12032

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm

Medicare pricing data for 25,492 providers across 52 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

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS code 12032) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $251.03, but hospitals typically charge $677.01 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$50.21

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $251.03, your out-of-pocket cost would be approximately $50.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$251.03
Average Hospital Charge
$677.01
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$677.01
Medicare Allowed$251.03
Medicare Payment$193.79

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $193.79 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$306$60756689+21.7%
California$292$7312,30127,529+16.4%
Hawaii$288$66997988+14.9%
Alaska$287$1,03548449+14.4%
New Jersey$279$8546497,997+11.1%
Connecticut$274$8532843,522+9.1%
Massachusetts$269$94273912,020+7.2%
Colorado$268$7184734,996+6.9%
Maryland$267$6555248,927+6.3%
Washington$266$6855716,913+6.0%
Puerto Rico$263$4102472+4.8%
Illinois$262$7261,03212,328+4.2%
Oregon$259$7943524,377+3.0%
Florida$258$6042,18837,643+2.9%
Nevada$258$6561842,114+2.8%
New York$255$8651,21310,593+1.5%
Virginia$254$60271813,213+1.3%
Rhode Island$252$8661181,439+0.4%
Arizona$250$65453710,177-0.3%
Texas$250$6621,66223,905-0.4%
North Carolina$250$62289015,109-0.4%
Delaware$250$5651311,505-0.6%
Michigan$248$6517727,257-1.1%
Montana$248$5891031,624-1.3%
Pennsylvania$247$5811,15914,320-1.6%
South Carolina$245$57747410,671-2.5%
Louisiana$240$5833613,669-4.3%
Utah$239$5602632,654-4.8%
Nebraska$238$7031922,252-5.0%
Georgia$237$65268712,912-5.6%
New Hampshire$235$9311672,065-6.4%
Ohio$234$63192111,942-6.9%
Minnesota$234$8494984,966-7.0%
Kansas$233$6713054,879-7.1%
Oklahoma$229$6243283,672-8.9%
Mississippi$229$5852773,605-8.9%
Missouri$229$6365275,487-8.9%
Maine$227$6631131,006-9.5%
Alabama$227$5593385,530-9.6%
Kentucky$225$5643584,364-10.4%
Tennessee$224$5885868,495-10.6%
Idaho$224$5891692,543-10.8%
Iowa$222$7873013,942-11.6%
Arkansas$219$5332503,830-12.6%
Wyoming$218$63038863-13.0%
Indiana$218$6414835,556-13.3%
West Virginia$217$5801451,878-13.5%
Wisconsin$217$1,0275195,285-13.8%
New Mexico$216$6551321,328-14.0%
Vermont$210$51263648-16.5%
South Dakota$192$55189963-23.3%
North Dakota$187$48672673-25.4%

⚠️ 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

🏥 See Medicare hospital data on OpenMedicare