Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm
Medicare pricing data for 13,210 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 neck, hands, feet, or genitals, 2.6-7.5 cm (HCPCS code 12042) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $219.11, but hospitals typically charge $677.73 — a 3.1x 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 $219.11, your out-of-pocket cost would be approximately $43.82. 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 3.1x more than what Medicare allows for this procedure. Medicare actually pays $170.21 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $284 | $586 | 19 | 107 | +29.5% |
| Hawaii | $270 | $687 | 47 | 151 | +23.2% |
| California | $262 | $732 | 1,123 | 4,763 | +19.5% |
| Nevada | $247 | $658 | 85 | 355 | +12.5% |
| New Jersey | $245 | $766 | 277 | 1,012 | +11.7% |
| Maryland | $244 | $666 | 275 | 1,498 | +11.5% |
| Alaska | $242 | $988 | 28 | 120 | +10.6% |
| Oregon | $242 | $772 | 204 | 868 | +10.2% |
| Washington | $236 | $673 | 324 | 1,435 | +7.8% |
| Colorado | $231 | $709 | 239 | 1,029 | +5.5% |
| Rhode Island | $230 | $747 | 62 | 169 | +5.2% |
| Delaware | $229 | $695 | 66 | 267 | +4.7% |
| Connecticut | $228 | $756 | 141 | 678 | +4.2% |
| Montana | $228 | $583 | 70 | 457 | +4.0% |
| Florida | $228 | $620 | 1,154 | 6,440 | +3.9% |
| South Carolina | $227 | $621 | 285 | 1,746 | +3.8% |
| Michigan | $226 | $654 | 379 | 1,367 | +3.1% |
| Texas | $225 | $697 | 949 | 4,939 | +2.7% |
| Illinois | $223 | $735 | 472 | 2,142 | +2.0% |
| Louisiana | $223 | $639 | 191 | 910 | +1.7% |
| Nebraska | $222 | $688 | 98 | 510 | +1.2% |
| North Carolina | $220 | $618 | 476 | 3,145 | +0.4% |
| Massachusetts | $217 | $878 | 374 | 2,070 | -0.8% |
| Virginia | $215 | $590 | 346 | 2,755 | -1.7% |
| Georgia | $215 | $662 | 388 | 2,381 | -1.8% |
| Arizona | $212 | $640 | 282 | 1,910 | -3.3% |
| New York | $211 | $793 | 518 | 1,803 | -3.6% |
| Puerto Rico | $211 | $319 | 4 | 14 | -3.8% |
| Oklahoma | $210 | $685 | 185 | 782 | -4.2% |
| Pennsylvania | $209 | $612 | 567 | 2,530 | -4.6% |
| Alabama | $208 | $529 | 216 | 1,207 | -5.1% |
| Idaho | $206 | $594 | 99 | 565 | -6.0% |
| Kansas | $205 | $661 | 175 | 1,177 | -6.3% |
| Ohio | $205 | $686 | 478 | 2,259 | -6.6% |
| Utah | $203 | $565 | 141 | 639 | -7.1% |
| Missouri | $202 | $644 | 271 | 1,336 | -7.8% |
| Mississippi | $202 | $590 | 155 | 843 | -8.0% |
| Wyoming | $198 | $685 | 29 | 282 | -9.8% |
| Tennessee | $196 | $618 | 344 | 1,734 | -10.6% |
| Minnesota | $195 | $841 | 232 | 1,097 | -11.0% |
| Kentucky | $194 | $613 | 196 | 926 | -11.4% |
| Iowa | $193 | $756 | 160 | 845 | -11.8% |
| Vermont | $193 | $483 | 39 | 188 | -11.9% |
| New Mexico | $188 | $688 | 70 | 311 | -14.4% |
| West Virginia | $187 | $611 | 77 | 380 | -14.4% |
| Indiana | $187 | $678 | 249 | 1,100 | -14.5% |
| South Dakota | $186 | $567 | 56 | 194 | -14.9% |
| New Hampshire | $184 | $840 | 82 | 469 | -15.8% |
| Wisconsin | $184 | $1,001 | 274 | 1,182 | -16.1% |
| Maine | $182 | $603 | 56 | 171 | -17.1% |
| Arkansas | $181 | $556 | 138 | 805 | -17.4% |
| North Dakota | $157 | $497 | 29 | 136 | -28.5% |
⚠️ 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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