Biopsy of lip
Medicare pricing data for 10,720 providers across 51 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
Biopsy of lip (HCPCS code 40490) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $110.28, but hospitals typically charge $278.19 — a 2.5x 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 $110.28, your out-of-pocket cost would be approximately $22.06. 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 2.5x more than what Medicare allows for this procedure. Medicare actually pays $79.78 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $141 | $484 | 12 | 26 | +28.2% |
| District of Columbia | $130 | $237 | 17 | 33 | +17.6% |
| New York | $126 | $330 | 557 | 1,561 | +14.6% |
| California | $125 | $281 | 967 | 2,844 | +13.5% |
| Maryland | $124 | $276 | 194 | 416 | +12.0% |
| New Jersey | $121 | $316 | 320 | 747 | +10.2% |
| Connecticut | $119 | $292 | 106 | 202 | +8.3% |
| Rhode Island | $117 | $290 | 46 | 105 | +6.1% |
| Hawaii | $117 | $275 | 22 | 43 | +6.0% |
| Massachusetts | $116 | $384 | 328 | 724 | +5.4% |
| Delaware | $115 | $198 | 33 | 98 | +3.9% |
| Colorado | $113 | $285 | 231 | 493 | +2.6% |
| Illinois | $113 | $327 | 349 | 806 | +2.5% |
| Virginia | $112 | $263 | 274 | 710 | +2.0% |
| Pennsylvania | $111 | $253 | 400 | 853 | +1.0% |
| Florida | $110 | $242 | 1,214 | 4,139 | +0.0% |
| Maine | $110 | $319 | 34 | 81 | -0.1% |
| Texas | $109 | $267 | 721 | 1,786 | -0.7% |
| New Hampshire | $109 | $376 | 61 | 144 | -1.4% |
| Nevada | $108 | $252 | 79 | 160 | -1.7% |
| Arizona | $108 | $256 | 314 | 994 | -1.9% |
| Washington | $108 | $282 | 251 | 597 | -2.4% |
| Michigan | $108 | $258 | 269 | 499 | -2.5% |
| Oregon | $107 | $309 | 152 | 362 | -2.7% |
| Georgia | $107 | $293 | 317 | 788 | -3.1% |
| Montana | $106 | $260 | 39 | 107 | -3.5% |
| Louisiana | $106 | $245 | 107 | 249 | -3.7% |
| Ohio | $105 | $262 | 338 | 641 | -4.7% |
| Missouri | $105 | $253 | 182 | 410 | -5.0% |
| Minnesota | $104 | $395 | 179 | 314 | -5.3% |
| North Carolina | $104 | $257 | 396 | 955 | -5.6% |
| Wyoming | $104 | $287 | 21 | 111 | -6.0% |
| Utah | $103 | $261 | 107 | 239 | -6.6% |
| Nebraska | $103 | $303 | 79 | 234 | -6.6% |
| Vermont | $103 | $275 | 25 | 50 | -6.8% |
| New Mexico | $102 | $264 | 49 | 151 | -7.2% |
| North Dakota | $102 | $291 | 22 | 47 | -7.3% |
| Kansas | $102 | $253 | 99 | 297 | -7.4% |
| Oklahoma | $101 | $261 | 109 | 355 | -8.1% |
| Indiana | $101 | $289 | 208 | 423 | -8.1% |
| Idaho | $101 | $235 | 85 | 185 | -8.8% |
| Arkansas | $100 | $211 | 92 | 245 | -8.9% |
| West Virginia | $100 | $306 | 54 | 113 | -9.1% |
| Kentucky | $100 | $220 | 151 | 440 | -9.6% |
| Tennessee | $99 | $242 | 233 | 598 | -10.5% |
| Iowa | $98 | $321 | 127 | 288 | -10.9% |
| South Carolina | $97 | $240 | 192 | 699 | -12.2% |
| Alabama | $96 | $257 | 167 | 377 | -12.6% |
| Mississippi | $96 | $262 | 73 | 243 | -12.7% |
| South Dakota | $92 | $199 | 43 | 125 | -16.5% |
| Wisconsin | $91 | $492 | 165 | 360 | -17.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber