Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less
Medicare pricing data for 12,078 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 face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less (HCPCS code 12051) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $191.32, but hospitals typically charge $649.78 — a 3.4x 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 $191.32, your out-of-pocket cost would be approximately $38.26. 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 3.4x more than what Medicare allows for this procedure. Medicare actually pays $148.24 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 | $661 | 26 | 79 | +39.3% |
| Hawaii | $246 | $577 | 46 | 201 | +28.7% |
| Wyoming | $223 | $623 | 21 | 195 | +16.6% |
| California | $223 | $700 | 1,142 | 4,855 | +16.3% |
| Delaware | $218 | $616 | 49 | 141 | +13.8% |
| New York | $215 | $874 | 614 | 1,935 | +12.1% |
| Washington | $214 | $607 | 274 | 817 | +11.7% |
| Maryland | $211 | $646 | 268 | 1,466 | +10.4% |
| Nevada | $206 | $611 | 86 | 275 | +7.9% |
| New Jersey | $203 | $860 | 311 | 1,014 | +6.3% |
| Mississippi | $203 | $525 | 145 | 853 | +6.1% |
| Colorado | $201 | $663 | 207 | 844 | +5.3% |
| Connecticut | $201 | $725 | 129 | 692 | +5.1% |
| Illinois | $200 | $742 | 513 | 1,991 | +4.8% |
| Pennsylvania | $199 | $592 | 554 | 2,225 | +4.2% |
| Puerto Rico | $196 | $290 | 10 | 42 | +2.3% |
| Louisiana | $195 | $554 | 181 | 789 | +1.9% |
| South Carolina | $195 | $561 | 252 | 877 | +1.8% |
| Oregon | $194 | $704 | 169 | 950 | +1.4% |
| Virginia | $192 | $536 | 312 | 1,894 | +0.2% |
| Alaska | $191 | $825 | 19 | 74 | +0.0% |
| Montana | $191 | $522 | 59 | 299 | -0.4% |
| North Dakota | $190 | $613 | 34 | 117 | -0.8% |
| Texas | $189 | $686 | 753 | 3,057 | -1.2% |
| Rhode Island | $189 | $666 | 46 | 118 | -1.4% |
| Michigan | $188 | $635 | 363 | 1,237 | -1.9% |
| Florida | $187 | $581 | 998 | 4,985 | -2.2% |
| Nebraska | $187 | $625 | 102 | 436 | -2.4% |
| Massachusetts | $182 | $801 | 354 | 1,590 | -5.0% |
| North Carolina | $181 | $553 | 390 | 1,542 | -5.2% |
| Missouri | $181 | $566 | 255 | 994 | -5.4% |
| Wisconsin | $181 | $1,007 | 239 | 753 | -5.5% |
| Alabama | $180 | $475 | 149 | 583 | -6.0% |
| Ohio | $178 | $600 | 466 | 2,038 | -6.9% |
| Georgia | $176 | $659 | 285 | 1,665 | -7.9% |
| Tennessee | $176 | $561 | 249 | 1,056 | -8.0% |
| New Hampshire | $176 | $821 | 75 | 230 | -8.1% |
| Kentucky | $176 | $595 | 168 | 477 | -8.2% |
| Idaho | $174 | $510 | 73 | 369 | -9.1% |
| Arizona | $174 | $596 | 248 | 1,499 | -9.2% |
| Oklahoma | $172 | $698 | 168 | 555 | -10.0% |
| Indiana | $170 | $627 | 241 | 1,077 | -11.0% |
| West Virginia | $169 | $508 | 66 | 282 | -11.9% |
| Utah | $168 | $518 | 126 | 528 | -12.2% |
| Iowa | $167 | $705 | 157 | 714 | -12.7% |
| Arkansas | $166 | $536 | 104 | 368 | -13.1% |
| Minnesota | $166 | $772 | 211 | 965 | -13.1% |
| Kansas | $166 | $572 | 145 | 764 | -13.2% |
| Maine | $162 | $648 | 61 | 206 | -15.6% |
| Vermont | $155 | $497 | 34 | 130 | -18.8% |
| New Mexico | $155 | $558 | 57 | 292 | -18.9% |
| South Dakota | $151 | $660 | 52 | 303 | -20.9% |
⚠️ 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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