Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less
Medicare pricing data for 16,157 providers across 52 states
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
Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less (HCPCS code 12031) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $220.77, but hospitals typically charge $581.38 — a 2.6x 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 $220.77, your out-of-pocket cost would be approximately $44.15. 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 2.6x more than what Medicare allows for this procedure. Medicare actually pays $167.73 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $266 | $492 | 25 | 90 | +20.4% |
| Alaska | $264 | $824 | 16 | 57 | +19.6% |
| Hawaii | $257 | $518 | 56 | 251 | +16.3% |
| California | $255 | $591 | 1,534 | 7,081 | +15.5% |
| Puerto Rico | $243 | $268 | 11 | 32 | +10.1% |
| New York | $242 | $685 | 784 | 2,552 | +9.4% |
| New Jersey | $239 | $788 | 464 | 1,830 | +8.3% |
| Maryland | $237 | $558 | 360 | 1,938 | +7.4% |
| Washington | $235 | $566 | 367 | 1,187 | +6.5% |
| Connecticut | $233 | $792 | 165 | 594 | +5.5% |
| Massachusetts | $231 | $768 | 499 | 1,794 | +4.7% |
| Colorado | $230 | $655 | 315 | 964 | +4.2% |
| Rhode Island | $228 | $647 | 72 | 186 | +3.4% |
| Wyoming | $227 | $556 | 25 | 136 | +2.8% |
| Oregon | $224 | $625 | 219 | 850 | +1.6% |
| Illinois | $224 | $617 | 651 | 2,870 | +1.4% |
| Texas | $223 | $602 | 1,015 | 4,563 | +1.0% |
| Florida | $223 | $546 | 1,377 | 5,805 | +0.9% |
| Virginia | $222 | $486 | 445 | 2,109 | +0.7% |
| Louisiana | $219 | $572 | 216 | 776 | -0.8% |
| Nevada | $219 | $571 | 134 | 395 | -0.8% |
| Pennsylvania | $218 | $514 | 792 | 2,985 | -1.2% |
| Delaware | $217 | $572 | 79 | 252 | -1.6% |
| Michigan | $216 | $523 | 452 | 1,317 | -2.4% |
| New Hampshire | $214 | $763 | 99 | 261 | -3.1% |
| Arizona | $213 | $527 | 369 | 1,695 | -3.6% |
| North Carolina | $210 | $534 | 526 | 1,839 | -4.7% |
| South Carolina | $207 | $509 | 293 | 1,173 | -6.1% |
| Ohio | $206 | $532 | 587 | 2,350 | -6.8% |
| Nebraska | $204 | $592 | 109 | 388 | -7.4% |
| Georgia | $204 | $584 | 442 | 2,089 | -7.7% |
| Minnesota | $203 | $712 | 332 | 988 | -8.0% |
| Tennessee | $201 | $501 | 388 | 1,363 | -9.1% |
| Kentucky | $201 | $471 | 194 | 752 | -9.1% |
| Utah | $200 | $462 | 171 | 489 | -9.2% |
| Missouri | $200 | $522 | 310 | 999 | -9.5% |
| Montana | $199 | $440 | 75 | 220 | -10.0% |
| Mississippi | $199 | $474 | 156 | 720 | -10.1% |
| Oklahoma | $196 | $537 | 182 | 615 | -11.1% |
| Alabama | $195 | $437 | 187 | 693 | -11.9% |
| North Dakota | $194 | $558 | 60 | 169 | -11.9% |
| Iowa | $194 | $624 | 171 | 636 | -12.2% |
| West Virginia | $193 | $475 | 96 | 425 | -12.6% |
| Kansas | $193 | $531 | 204 | 611 | -12.8% |
| Maine | $191 | $530 | 69 | 156 | -13.3% |
| Idaho | $191 | $502 | 109 | 324 | -13.6% |
| Arkansas | $190 | $502 | 137 | 365 | -14.0% |
| Wisconsin | $189 | $863 | 303 | 899 | -14.6% |
| Vermont | $186 | $489 | 32 | 66 | -15.9% |
| Indiana | $185 | $517 | 301 | 1,333 | -16.4% |
| New Mexico | $180 | $554 | 78 | 237 | -18.2% |
| South Dakota | $179 | $563 | 71 | 328 | -19.0% |
⚠️ 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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