97597

Removal of tissue from wound, 20.0 sq cm or less

Medicare pricing data for 25,170 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $46 in Idaho to $102 in New York. Where you get this procedure matters more than almost any other factor. 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 tissue from wound, 20.0 sq cm or less (HCPCS code 97597) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $74.84, but hospitals typically charge $173.95 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $74.84, your out-of-pocket cost would be approximately $14.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$74.84
Average Hospital Charge
$173.95
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$173.95
Medicare Allowed$74.84
Medicare Payment$57.56

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $57.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$102$1861,78951,383+36.4%
California$89$1741,92563,016+19.2%
New Jersey$86$1951,01626,047+15.6%
Maryland$86$16653113,872+14.3%
Wyoming$85$1261058,244+14.0%
Florida$84$1702,27379,666+11.8%
Puerto Rico$84$9238935+11.8%
Colorado$81$1893755,626+8.7%
Hawaii$80$187961,379+7.5%
Texas$77$1791,57744,215+2.4%
Illinois$76$1911,24538,596+2.1%
Utah$75$1641973,883+0.8%
Pennsylvania$75$1451,36739,434+0.5%
Nevada$74$2061883,652-0.5%
Arizona$74$15654611,864-1.1%
Alaska$73$28566612-2.4%
Oregon$72$2042544,875-3.9%
Michigan$71$15383915,621-5.2%
Washington$70$1774468,013-5.9%
Virginia$70$16061914,320-6.4%
Mississippi$70$1501933,767-6.7%
New Mexico$69$1851563,391-8.3%
Connecticut$68$1793478,560-8.7%
West Virginia$68$1741082,204-9.0%
Ohio$68$14895216,871-9.2%
District of Columbia$68$19844888-9.5%
Tennessee$66$16152416,560-11.2%
Massachusetts$66$19159415,835-12.0%
Georgia$66$17159515,990-12.2%
Minnesota$65$2554348,736-13.0%
Arkansas$64$1532314,471-14.2%
Louisiana$64$1713936,415-15.1%
Oklahoma$62$14627613,637-17.5%
North Carolina$62$19574316,084-17.7%
Indiana$60$15845910,212-19.3%
Alabama$58$1362788,416-21.8%
Wisconsin$58$25758814,433-22.3%
Montana$57$1191152,942-23.7%
Vermont$57$12055729-23.8%
North Dakota$57$188891,684-24.1%
South Carolina$56$1503598,755-25.7%
Delaware$55$1971015,188-26.1%
Kentucky$54$1493049,733-27.5%
Missouri$54$15844712,921-27.8%
Maine$54$1761141,487-27.9%
Nebraska$53$1671864,192-28.8%
Rhode Island$53$306974,307-29.8%
Iowa$50$16028710,898-33.6%
South Dakota$48$162782,506-35.8%
New Hampshire$48$1761583,910-36.0%
Kansas$46$1652246,614-38.0%
Idaho$46$1131313,780-38.5%

⚠️ 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