OpenMedicare
Start Here
Explore
Fraud
Investigations
Data
Tools
About

Footer

OpenMedicare

Independent Medicare data journalism

Sister Sites

  • OpenMedicaid
  • OpenFeds
  • OpenSpending

Explore

  • Providers
  • Procedures
  • States
  • Specialties
  • Search

Fraud Analysis

  • Still Out There (AI)
  • Fraud Overview
  • Fraud Watchlist
  • Deep Dive Profiles
  • Impossible Numbers
  • Report Fraud

Investigations

  • The Algorithm Knows
  • How We Built the Model
  • Internal Medicine Crisis
  • Florida & California Fraud
  • Million Dollar Flagged
  • All Investigations

Tools

  • Provider Lookup
  • Compare
  • Cost Calculator
  • Your Medicare Dollar
  • Downloads

About

  • About OpenMedicare
  • Methodology
  • Glossary
  • Data Sources
  • API Docs
  • Updates
Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid · OpenFeds · OpenSpending

© 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodology•Download Data
  1. Home
  2. Procedures
  3. 11043
  4. Cost Analysis

How Much Does Removal of muscle and/or tissue, 20.0 sq cm or less Cost on Medicare?

Cost analysis for CPT 11043 — Removal of muscle and/or tissue, 20.0 sq cm or less

Share:

Average Medicare Payment

$142.60

2023 data

Total Payments (2023)

$66.1M

Services (2023)

422.7K

Price Change (2014–2023)

+3.3%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$138.06$27.7M188.3K—
2015$136.06$32.1M219.5K-1.4%
2016$134.94$39.1M268.6K-0.8%
2017$134.84$43.1M294.4K-0.1%
2018$137.67$50.5M333.9K+2.1%
2019$141.75$63.0M398.8K+3.0%
2020$144.91$70.7M435.7K+2.2%
2021$146.49$78.1M474.5K+1.1%
2022$144.85$71.4M442.9K-1.1%
2023$142.60$66.1M422.7K-1.6%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.8x more than the cheapest for this procedure. CA averages $168.63 vs KS at $94.86.

StateAvg PaymentTotal PaymentsServicesProviders
CA$168.63$19.3M114.7K371
DE$168.62$74.0K4397
PA$168.00$1.5M8.7K53
NY$165.97$2.8M17.1K98
HI$164.89$33.8K2054
IL$162.76$1.2M7.5K57
MD$161.05$1.2M7.7K49
RI$159.64$104.2K6535
CO$157.57$456.2K2.9K23
FL$155.98$19.1M122.3K314
DC$155.01$177.3K1.1K14
OR$153.05$248.9K1.6K13
MA$152.52$816.1K5.4K46
TX$151.66$5.4M35.4K163
VA$151.62$494.8K3.3K27
WI$149.77$220.9K1.5K8
WV$149.25$201.9K1.4K7
WA$148.85$644.7K4.3K40
NJ$148.78$1.5M9.9K88
NM$148.56$250.2K1.7K14
MP$148.25$38.7K2611
TN$147.08$959.0K6.5K43
AZ$146.08$441.6K3.0K28
MI$143.20$382.0K2.7K21
IN$143.04$467.9K3.3K25
CT$142.76$461.4K3.2K31
NV$142.49$343.1K2.4K26
OK$140.88$760.2K5.4K35
GA$140.44$572.9K4.1K32
NC$139.21$815.2K5.9K51
MS$137.95$1.0M7.3K52
MN$137.72$161.4K1.2K13
KY$137.17$495.6K3.6K36
OH$137.11$1.0M7.5K76
SC$134.72$581.7K4.3K32
MT$131.69$52.0K3955
LA$130.70$629.9K4.8K51
AL$130.35$454.1K3.5K27
UT$128.99$169.2K1.3K12
ME$127.63$43.7K3423
NH$127.61$21.3K1673
IA$124.84$106.7K8556
AR$115.88$99.2K8569
MO$114.49$98.8K86318
SD$111.86$12.3K1103
NE$107.62$45.0K4185
KS$94.86$55.7K58713

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Luis RosasGeneral SurgeryFL$1.3M8.5K$155.94
Joseph AddiegoPodiatryCA$549.6K3.2K$171.69
Stephanie NewsomFamily PracticeFL$535.6K3.5K$153.96
Joseph SidaouiGeneral SurgeryNY$489.5K2.8K$176.01
Magid FahimFamily PracticeFL$446.5K2.8K$161.08
Ryan WhitneyAnesthesiologyNY$428.4K3.2K$133.97
Louie HendricksGeneral SurgeryCA$418.3K2.1K$195.27
David RosingGeneral SurgeryCA$400.3K2.1K$188.99
Albert YoungInternal MedicineCA$393.0K1.8K$222.43
Jack AzadGeneral PracticeCA$391.7K2.0K$194.50
Kelly MctaggartNurse PractitionerFL$378.1K2.6K$145.69
Johnson LeePlastic and Reconstructive SurgeryCA$359.6K1.8K$200.35
Erika LepePhysician AssistantCA$355.1K2.2K$163.88
Lobaba HabachNurse PractitionerFL$338.3K2.4K$141.39
David ZhuGeneral PracticeGA$327.3K2.2K$152.18
Matthew BrennanGeneral PracticeMS$319.5K2.1K$154.58
Vicrumdeep TungGeneral SurgeryCA$312.9K1.8K$174.13
Bekele HaimanotPhysician AssistantCA$309.8K1.8K$174.05
Yoni SamochaGeneral SurgeryTX$307.8K1.9K$164.50
Timothy OnyiukeGeneral SurgeryMD$303.1K1.6K$188.25

🤔 Is Removal of muscle and/or tissue, 20.0 sq cm or less Overpriced?

Based on the data, CPT 11043 shows a 1.8x variation in pricing across states — moderate variation by Medicare standards.

Costs have increased 3.3% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.