15853

Removal of sutures or staples

Medicare pricing data for 12,497 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

Removal of sutures or staples (HCPCS code 15853) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $10.33, but hospitals typically charge $39.15 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.07

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $10.33, your out-of-pocket cost would be approximately $2.07. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$10.33
Average Hospital Charge
$39.15
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$39.15
Medicare Allowed$10.33
Medicare Payment$8.09

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $8.09 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$12$511,3012,497+17.7%
New York$12$62507829+16.0%
New Jersey$12$53360673+14.8%
Hawaii$11$3559102+10.5%
Alaska$11$713674+10.4%
District of Columbia$11$361540+9.1%
Connecticut$11$33125196+9.0%
Massachusetts$11$35301498+8.8%
Maryland$11$38362755+6.2%
Washington$11$35200289+6.0%
Minnesota$11$53350512+2.4%
New Hampshire$11$472430+2.3%
Delaware$11$2446202+2.2%
Montana$11$273456+2.2%
Colorado$11$30366601+1.7%
Virginia$10$40394678+1.5%
Wyoming$10$5934138+1.3%
Oregon$10$36131187+0.8%
Pennsylvania$10$315931,020+0.7%
Rhode Island$10$422869+0.1%
Nevada$10$36129194-1.3%
Michigan$10$33305452-1.9%
Texas$10$406751,015-2.1%
Florida$10$337991,564-2.6%
Maine$10$212228-3.1%
North Dakota$10$455576-4.5%
Wisconsin$10$104197264-4.5%
South Dakota$10$302639-5.1%
Utah$10$26165242-5.4%
Arizona$10$31380811-6.4%
Illinois$10$32458992-7.0%
Georgia$10$36342502-7.7%
Missouri$10$27242347-7.8%
Nebraska$10$33104159-8.0%
North Carolina$9$38424659-8.2%
Ohio$9$39430677-8.4%
Iowa$9$26237431-8.6%
Kansas$9$2993140-9.5%
Indiana$9$34300443-9.6%
Louisiana$9$67211386-10.5%
Oklahoma$9$26185316-10.5%
Alabama$9$27149207-10.6%
Idaho$9$326290-11.2%
Kentucky$9$24191279-11.5%
South Carolina$9$26284536-11.6%
New Mexico$9$2477110-13.6%
Tennessee$9$30373523-13.7%
Arkansas$9$22166271-14.1%
West Virginia$9$404156-14.8%
Mississippi$9$2993153-17.1%

⚠️ 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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