Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm
Medicare pricing data for 11,837 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, 2.6-5.0 cm (HCPCS code 12052) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $190.59, but hospitals typically charge $701.31 — a 3.7x 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 $190.59, your out-of-pocket cost would be approximately $38.12. 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 3.7x more than what Medicare allows for this procedure. Medicare actually pays $149.50 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Hawaii | $248 | $669 | 47 | 160 | +30.3% |
| District of Columbia | $243 | $710 | 43 | 87 | +27.7% |
| California | $224 | $806 | 1,080 | 6,996 | +17.3% |
| Washington | $217 | $667 | 268 | 1,682 | +14.0% |
| Maryland | $216 | $679 | 260 | 2,311 | +13.5% |
| Puerto Rico | $214 | $325 | 7 | 17 | +12.4% |
| Nevada | $213 | $718 | 78 | 409 | +11.9% |
| Wyoming | $212 | $848 | 31 | 428 | +11.4% |
| South Carolina | $211 | $635 | 245 | 2,229 | +10.6% |
| New Jersey | $206 | $842 | 274 | 1,381 | +8.0% |
| Nebraska | $206 | $656 | 95 | 661 | +7.9% |
| Connecticut | $203 | $859 | 159 | 1,366 | +6.5% |
| Oregon | $202 | $812 | 159 | 1,522 | +6.2% |
| Illinois | $201 | $737 | 446 | 3,210 | +5.6% |
| Texas | $200 | $686 | 763 | 6,843 | +4.9% |
| New York | $198 | $833 | 508 | 2,935 | +3.8% |
| Delaware | $197 | $646 | 52 | 223 | +3.2% |
| Michigan | $196 | $704 | 335 | 1,704 | +2.9% |
| Idaho | $195 | $565 | 81 | 895 | +2.2% |
| Florida | $195 | $613 | 1,012 | 8,794 | +2.1% |
| Alaska | $195 | $1,024 | 30 | 381 | +2.1% |
| Rhode Island | $194 | $921 | 56 | 148 | +1.9% |
| Colorado | $194 | $701 | 217 | 1,589 | +1.5% |
| Virginia | $191 | $590 | 337 | 4,720 | +0.4% |
| Montana | $191 | $516 | 58 | 698 | +0.3% |
| Louisiana | $189 | $574 | 172 | 1,587 | -0.7% |
| Massachusetts | $186 | $900 | 331 | 3,238 | -2.6% |
| Pennsylvania | $186 | $645 | 565 | 4,312 | -2.6% |
| Alabama | $185 | $525 | 179 | 1,388 | -2.8% |
| Mississippi | $185 | $683 | 138 | 1,546 | -3.2% |
| Arizona | $184 | $690 | 220 | 2,434 | -3.4% |
| North Carolina | $184 | $635 | 421 | 4,952 | -3.7% |
| Maine | $183 | $679 | 50 | 237 | -4.0% |
| Georgia | $182 | $712 | 298 | 2,945 | -4.6% |
| Oklahoma | $180 | $714 | 150 | 1,426 | -5.3% |
| Kansas | $179 | $753 | 143 | 1,818 | -5.9% |
| Missouri | $178 | $669 | 273 | 2,236 | -6.4% |
| Utah | $178 | $588 | 130 | 1,126 | -6.6% |
| South Dakota | $176 | $654 | 49 | 307 | -7.6% |
| Tennessee | $175 | $624 | 243 | 2,488 | -8.3% |
| Iowa | $174 | $849 | 153 | 1,540 | -8.8% |
| Ohio | $172 | $711 | 446 | 3,706 | -9.5% |
| Indiana | $171 | $673 | 225 | 1,847 | -10.1% |
| Vermont | $169 | $424 | 26 | 430 | -11.4% |
| Kentucky | $168 | $663 | 166 | 1,271 | -11.7% |
| Arkansas | $163 | $505 | 124 | 1,522 | -14.7% |
| West Virginia | $162 | $642 | 66 | 720 | -14.8% |
| Wisconsin | $162 | $1,071 | 234 | 1,598 | -14.9% |
| Minnesota | $159 | $868 | 224 | 2,264 | -16.4% |
| New Mexico | $159 | $662 | 57 | 602 | -16.4% |
| New Hampshire | $156 | $761 | 71 | 765 | -18.4% |
| North Dakota | $126 | $392 | 31 | 223 | -33.7% |
⚠️ 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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