13121

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

Medicare pricing data for 11,792 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 repair of wound of scalp, arms, or legs, 2.6-7.5 cm (HCPCS code 13121) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $302.56, but hospitals typically charge $963.80 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$60.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $302.56, your out-of-pocket cost would be approximately $60.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$302.56
Average Hospital Charge
$963.80
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$963.80
Medicare Allowed$302.56
Medicare Payment$237.88

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $237.88 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$404$1,16744488+33.7%
Puerto Rico$369$48318120+22.0%
California$337$1,0151,44126,182+11.5%
New York$331$1,3646679,765+9.6%
New Jersey$331$1,3063715,028+9.5%
Hawaii$329$97834452+8.7%
Florida$327$8841,42241,862+8.2%
Virginia$325$9802653,881+7.4%
Colorado$322$9851973,670+6.3%
Minnesota$314$1,1061641,288+3.9%
Nevada$307$8621262,546+1.4%
Montana$306$79846413+1.2%
Massachusetts$304$1,2682654,497+0.4%
Delaware$302$807411,353-0.3%
Illinois$301$1,1473905,837-0.4%
Arizona$301$8673528,447-0.6%
North Carolina$297$8903375,701-1.7%
New Mexico$293$97844449-3.2%
Pennsylvania$293$9084716,982-3.3%
Maryland$292$8522233,380-3.4%
Texas$292$87275112,483-3.4%
Oregon$292$1,0701221,420-3.6%
Washington$291$9692564,111-3.8%
Alaska$289$1,3072074-4.5%
Kentucky$288$7501222,526-4.9%
South Carolina$287$8142014,010-5.3%
Michigan$286$8772742,522-5.6%
Georgia$279$1,0103838,578-7.9%
Iowa$275$1,05684820-9.1%
Utah$275$7571181,138-9.1%
Connecticut$275$1,1091191,550-9.2%
Vermont$274$81421122-9.4%
Ohio$273$8123564,206-9.7%
West Virginia$273$910621,043-9.9%
Tennessee$263$7462304,060-12.9%
Indiana$263$9271923,899-13.1%
Nebraska$263$99878604-13.1%
New Hampshire$260$1,16762753-13.9%
Wisconsin$257$1,5641611,673-15.1%
Missouri$256$1,0442374,409-15.3%
Idaho$256$79673660-15.3%
Rhode Island$250$1,19347692-17.2%
Louisiana$249$8021201,506-17.7%
North Dakota$246$75036600-18.7%
Kansas$243$9201362,212-19.6%
Alabama$242$8301934,020-20.0%
Mississippi$239$1,0481171,074-20.8%
Oklahoma$239$8421021,285-21.1%
South Dakota$233$63644748-22.9%
Wyoming$225$89619710-25.7%
Maine$219$79228226-27.7%
Arkansas$215$7441002,215-29.0%

⚠️ 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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