10061

Complicated or multiple drainage of skin abscess

Medicare pricing data for 36,752 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

Complicated or multiple drainage of skin abscess (HCPCS code 10061) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $198.72, but hospitals typically charge $536.14 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$39.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $198.72, your out-of-pocket cost would be approximately $39.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$198.72
Average Hospital Charge
$536.14
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$536.14
Medicare Allowed$198.72
Medicare Payment$150.13

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $150.13 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$236$4892,0048,280+18.6%
New Jersey$223$4981,1694,800+12.2%
Alaska$221$933113156+11.4%
District of Columbia$217$627108241+9.1%
Maryland$210$5357551,907+5.6%
Connecticut$209$540403969+5.1%
Hawaii$207$485137351+4.4%
California$207$5073,85913,071+4.0%
Illinois$204$4781,3754,635+2.7%
Massachusetts$203$5919841,931+2.0%
Florida$200$5173,0419,570+0.8%
Pennsylvania$200$4221,6064,891+0.7%
Utah$198$588276591-0.2%
Michigan$197$4601,1993,001-0.8%
Rhode Island$193$615137214-2.7%
Puerto Rico$193$25433106-2.8%
Virginia$193$5811,0672,254-2.9%
Delaware$192$574184433-3.1%
New Hampshire$191$542168302-4.1%
Washington$190$6608891,311-4.6%
Texas$189$6182,4905,555-4.7%
Nevada$189$5053071,013-5.1%
Colorado$187$708574756-5.9%
Georgia$185$5831,0762,163-6.7%
Ohio$185$5631,2672,558-7.1%
Montana$184$469128168-7.3%
Arizona$182$6446911,206-8.2%
Oregon$182$661444621-8.3%
New Mexico$182$528204398-8.4%
Wisconsin$182$689525953-8.4%
Louisiana$180$6427791,796-9.3%
North Dakota$180$6317192-9.3%
South Carolina$180$5938221,452-9.3%
Missouri$180$5076781,324-9.4%
North Carolina$180$6011,4202,437-9.5%
Minnesota$179$729357444-9.7%
Vermont$179$4903952-9.9%
Indiana$179$5307881,577-10.1%
Wyoming$177$7176283-10.7%
Arkansas$177$482336919-10.7%
West Virginia$177$617174304-10.8%
South Dakota$177$28291580-10.8%
Tennessee$177$5907961,687-11.0%
Maine$177$606121169-11.0%
Alabama$177$4836211,466-11.0%
Oklahoma$175$739480747-11.9%
Iowa$175$562313494-12.0%
Nebraska$175$503182355-12.1%
Kansas$174$605272446-12.5%
Kentucky$174$5895401,032-12.7%
Mississippi$173$590411936-12.8%
Idaho$165$630154216-16.8%

⚠️ 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