56605

Biopsy of growth of external female genitals, first growth

Medicare pricing data for 15,810 providers across 52 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

Biopsy of growth of external female genitals, first growth (HCPCS code 56605) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $83.68, but hospitals typically charge $301.92 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$16.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $83.68, your out-of-pocket cost would be approximately $16.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$83.68
Average Hospital Charge
$301.92
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$301.92
Medicare Allowed$83.68
Medicare Payment$61.18

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $61.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$100$2576197+19.3%
Hawaii$100$2424366+19.0%
New Jersey$98$375464914+17.2%
New York$97$4661,0441,922+15.4%
Connecticut$94$339214348+12.3%
Maryland$93$265361678+10.5%
Alaska$92$9424884+10.3%
California$91$3301,2032,234+9.2%
Nevada$91$234105162+9.1%
Wyoming$91$3463465+9.0%
Puerto Rico$91$1901115+8.8%
Florida$87$3511,1672,231+3.8%
Massachusetts$87$2915391,097+3.5%
Illinois$86$3286821,214+2.3%
Virginia$85$247480840+1.9%
Georgia$85$285407705+1.0%
Pennsylvania$84$2687681,433+0.9%
Colorado$84$239260450+0.5%
Delaware$84$23273150-0.2%
Oregon$83$295236380-1.0%
Texas$83$2789181,456-1.3%
Washington$82$278347573-2.0%
Arizona$82$210315602-2.3%
Utah$81$20984125-3.5%
South Carolina$81$338269461-3.5%
North Carolina$80$2785911,010-5.0%
Alabama$79$250212341-5.5%
Mississippi$79$296138250-5.7%
Indiana$79$273360643-6.1%
Rhode Island$78$23580141-6.7%
Missouri$78$232323551-6.8%
Michigan$78$217521836-7.2%
Arkansas$78$208141277-7.2%
Ohio$77$257586930-7.9%
Oklahoma$77$211192349-8.0%
New Hampshire$77$261106198-8.2%
Montana$77$20474147-8.5%
Tennessee$77$230375680-8.5%
Louisiana$76$283195325-8.7%
Minnesota$74$354322473-11.5%
Kentucky$74$223204352-11.6%
Nebraska$72$258128266-13.7%
Kansas$71$340170318-14.7%
New Mexico$71$25182140-15.1%
Iowa$71$305182312-15.4%
Wisconsin$70$494282487-15.9%
Idaho$70$18880112-16.1%
West Virginia$69$23889196-17.7%
North Dakota$68$2684583-19.3%
Maine$67$19078146-19.9%
Vermont$66$20444128-21.7%
South Dakota$60$13669130-28.4%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber