69220

Simple removal of skin debris and drainage of mastoid cavity

Medicare pricing data for 5,365 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

Simple removal of skin debris and drainage of mastoid cavity (HCPCS code 69220) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $76.75, but hospitals typically charge $310.41 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $76.75, your out-of-pocket cost would be approximately $15.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$76.75
Average Hospital Charge
$310.41
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$310.41
Medicare Allowed$76.75
Medicare Payment$53.95

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $53.95 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$96$5141786+24.4%
Rhode Island$90$28216228+17.5%
District of Columbia$90$3211493+16.8%
New Jersey$87$3721481,083+13.9%
Delaware$86$27221397+11.9%
Connecticut$85$41661332+10.9%
California$85$3394033,211+10.7%
Maryland$84$341111895+9.6%
New York$84$4903252,444+9.3%
Hawaii$83$2731556+8.8%
Nevada$82$30129203+7.3%
Virginia$80$278139944+3.7%
Massachusetts$78$4361591,418+2.0%
Wyoming$78$3061276+1.6%
Washington$78$270130840+1.4%
Colorado$78$26691402+1.3%
Florida$77$2483903,308+0.5%
Texas$77$2853532,077+0.1%
Indiana$75$247112814-1.8%
Georgia$75$316158914-2.0%
Oregon$75$29873492-2.0%
Michigan$75$233158928-2.4%
Pennsylvania$75$2812521,696-2.8%
Oklahoma$75$30048562-2.9%
Utah$74$28539159-3.5%
Illinois$74$3172201,560-3.7%
Tennessee$74$323121724-3.7%
Missouri$74$263130871-3.8%
South Carolina$73$245105625-4.5%
Arizona$73$160931,239-4.7%
Minnesota$73$370125587-4.9%
Idaho$73$22324138-4.9%
Louisiana$73$35582440-5.2%
North Carolina$72$268199960-5.6%
Mississippi$72$27635236-6.7%
Montana$72$21927161-6.7%
Kentucky$71$24390496-7.5%
Puerto Rico$71$1521227-7.5%
Alabama$71$15561250-7.6%
Wisconsin$71$588129754-8.0%
Ohio$70$2801861,078-8.6%
South Dakota$69$23631175-9.6%
Nebraska$69$30051213-9.7%
Kansas$69$26253247-10.6%
Arkansas$68$24234203-10.9%
Iowa$67$31380628-13.0%
New Mexico$67$22427178-13.3%
West Virginia$66$29742267-14.6%
New Hampshire$65$26830132-15.7%
North Dakota$59$18222123-23.0%
Maine$58$20029185-24.3%
Vermont$49$9511103-36.3%

⚠️ 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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