Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm
Medicare pricing data for 5,324 providers across 50 states
Prices vary significantly by location — from $162 in North Dakota to $387 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
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm (HCPCS code 13131) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $241.06, but hospitals typically charge $881.69 — 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 $241.06, your out-of-pocket cost would be approximately $48.21. 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 $189.71 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $387 | $1,044 | 10 | 264 | +60.7% |
| Hawaii | $326 | $836 | 15 | 29 | +35.0% |
| New York | $294 | $1,338 | 351 | 2,134 | +21.9% |
| Wyoming | $279 | $767 | 10 | 60 | +15.9% |
| Virginia | $279 | $909 | 119 | 689 | +15.7% |
| California | $262 | $846 | 716 | 5,485 | +8.8% |
| Nevada | $262 | $805 | 50 | 257 | +8.8% |
| Puerto Rico | $262 | $413 | 10 | 18 | +8.6% |
| Oregon | $257 | $951 | 61 | 327 | +6.5% |
| New Jersey | $256 | $1,564 | 172 | 1,004 | +6.3% |
| Florida | $255 | $776 | 621 | 6,353 | +5.8% |
| Colorado | $250 | $932 | 85 | 623 | +3.5% |
| Texas | $238 | $858 | 353 | 1,867 | -1.3% |
| Connecticut | $238 | $1,112 | 46 | 147 | -1.3% |
| Arizona | $236 | $793 | 165 | 1,208 | -1.9% |
| Michigan | $233 | $848 | 114 | 564 | -3.5% |
| Illinois | $232 | $1,025 | 176 | 1,234 | -3.8% |
| North Carolina | $231 | $810 | 138 | 749 | -4.0% |
| Maryland | $230 | $736 | 109 | 616 | -4.7% |
| Nebraska | $227 | $921 | 43 | 290 | -5.8% |
| Kansas | $226 | $883 | 60 | 210 | -6.3% |
| Idaho | $225 | $749 | 23 | 95 | -6.8% |
| Massachusetts | $224 | $1,175 | 97 | 590 | -7.0% |
| New Hampshire | $224 | $964 | 21 | 70 | -7.1% |
| Pennsylvania | $223 | $721 | 205 | 920 | -7.5% |
| Minnesota | $222 | $934 | 55 | 235 | -7.8% |
| Washington | $222 | $835 | 105 | 566 | -8.1% |
| Delaware | $219 | $713 | 18 | 112 | -9.0% |
| Iowa | $219 | $938 | 51 | 291 | -9.1% |
| Georgia | $218 | $900 | 186 | 1,187 | -9.4% |
| Wisconsin | $218 | $1,255 | 73 | 220 | -9.4% |
| Indiana | $217 | $760 | 85 | 438 | -9.8% |
| New Mexico | $216 | $785 | 28 | 126 | -10.2% |
| Rhode Island | $215 | $853 | 14 | 173 | -11.0% |
| Mississippi | $212 | $752 | 39 | 251 | -12.1% |
| Ohio | $211 | $717 | 146 | 839 | -12.4% |
| Alabama | $209 | $726 | 84 | 453 | -13.2% |
| Missouri | $208 | $1,048 | 108 | 566 | -13.7% |
| Montana | $207 | $616 | 9 | 114 | -14.3% |
| Louisiana | $206 | $723 | 43 | 304 | -14.5% |
| Maine | $205 | $758 | 9 | 30 | -15.0% |
| Tennessee | $201 | $730 | 110 | 919 | -16.5% |
| West Virginia | $196 | $679 | 24 | 166 | -18.7% |
| Kentucky | $195 | $761 | 52 | 358 | -19.0% |
| South Carolina | $195 | $526 | 83 | 869 | -19.1% |
| Oklahoma | $194 | $812 | 33 | 295 | -19.4% |
| Utah | $185 | $875 | 57 | 347 | -23.3% |
| Arkansas | $176 | $842 | 43 | 496 | -27.0% |
| South Dakota | $163 | $762 | 21 | 168 | -32.4% |
| North Dakota | $162 | $616 | 17 | 56 | -33.0% |
⚠️ 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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