, your out-of-pocket cost would be approximately $15.04. 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 7.4x more than what Medicare allows for this procedure. Medicare actually pays $56.87 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $87 | $835 | 35 | 42 | +15.3% |
| Hawaii | $84 | $431 | 52 | 75 | +11.4% |
| New York | $84 | $636 | 773 | 910 | +11.3% |
| New Jersey | $82 | $642 | 341 | 441 | +9.3% |
| California | $82 | $545 | 1,291 | 1,605 | +9.1% |
| Delaware | $81 | $433 | 74 | 92 | +8.0% |
| Florida | $80 | $631 | 1,203 | 1,576 | +6.4% |
| New Mexico | $79 | $525 | 90 | 105 | +5.6% |
| North Dakota | $79 | $567 | 35 | 42 | +5.0% |
| Colorado | $79 | $517 | 242 | 274 | +4.8% |
| Utah | $79 | $439 | 129 | 150 | +4.7% |
| Maryland | $78 | $542 | 310 | 412 | +3.9% |
| Washington | $78 | $479 | 281 | 324 | +3.7% |
| Nevada | $77 | $668 | 133 | 156 | +2.6% |
| Illinois | $77 | $588 | 629 | 767 | +2.1% |
| Massachusetts | $76 | $420 | 458 | 584 | +1.4% |
| Virginia | $76 | $499 | 457 | 579 | +0.9% |
| Montana | $75 | $318 | 65 | 80 | +0.3% |
| Michigan | $75 | $529 | 580 | 690 | +0.1% |
| South Carolina | $75 | $531 | 411 | 541 | -0.5% |
| Connecticut | $75 | $570 | 188 | 244 | -0.6% |
| Georgia | $74 | $582 | 428 | 511 | -1.4% |
| Louisiana | $74 | $741 | 241 | 288 | -1.7% |
| Pennsylvania | $74 | $462 | 759 | 940 | -2.0% |
| North Carolina | $74 | $475 | 545 | 662 | -2.2% |
| Puerto Rico | $74 | $432 | 16 | 16 | -2.2% |
| Oklahoma | $73 | $506 | 246 | 310 | -2.6% |
| West Virginia | $73 | $474 | 106 | 121 | -3.1% |
| New Hampshire | $73 | $538 | 84 | 100 | -3.6% |
| Oregon | $72 | $453 | 175 | 205 | -4.3% |
| Texas | $72 | $668 | 1,062 | 1,310 | -4.3% |
| Idaho | $72 | $399 | 89 | 105 | -4.3% |
| Alabama | $72 | $509 | 259 | 316 | -4.4% |
| Iowa | $71 | $468 | 152 | 177 | -5.0% |
| District of Columbia | $71 | $496 | 35 | 41 | -5.2% |
| Arizona | $71 | $584 | 310 | 387 | -5.7% |
| Rhode Island | $70 | $668 | 62 | 78 | -6.5% |
| Missouri | $70 | $490 | 343 | 408 | -6.7% |
| Minnesota | $70 | $636 | 254 | 290 | -7.3% |
| Kentucky | $70 | $525 | 289 | 357 | -7.4% |
| Wisconsin | $70 | $779 | 249 | 294 | -7.4% |
| Ohio | $69 | $526 | 612 | 742 | -7.6% |
| Arkansas | $69 | $534 | 170 | 210 | -7.7% |
| Wyoming | $69 | $547 | 29 | 38 | -8.0% |
| Kansas | $68 | $519 | 177 | 216 | -9.0% |
| Mississippi | $68 | $627 | 179 | 248 | -9.0% |
| Indiana | $68 | $514 | 355 | 423 | -9.1% |
| Tennessee | $68 | $562 | 396 | 490 | -9.7% |
| Nebraska | $67 | $450 | 91 | 112 | -10.9% |
| Maine | $66 | $436 | 83 | 100 | -12.0% |
| Vermont | $65 | $498 | 29 | 35 | -14.0% |
| South Dakota | $65 | $590 | 47 | 58 | -14.2% |
⚠️ 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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