Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less
Medicare pricing data for 1,691 providers across 38 states
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
Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less (HCPCS code 15274) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.93, but hospitals typically charge $235.71 — a 4.5x 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 $51.93, your out-of-pocket cost would be approximately $10.39. 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 4.5x more than what Medicare allows for this procedure. Medicare actually pays $41.38 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Arizona | $69 | $95 | 63 | 4,051 | +33.0% |
| Colorado | $63 | $158 | 33 | 488 | +20.5% |
| California | $60 | $307 | 178 | 4,193 | +15.4% |
| New Jersey | $59 | $687 | 60 | 382 | +13.0% |
| Illinois | $58 | $244 | 51 | 474 | +12.5% |
| New York | $57 | $421 | 72 | 641 | +10.0% |
| Kansas | $56 | $241 | 24 | 475 | +7.4% |
| Maryland | $55 | $201 | 29 | 333 | +5.5% |
| Mississippi | $53 | $303 | 48 | 550 | +2.8% |
| Louisiana | $52 | $176 | 31 | 715 | +1.0% |
| Kentucky | $51 | $158 | 23 | 314 | -1.9% |
| Texas | $51 | $251 | 129 | 1,595 | -2.1% |
| Florida | $51 | $205 | 141 | 2,367 | -2.2% |
| District of Columbia | $50 | $128 | 9 | 206 | -3.0% |
| Missouri | $50 | $261 | 40 | 406 | -4.2% |
| Oklahoma | $49 | $131 | 34 | 584 | -5.6% |
| South Carolina | $48 | $190 | 32 | 208 | -7.0% |
| Nevada | $48 | $158 | 23 | 668 | -7.2% |
| Ohio | $48 | $197 | 64 | 475 | -8.4% |
| Connecticut | $47 | $347 | 14 | 100 | -9.5% |
| Massachusetts | $47 | $196 | 25 | 212 | -10.3% |
| Michigan | $45 | $155 | 52 | 286 | -12.5% |
| Pennsylvania | $45 | $156 | 74 | 948 | -12.9% |
| Georgia | $45 | $305 | 74 | 3,890 | -13.5% |
| Virginia | $43 | $304 | 40 | 799 | -16.6% |
| Utah | $43 | $221 | 7 | 121 | -17.7% |
| Washington | $43 | $163 | 6 | 481 | -17.9% |
| Tennessee | $42 | $208 | 42 | 1,496 | -18.4% |
| Maine | $42 | $111 | 8 | 107 | -18.5% |
| North Carolina | $42 | $239 | 33 | 1,418 | -19.1% |
| Iowa | $42 | $217 | 12 | 338 | -19.2% |
| Alabama | $42 | $206 | 15 | 454 | -19.4% |
| Minnesota | $41 | $174 | 19 | 948 | -20.2% |
| Arkansas | $40 | $1,046 | 11 | 316 | -22.9% |
| Wisconsin | $40 | $408 | 19 | 84 | -23.4% |
| Indiana | $40 | $150 | 24 | 539 | -23.4% |
| Nebraska | $40 | $177 | 11 | 503 | -23.9% |
| South Dakota | $36 | $229 | 8 | 81 | -30.1% |
⚠️ 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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