97598

Removal of tissue from wound, each additional 20.0 sq cm

Medicare pricing data for 5,468 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $20 in North Dakota to $40 in California. Where you get this procedure matters more than almost any other factor. 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

Removal of tissue from wound, each additional 20.0 sq cm (HCPCS code 97598) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $31.04, but hospitals typically charge $99.04 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.21

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $31.04, your out-of-pocket cost would be approximately $6.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$31.04
Average Hospital Charge
$99.04
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$99.04
Medicare Allowed$31.04
Medicare Payment$24.56

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $24.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$40$8431628,284+29.9%
New York$40$1072506,021+28.2%
Hawaii$35$9728559+12.9%
Wyoming$34$6924770+8.5%
Florida$33$7649914,145+7.3%
Nevada$33$12641835+5.5%
Mississippi$32$11449400+3.3%
Texas$32$903638,505+2.6%
Wisconsin$30$1751582,929-2.4%
Maryland$30$891173,040-4.1%
Louisiana$30$96941,142-4.8%
Arkansas$29$6752530-5.2%
Oklahoma$29$83827,146-6.2%
Massachusetts$29$1171343,529-6.2%
Alaska$29$2341069-6.7%
South Carolina$29$981021,991-6.9%
Pennsylvania$29$913109,042-7.2%
Minnesota$29$149991,588-7.4%
New Jersey$29$1081815,049-7.4%
District of Columbia$28$148455-8.9%
Colorado$28$8664438-9.2%
Illinois$28$1462706,925-9.9%
Utah$27$11846371-11.5%
West Virginia$27$15419327-12.3%
Georgia$27$1121493,781-13.0%
Tennessee$27$951322,647-13.4%
Oregon$27$17250744-13.5%
Indiana$27$921312,555-13.8%
Ohio$27$1631862,288-14.4%
Virginia$26$861463,459-15.0%
Arizona$26$881101,578-15.5%
North Carolina$26$1151672,990-17.4%
Rhode Island$25$199302,400-18.3%
Connecticut$25$97881,960-18.6%
Michigan$25$951792,878-19.6%
Missouri$25$991293,073-19.9%
Kentucky$25$72882,166-20.5%
Delaware$25$97251,697-20.6%
New Mexico$25$8732832-20.9%
New Hampshire$24$10547482-21.2%
Alabama$24$76661,742-22.9%
Washington$24$82641,319-23.7%
Idaho$23$4328287-25.0%
Montana$23$8327436-25.6%
Kansas$23$125741,651-27.3%
South Dakota$22$10219497-28.8%
Maine$22$11022276-28.9%
Nebraska$22$8849897-29.2%
Iowa$21$80702,527-31.4%
North Dakota$20$13210111-35.9%

⚠️ 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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