Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm
Medicare pricing data for 29,577 providers across 52 states
This procedure has a 8.6x markup — hospitals charge $507.57 but Medicare allows only $58.85. Uninsured patients may face bills 8.6 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 face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm (HCPCS code 12013) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $58.85, but hospitals typically charge $507.57 — a 8.6x 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 $58.85, your out-of-pocket cost would be approximately $11.77. 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 8.6x more than what Medicare allows for this procedure. Medicare actually pays $45.05 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $71 | $814 | 71 | 95 | +20.1% |
| New York | $65 | $612 | 1,720 | 2,594 | +11.0% |
| New Jersey | $64 | $582 | 766 | 1,250 | +8.4% |
| Illinois | $62 | $526 | 1,332 | 2,173 | +6.0% |
| Maryland | $62 | $452 | 563 | 995 | +5.5% |
| Wyoming | $62 | $447 | 46 | 71 | +5.5% |
| Florida | $62 | $616 | 2,055 | 3,659 | +5.1% |
| Washington | $62 | $456 | 541 | 851 | +5.0% |
| California | $62 | $441 | 2,681 | 4,901 | +4.9% |
| Delaware | $61 | $410 | 118 | 216 | +4.2% |
| Montana | $61 | $315 | 110 | 172 | +4.0% |
| Hawaii | $61 | $437 | 94 | 150 | +3.6% |
| Puerto Rico | $60 | $625 | 28 | 41 | +2.3% |
| Michigan | $60 | $479 | 1,019 | 1,459 | +2.0% |
| Utah | $60 | $390 | 255 | 376 | +2.0% |
| Colorado | $59 | $464 | 499 | 746 | +0.9% |
| Louisiana | $59 | $650 | 490 | 738 | +0.9% |
| Nevada | $59 | $585 | 242 | 363 | +0.7% |
| District of Columbia | $59 | $455 | 88 | 131 | +0.3% |
| Virginia | $59 | $440 | 806 | 1,292 | -0.1% |
| Pennsylvania | $59 | $438 | 1,480 | 2,228 | -0.6% |
| Connecticut | $59 | $506 | 358 | 530 | -0.6% |
| New Mexico | $58 | $485 | 174 | 244 | -1.3% |
| Georgia | $58 | $622 | 843 | 1,353 | -1.4% |
| New Hampshire | $58 | $488 | 146 | 181 | -1.5% |
| South Carolina | $58 | $503 | 664 | 1,067 | -1.7% |
| Massachusetts | $58 | $377 | 810 | 1,362 | -1.8% |
| Idaho | $57 | $347 | 130 | 182 | -2.8% |
| West Virginia | $57 | $413 | 158 | 218 | -2.9% |
| Texas | $57 | $594 | 2,051 | 3,453 | -3.2% |
| Oregon | $57 | $375 | 304 | 414 | -3.2% |
| Arizona | $56 | $494 | 560 | 943 | -4.2% |
| Missouri | $56 | $419 | 627 | 967 | -5.1% |
| North Carolina | $55 | $477 | 1,067 | 1,621 | -6.0% |
| Mississippi | $55 | $552 | 337 | 590 | -6.0% |
| Rhode Island | $55 | $639 | 136 | 199 | -6.1% |
| Nebraska | $55 | $393 | 177 | 244 | -6.1% |
| Alabama | $55 | $491 | 375 | 624 | -6.3% |
| Kentucky | $55 | $478 | 445 | 681 | -6.4% |
| Oklahoma | $55 | $416 | 409 | 641 | -6.5% |
| Kansas | $55 | $465 | 275 | 434 | -6.6% |
| Ohio | $55 | $466 | 1,197 | 1,806 | -6.6% |
| Iowa | $55 | $452 | 308 | 460 | -6.9% |
| Maine | $55 | $406 | 146 | 201 | -7.0% |
| Wisconsin | $54 | $708 | 528 | 735 | -7.8% |
| Indiana | $54 | $462 | 633 | 1,004 | -8.2% |
| Arkansas | $54 | $446 | 303 | 545 | -8.5% |
| Tennessee | $53 | $488 | 657 | 1,078 | -9.2% |
| Minnesota | $53 | $604 | 480 | 659 | -9.4% |
| South Dakota | $53 | $456 | 90 | 146 | -9.4% |
| North Dakota | $53 | $440 | 74 | 104 | -9.7% |
| Vermont | $51 | $502 | 60 | 78 | -12.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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