13131

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

🤖AI Overview

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

$48.21

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.

Average Allowed Cost
$241.06
Average Hospital Charge
$881.69
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$881.69
Medicare Allowed$241.06
Medicare Payment$189.71

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

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$387$1,04410264+60.7%
Hawaii$326$8361529+35.0%
New York$294$1,3383512,134+21.9%
Wyoming$279$7671060+15.9%
Virginia$279$909119689+15.7%
California$262$8467165,485+8.8%
Nevada$262$80550257+8.8%
Puerto Rico$262$4131018+8.6%
Oregon$257$95161327+6.5%
New Jersey$256$1,5641721,004+6.3%
Florida$255$7766216,353+5.8%
Colorado$250$93285623+3.5%
Texas$238$8583531,867-1.3%
Connecticut$238$1,11246147-1.3%
Arizona$236$7931651,208-1.9%
Michigan$233$848114564-3.5%
Illinois$232$1,0251761,234-3.8%
North Carolina$231$810138749-4.0%
Maryland$230$736109616-4.7%
Nebraska$227$92143290-5.8%
Kansas$226$88360210-6.3%
Idaho$225$7492395-6.8%
Massachusetts$224$1,17597590-7.0%
New Hampshire$224$9642170-7.1%
Pennsylvania$223$721205920-7.5%
Minnesota$222$93455235-7.8%
Washington$222$835105566-8.1%
Delaware$219$71318112-9.0%
Iowa$219$93851291-9.1%
Georgia$218$9001861,187-9.4%
Wisconsin$218$1,25573220-9.4%
Indiana$217$76085438-9.8%
New Mexico$216$78528126-10.2%
Rhode Island$215$85314173-11.0%
Mississippi$212$75239251-12.1%
Ohio$211$717146839-12.4%
Alabama$209$72684453-13.2%
Missouri$208$1,048108566-13.7%
Montana$207$6169114-14.3%
Louisiana$206$72343304-14.5%
Maine$205$758930-15.0%
Tennessee$201$730110919-16.5%
West Virginia$196$67924166-18.7%
Kentucky$195$76152358-19.0%
South Carolina$195$52683869-19.1%
Oklahoma$194$81233295-19.4%
Utah$185$87557347-23.3%
Arkansas$176$84243496-27.0%
South Dakota$163$76221168-32.4%
North Dakota$162$6161756-33.0%

⚠️ 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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