13160

Extensive or complicated repair of surface wound reopening

Medicare pricing data for 8,468 providers across 51 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

Extensive or complicated repair of surface wound reopening (HCPCS code 13160) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $687.81, but hospitals typically charge $2,673 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$137.56

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $687.81, your out-of-pocket cost would be approximately $137.56. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$687.81
Average Hospital Charge
$2,673
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,673.09
Medicare Allowed$687.81
Medicare Payment$547.35

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $547.35 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$865$5,2502741+25.8%
Maryland$792$2,496154406+15.1%
New Jersey$760$3,789241500+10.5%
Wyoming$754$3,3531848+9.7%
District of Columbia$747$2,16950344+8.5%
New York$745$5,089292501+8.3%
Connecticut$743$2,67672117+8.1%
California$740$2,8057861,558+7.6%
New Hampshire$738$3,2415988+7.2%
West Virginia$736$2,0233372+7.1%
Massachusetts$731$2,954196350+6.3%
Hawaii$728$2,0231824+5.8%
Rhode Island$716$2,5981015+4.1%
Virginia$714$4,160237541+3.8%
Illinois$713$2,657255434+3.7%
Delaware$700$2,5843861+1.8%
Michigan$699$2,115281480+1.6%
Washington$690$2,215159251+0.3%
Florida$689$2,8956231,208+0.1%
Montana$688$2,1404264-0.0%
Arizona$683$2,532223398-0.7%
Colorado$682$2,493187285-0.8%
Maine$681$2,0871723-1.0%
South Dakota$680$2,01349126-1.1%
Ohio$678$2,259380687-1.4%
Louisiana$678$2,101121217-1.5%
Pennsylvania$676$2,145444766-1.7%
Minnesota$674$3,418196372-1.9%
New Mexico$673$2,23262170-2.1%
Georgia$673$2,530210415-2.2%
North Dakota$664$2,7433450-3.5%
Texas$659$2,5256701,416-4.2%
Indiana$657$2,287207384-4.5%
Oklahoma$656$1,918148280-4.6%
North Carolina$650$2,138266493-5.5%
Idaho$648$2,1425597-5.9%
Kentucky$647$2,017129200-6.0%
Oregon$646$2,56786162-6.1%
Nebraska$644$2,3256287-6.4%
Utah$640$2,31180144-6.9%
Missouri$636$2,312174278-7.5%
Wisconsin$633$3,475180298-7.9%
South Carolina$630$2,070130237-8.3%
Kansas$629$2,12899238-8.6%
Tennessee$628$2,195194333-8.8%
Iowa$621$2,74573118-9.7%
Mississippi$619$2,83662120-9.9%
Alabama$615$2,273102187-10.5%
Nevada$615$2,25474179-10.6%
Vermont$596$3,5501216-13.4%
Arkansas$586$1,86564128-14.8%

⚠️ 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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