15240

Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less

Medicare pricing data for 1,963 providers across 48 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less (HCPCS code 15240) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $881.88, but hospitals typically charge $2,167 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$176.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $881.88, your out-of-pocket cost would be approximately $176.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$881.88
Average Hospital Charge
$2,167
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,166.74
Medicare Allowed$881.88
Medicare Payment$697.83

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $697.83 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$999$2,04327104+13.3%
New Jersey$971$3,03744164+10.1%
New York$963$2,540110335+9.2%
Massachusetts$952$2,64259380+7.9%
California$945$2,138208720+7.1%
Illinois$933$3,01065279+5.8%
Connecticut$932$2,1601990+5.7%
Rhode Island$922$2,739622+4.5%
Delaware$917$1,8541146+4.0%
Colorado$901$2,04142114+2.2%
Pennsylvania$899$1,97467234+2.0%
Florida$898$1,917259994+1.9%
Virginia$894$2,24457228+1.4%
Washington$888$1,94944166+0.7%
Texas$879$2,078151621-0.4%
Arizona$860$2,10357224-2.5%
Maine$860$1,733613-2.5%
Louisiana$859$1,82317107-2.6%
Georgia$852$2,26865288-3.4%
Montana$850$1,896717-3.6%
Indiana$848$2,2622264-3.8%
Nevada$842$1,9332078-4.5%
South Dakota$839$1,879814-4.9%
Oregon$836$2,4243180-5.2%
Michigan$834$2,1313055-5.4%
Iowa$834$2,5831631-5.5%
West Virginia$830$1,826946-5.9%
Ohio$825$1,83158211-6.4%
Idaho$825$1,9231542-6.5%
North Carolina$824$2,04678247-6.5%
Kansas$824$1,7281550-6.5%
Missouri$823$1,63133159-6.7%
Tennessee$818$1,60843167-7.3%
Oklahoma$817$1,90121102-7.4%
Arkansas$814$1,80016120-7.7%
Kentucky$810$1,91924143-8.2%
South Carolina$808$2,45428231-8.4%
Alabama$802$1,96434149-9.1%
Wisconsin$797$4,1212562-9.6%
New Hampshire$796$2,7331070-9.7%
Mississippi$793$1,7931549-10.1%
Hawaii$789$2,108915-10.6%
Utah$775$1,6842854-12.2%
Nebraska$774$2,3011625-12.2%
North Dakota$769$1,299321-12.8%
Minnesota$753$3,0731945-14.7%
New Mexico$686$3,100912-22.2%
District of Columbia$573$2,158916-35.1%

⚠️ 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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