15260

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less

Medicare pricing data for 6,870 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

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less (HCPCS code 15260) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $905.42, but hospitals typically charge $2,471 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$181.08

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $905.42, your out-of-pocket cost would be approximately $181.08. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$905.42
Average Hospital Charge
$2,471
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,470.61
Medicare Allowed$905.42
Medicare Payment$715.88

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $715.88 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$1,155$2,055624+27.6%
Connecticut$1,022$2,61566535+12.9%
New York$1,016$2,9553182,271+12.2%
Massachusetts$1,011$2,8681731,994+11.6%
New Jersey$998$3,4101681,106+10.2%
Puerto Rico$995$1,013520+9.9%
California$990$2,8977385,422+9.3%
Hawaii$987$2,1591251+9.0%
Montana$952$1,96324285+5.1%
Alaska$951$3,8921070+5.0%
Colorado$950$2,584133898+4.9%
Illinois$944$3,2462301,390+4.2%
Rhode Island$934$2,40318150+3.2%
Nevada$929$2,66444458+2.6%
Maryland$918$2,1561441,169+1.4%
Florida$917$2,3357006,599+1.2%
Virginia$915$2,2421831,660+1.1%
Pennsylvania$915$2,1822822,177+1.1%
North Carolina$903$2,2272012,112-0.3%
Texas$896$2,5364564,020-1.1%
New Hampshire$894$2,92938433-1.2%
South Carolina$883$2,4811151,330-2.5%
Washington$880$2,2921541,896-2.9%
Maine$877$2,51830134-3.1%
Vermont$877$1,5401074-3.1%
Oregon$875$2,48896455-3.4%
Louisiana$871$2,02483744-3.8%
Arizona$870$2,4071822,173-3.9%
Oklahoma$870$2,14267586-3.9%
Wyoming$870$2,0439118-4.0%
Kentucky$863$1,88493946-4.6%
Georgia$863$2,5032101,921-4.7%
Delaware$863$1,87634382-4.7%
Arkansas$862$2,009671,572-4.8%
West Virginia$861$2,15838272-4.9%
North Dakota$861$1,5321190-4.9%
Missouri$860$2,3171541,160-5.0%
Ohio$855$2,0612261,700-5.6%
Wisconsin$853$4,221102675-5.8%
Utah$847$2,33888570-6.5%
Minnesota$844$3,484117472-6.8%
Indiana$843$2,0381281,265-6.9%
Michigan$842$2,291171711-7.0%
Alabama$835$1,8481151,302-7.8%
Iowa$832$2,96987578-8.1%
Kansas$832$2,231941,203-8.2%
Idaho$827$2,06051228-8.7%
New Mexico$825$2,7971679-8.9%
South Dakota$822$1,74231166-9.2%
Tennessee$822$2,0771711,288-9.3%
Nebraska$796$2,38270267-12.1%
Mississippi$764$2,56574595-15.6%

⚠️ 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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