Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm
Medicare pricing data for 3,851 providers across 50 states
Prices vary significantly by location — from $123 in North Dakota to $354 in District of Columbia. Where you get this procedure matters more than almost any other factor. 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, 5.1-7.5 cm (HCPCS code 12053) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $199.44, but hospitals typically charge $837.15 — a 4.2x 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 $199.44, your out-of-pocket cost would be approximately $39.89. 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 4.2x more than what Medicare allows for this procedure. Medicare actually pays $157.17 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $354 | $1,100 | 4 | 12 | +77.6% |
| Nevada | $274 | $778 | 12 | 41 | +37.6% |
| Alaska | $244 | $1,108 | 6 | 42 | +22.3% |
| South Carolina | $239 | $721 | 90 | 376 | +19.6% |
| Connecticut | $236 | $1,064 | 44 | 169 | +18.2% |
| California | $231 | $1,035 | 294 | 966 | +16.0% |
| Oregon | $229 | $887 | 58 | 189 | +14.8% |
| Maryland | $228 | $814 | 72 | 251 | +14.1% |
| New Jersey | $218 | $1,090 | 72 | 156 | +9.1% |
| Illinois | $217 | $829 | 136 | 527 | +8.8% |
| Florida | $215 | $742 | 287 | 1,140 | +8.0% |
| New York | $208 | $1,156 | 151 | 431 | +4.4% |
| Washington | $205 | $756 | 84 | 289 | +3.0% |
| Colorado | $205 | $764 | 75 | 321 | +2.6% |
| Idaho | $204 | $658 | 52 | 196 | +2.3% |
| Mississippi | $202 | $712 | 44 | 212 | +1.4% |
| Wyoming | $202 | $902 | 11 | 65 | +1.2% |
| Texas | $202 | $833 | 256 | 998 | +1.2% |
| Arizona | $202 | $846 | 89 | 402 | +1.1% |
| Nebraska | $201 | $856 | 37 | 147 | +0.9% |
| Michigan | $200 | $824 | 92 | 234 | +0.4% |
| Georgia | $200 | $854 | 92 | 457 | +0.2% |
| Virginia | $199 | $684 | 124 | 756 | -0.2% |
| North Carolina | $199 | $794 | 139 | 838 | -0.3% |
| Louisiana | $199 | $755 | 52 | 202 | -0.3% |
| Utah | $197 | $720 | 49 | 141 | -1.2% |
| Massachusetts | $196 | $962 | 112 | 484 | -1.6% |
| Montana | $196 | $556 | 17 | 128 | -1.6% |
| Missouri | $196 | $770 | 105 | 402 | -1.7% |
| Alabama | $196 | $710 | 61 | 218 | -1.8% |
| Rhode Island | $193 | $631 | 5 | 57 | -3.3% |
| Tennessee | $191 | $704 | 115 | 521 | -4.2% |
| Ohio | $189 | $821 | 139 | 622 | -5.1% |
| Kansas | $189 | $806 | 51 | 322 | -5.4% |
| Oklahoma | $188 | $820 | 53 | 254 | -5.8% |
| Pennsylvania | $188 | $799 | 203 | 790 | -5.8% |
| Arkansas | $185 | $519 | 31 | 245 | -7.3% |
| Indiana | $182 | $886 | 62 | 304 | -8.7% |
| Vermont | $179 | $527 | 18 | 110 | -10.2% |
| Iowa | $178 | $1,039 | 54 | 238 | -10.8% |
| Kentucky | $178 | $754 | 54 | 312 | -10.8% |
| New Hampshire | $178 | $1,053 | 34 | 174 | -10.9% |
| Maine | $172 | $509 | 11 | 87 | -13.7% |
| West Virginia | $168 | $724 | 22 | 101 | -15.9% |
| Minnesota | $161 | $1,095 | 85 | 505 | -19.1% |
| Delaware | $161 | $961 | 14 | 20 | -19.5% |
| New Mexico | $156 | $759 | 16 | 128 | -21.5% |
| South Dakota | $153 | $549 | 7 | 24 | -23.4% |
| Wisconsin | $151 | $1,105 | 88 | 445 | -24.3% |
| North Dakota | $123 | $645 | 5 | 14 | -38.4% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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