12041

Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less

Medicare pricing data for 10,217 providers across 51 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 neck, hands, feet, or genitals, 2.5 cm or less (HCPCS code 12041) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $197.63, but hospitals typically charge $609.41 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$39.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $197.63, your out-of-pocket cost would be approximately $39.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$197.63
Average Hospital Charge
$609.41
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$609.41
Medicare Allowed$197.63
Medicare Payment$150.30

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $150.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$280$6091631+41.6%
Hawaii$252$52430103+27.4%
California$240$6189652,057+21.3%
Maryland$221$576230539+11.7%
Alaska$220$1,4702838+11.1%
New Jersey$218$711233452+10.3%
New York$212$693426686+7.1%
Colorado$212$629194360+7.0%
Washington$209$599228393+5.8%
Oregon$208$663162341+5.2%
Delaware$206$5855688+4.4%
Texas$206$6407171,458+4.2%
Wyoming$205$6142873+3.5%
Connecticut$203$61898231+2.9%
Pennsylvania$199$529463913+0.9%
Nevada$199$58776120+0.6%
North Dakota$198$5671845+0.4%
Virginia$198$536294674+0.1%
South Carolina$198$567195365+0.0%
Florida$196$6198501,798-0.9%
Louisiana$195$572152288-1.4%
Mississippi$192$575110341-2.8%
Massachusetts$191$714281594-3.2%
North Carolina$191$558338618-3.3%
Illinois$191$673371742-3.4%
Arizona$191$537215572-3.4%
Michigan$190$573296527-3.8%
Ohio$189$595380745-4.4%
New Hampshire$189$7075081-4.4%
Utah$185$464109218-6.2%
Nebraska$185$56668131-6.3%
West Virginia$184$51657130-6.8%
Georgia$183$598308743-7.6%
Kansas$181$566121238-8.3%
Iowa$180$663125223-8.7%
Missouri$180$617220390-9.2%
Kentucky$178$520130227-9.8%
Oklahoma$178$589157284-10.1%
Tennessee$175$568237464-11.4%
Rhode Island$172$6674164-12.9%
Alabama$172$505128286-12.9%
New Mexico$171$60058101-13.3%
Montana$171$48054118-13.4%
Maine$171$6135067-13.6%
Arkansas$169$638104153-14.4%
Idaho$169$48173161-14.5%
Minnesota$168$757174344-15.2%
Indiana$166$533212475-16.0%
Wisconsin$165$874188346-16.7%
Vermont$154$5962738-22.0%
South Dakota$153$56438108-22.3%

⚠️ 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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