96574

Application of light with debridement to destroy precancer skin growth

Medicare pricing data for 3,284 providers across 49 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

Application of light with debridement to destroy precancer skin growth (HCPCS code 96574) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $275.79, but hospitals typically charge $544.34 — a 2.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$55.16

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $275.79, your out-of-pocket cost would be approximately $55.16. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$275.79
Average Hospital Charge
$544.34
Markup Ratio
2.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$544.34
Medicare Allowed$275.79
Medicare Payment$207.98

Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $207.98 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$315$5502385,246+14.4%
California$315$5034359,882+14.3%
New Jersey$311$6261281,751+12.7%
Connecticut$311$59229271+12.6%
Hawaii$309$419875+12.2%
District of Columbia$305$501639+10.6%
Massachusetts$296$668691,781+7.4%
Maryland$294$432511,036+6.8%
New Hampshire$290$75922165+5.1%
Maine$282$849625+2.1%
Colorado$282$55855908+2.1%
Virginia$280$57260791+1.6%
Illinois$279$635103913+1.3%
Washington$279$532571,071+1.2%
Pennsylvania$273$5661031,534-0.9%
Minnesota$271$57729416-1.8%
South Dakota$271$285213-1.9%
Delaware$270$5328394-2.1%
Texas$266$5472554,525-3.5%
Montana$265$51012118-3.8%
Nevada$264$57836700-4.3%
Florida$264$5414608,774-4.4%
Michigan$262$48554471-4.8%
Rhode Island$261$8601180-5.2%
Arizona$257$5471112,699-6.7%
Oregon$257$692681,677-6.7%
Wyoming$256$62119975-7.3%
South Carolina$255$391201,049-7.4%
Wisconsin$254$80443401-7.8%
Georgia$254$647711,872-7.9%
Nebraska$251$58017159-8.9%
North Carolina$249$55959854-9.5%
New Mexico$249$627886-9.8%
Ohio$248$4721052,114-10.0%
North Dakota$247$69814208-10.3%
Utah$247$46948727-10.6%
Louisiana$245$36743894-11.0%
Tennessee$245$49140518-11.1%
Missouri$243$47846662-12.0%
Kentucky$236$35547904-14.6%
Oklahoma$235$46928582-14.7%
Indiana$235$60758811-14.9%
Mississippi$234$73720248-15.0%
Idaho$234$52629496-15.0%
Iowa$232$65531345-15.9%
Alabama$231$56531359-16.3%
Kansas$225$71210207-18.5%
Arkansas$222$41347757-19.5%
West Virginia$219$57819201-20.7%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber