13102

Complicated repair of wound of trunk, each additional 5.0 cm or less

Medicare pricing data for 4,830 providers across 50 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

Complicated repair of wound of trunk, each additional 5.0 cm or less (HCPCS code 13102) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $92.87, but hospitals typically charge $415.65 — a 4.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $92.87, your out-of-pocket cost would be approximately $18.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$92.87
Average Hospital Charge
$415.65
Markup Ratio
4.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$415.65
Medicare Allowed$92.87
Medicare Payment$74.11

Hospitals charge 4.5x more than what Medicare allows for this procedure. Medicare actually pays $74.11 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$120$3081128+29.0%
California$105$4375352,254+12.6%
New Mexico$104$313717+11.8%
Florida$103$2585562,422+11.3%
Nevada$103$23759215+11.1%
Massachusetts$103$368108479+11.0%
New York$102$1,1102871,391+9.6%
Idaho$102$2061532+9.4%
West Virginia$100$2542053+7.8%
Connecticut$100$36244173+7.8%
Maine$98$274712+5.5%
Colorado$96$28896360+3.8%
Illinois$96$406178821+3.3%
Washington$95$250121463+2.3%
Virginia$93$341115513+0.4%
New Jersey$93$1,183133725+0.3%
Michigan$93$283118369-0.3%
North Carolina$92$299140573-0.7%
Arizona$92$255154701-0.7%
Georgia$92$317154788-1.4%
Alaska$91$1,472611-1.9%
Maryland$91$326100586-2.3%
Alabama$91$26765309-2.3%
Utah$91$19543130-2.4%
Pennsylvania$89$326197762-4.4%
Texas$88$3413281,796-4.7%
Delaware$88$24818126-4.8%
Minnesota$88$43364189-5.0%
South Carolina$88$24085355-5.2%
North Dakota$88$196930-5.6%
Oklahoma$87$23335123-6.1%
Oregon$87$31847127-6.5%
District of Columbia$85$25719179-8.3%
Kentucky$84$24260246-9.4%
Arkansas$83$22940134-10.2%
Tennessee$83$230101356-10.5%
South Dakota$83$21221109-10.8%
Wisconsin$82$51278295-11.7%
Ohio$82$337160591-11.9%
Missouri$82$38795547-12.0%
New Hampshire$81$2781848-13.0%
Montana$80$2052068-13.9%
Indiana$79$29382524-15.2%
Nebraska$79$4082168-15.2%
Iowa$78$37536127-16.3%
Mississippi$78$29945148-16.5%
Rhode Island$78$27522282-16.5%
Louisiana$75$86451518-19.2%
Kansas$74$28857248-20.3%
Wyoming$69$331415-25.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

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