Level 3 Extraocular, Repair, and Plastic Eye Procedures
What 1,174 hospitals in the U.S. charged and were paid for level 3 extraocular, repair, and plastic eye procedures (APC 5503), from 2024 Medicare claims.
Average charge
$16,126
Hospital list price billed
Average allowed
$2,242
Medicare's payment + patient's share
Medicare paid
$1,780
Average per service
Volume
21,531
Medicare services
Hospitals in the U.S. billed an average of $16,126 for level 3 extraocular, repair, and plastic eye procedures, about 7.2 times the average medicare-allowed amount of $2,242.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $2,242Billed $16,126
About 14¢ was paid for every $1 hospitals in the U.S. billed for this service.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Memorial Hospital at GulfportGulfport, MS | $785 |
|---|---|
| Toledo Hospital theToledo, OH | $850 |
| Barnes-Jewish West County HospitalSt Louis, MO | $854 |
| Metrohealth SystemCleveland, OH | $983 |
| Shands Hospital at the University of FloridaGainesville, FL | $1,023 |
| MUSC Medical CenterCharleston, SC | $1,175 |
| Piedmont HospitalAtlanta, GA | $1,189 |
| Fletcher Allen Hospital of VermontBurlington, VT | $1,204 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre, PA | $1,252 |
| St Mary Mercy HospitalLivonia, MI | $1,391 |
Highest
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco, CA | $3,340 |
|---|---|
| Peninsula Medical CenterBurlingame, CA | $3,340 |
| Stanford Health Care Tri-ValleyPleasanton, CA | $3,291 |
| El Camino HospitalMountain View, CA | $3,291 |
| San Francisco General HospitalSan Francisco, CA | $3,273 |
| Santa Rosa Memorial HospitalSanta Rosa, CA | $3,273 |
| UCSF Medical CenterSan Francisco, CA | $3,265 |
| San Ramon Regional Medical CtrSan Ramon, CA | $3,254 |
| Stanford HospitalPalo Alto, CA | $3,250 |
| Alta Bates Summit Medical Center - Alta Bates CampBerkeley, CA | $3,245 |
Level 3 Extraocular, Repair, and Plastic Eye Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 21 | $8,353 | $1,933 | $1,923 – $1,934 |
| Alaska | 3 | $19,947 | $2,412 | $2,412 – $2,412 |
| Arizona | 14 | $17,511 | $2,142 | $2,076 – $2,279 |
| Arkansas | 9 | $14,069 | $1,993 | $1,971 – $2,003 |
| California | 123 | $23,669 | $2,975 | $1,409 – $3,340 |
| Colorado | 22 | $15,796 | $2,220 | $2,167 – $2,225 |
| Connecticut | 12 | $11,327 | $2,574 | $2,068 – $2,632 |
| Delaware | 4 | – | – | – – – |
| Florida | 51 | $25,585 | $2,000 | $1,023 – $2,117 |
| Georgia | 42 | $19,382 | $1,891 | $1,189 – $2,169 |
| Hawaii | 3 | $18,276 | $2,569 | $2,569 – $2,569 |
| Idaho | 4 | $7,609 | $2,081 | $2,069 – $2,103 |
| Illinois | 59 | $18,177 | $2,211 | $2,101 – $2,273 |
| Indiana | 33 | $14,227 | $2,118 | $2,070 – $2,231 |
| Iowa | 15 | $12,172 | $2,064 | $2,007 – $2,131 |
| Kansas | 13 | $10,856 | $1,818 | $1,750 – $1,938 |
| Kentucky | 17 | $14,783 | $2,004 | $1,964 – $2,122 |
| Louisiana | 30 | $20,985 | $1,975 | $1,943 – $2,025 |
| Maine | 8 | $14,134 | $2,149 | $2,040 – $2,196 |
| Massachusetts | 28 | $7,304 | $2,493 | $2,260 – $2,510 |
| Michigan | 37 | $15,622 | $1,999 | $1,391 – $2,156 |
| Minnesota | 28 | $12,760 | $2,267 | $2,097 – $2,330 |
| Mississippi | 12 | $10,007 | $1,656 | $785 – $2,044 |
| Missouri | 26 | $13,807 | $1,767 | $854 – $2,080 |
| Montana | 8 | $4,815 | $2,191 | $2,191 – $2,191 |
| Nebraska | 12 | $8,256 | $2,048 | $1,600 – $2,106 |
| Nevada | 5 | $25,499 | $2,503 | $2,503 – $2,503 |
| New Hampshire | 5 | $19,813 | $2,353 | $2,272 – $2,372 |
| New Jersey | 29 | $16,468 | $2,579 | $2,477 – $2,659 |
| New Mexico | 4 | $22,980 | $2,008 | $1,905 – $2,051 |
| New York | 63 | $18,307 | $2,595 | $1,321 – $2,659 |
| North Carolina | 40 | $13,284 | $2,111 | $2,034 – $2,381 |
| North Dakota | 5 | $6,832 | $2,296 | $2,191 – $2,346 |
| Ohio | 48 | $12,961 | $1,789 | $850 – $2,130 |
| Oklahoma | 16 | $27,950 | $1,995 | $1,853 – $2,008 |
| Oregon | 13 | $11,300 | $2,447 | $2,446 – $2,452 |
| Pennsylvania | 63 | $17,183 | $2,154 | $1,079 – $2,354 |
| Rhode Island | 3 | $7,385 | $2,371 | $2,371 – $2,371 |
| South Carolina | 15 | $18,882 | $1,648 | $1,175 – $2,008 |
| South Dakota | 5 | – | – | – – – |
| Tennessee | 23 | $22,300 | $1,948 | $1,880 – $2,030 |
| Texas | 81 | $17,221 | $2,070 | $1,632 – $2,259 |
| Utah | 18 | $7,983 | $2,032 | $2,014 – $2,094 |
| Vermont | 2 | $8,274 | $1,204 | $1,204 – $1,204 |
| Virginia | 27 | $12,726 | $2,119 | $1,982 – $2,259 |
| Washington | 20 | $14,918 | $2,363 | $2,277 – $2,504 |
| West Virginia | 14 | $15,004 | $1,934 | $1,909 – $1,981 |
| Wisconsin | 35 | $12,377 | $2,170 | $2,048 – $2,240 |
| Wyoming | 1 | – | – | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Massachusetts Eye and Ear InfirmaryBoston, MA | 711 | $7,558 | $2,499 |
| UCI Health-OrangeOrange, CA | 466 | $14,196 | $2,863 |
| UAB Callahan Eye Hospital AuthorityBirmingham, AL | 425 | $8,408 | $1,934 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 406 | $13,500 | $2,301 |
| Wills Eye HospitalPhiladelphia, PA | 400 | $8,909 | $2,270 |
| University of California San Diego Medical CenterSan Diego, CA | 398 | $17,118 | $2,866 |
| University of Iowa Hospital & ClinicsIowa City, IA | 343 | $12,694 | $2,071 |
| Stanford HospitalPalo Alto, CA | 321 | $53,589 | $3,250 |
| Summit Medical CenterEdmond, OK | 310 | $28,693 | $2,008 |
| University of Colorado Hospital Anschutz InpatientAurora, CO | 301 | $14,932 | $2,225 |
| Cleveland Clinic - Main CampusCleveland, OH | 299 | $9,475 | $1,984 |
| Ny Eye and Ear InfirmaryNew York, NY | 298 | $12,528 | $2,645 |
| Univ of Miami Hosp & ClinicsMiami, FL | 293 | $23,919 | $2,112 |
| Univ of Michigan HospitalsAnn Arbor, MI | 293 | $17,349 | $2,156 |
| UCLA Medical CenterLos Angeles, CA | 289 | $13,659 | $2,849 |
Questions
How much does level 3 extraocular, repair, and plastic eye procedures cost in the U.S.?
In 2024 Medicare data, level 3 extraocular, repair, and plastic eye procedures (APC 5503) at 1,174 hospitals in the U.S. was billed at $16,126 on average, while the average medicare-allowed amount was $2,242, of which Medicare paid $1,780. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 3 extraocular, repair, and plastic eye procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($2,975), New York ($2,595), New Jersey ($2,579) and lowest in South Carolina ($1,648), Mississippi ($1,656), Missouri ($1,767).
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in the U.S., average charges were 7.2 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.