facebook tracking Level 3 Extraocular, Repair, and Plastic Eye Procedures cost in Maine: 8 hospitals compared (APC 5503)

Level 3 Extraocular, Repair, and Plastic Eye Procedures in Maine

What 8 hospitals in Maine charged and were paid for level 3 extraocular, repair, and plastic eye procedures (APC 5503), from 2024 Medicare claims.

APC 5503 Outpatient 2024 Medicare data
Average charge $14,134 Hospital list price billed
Average allowed $2,149 Medicare's payment + patient's share
Medicare paid $1,711 Average per service
State rank #26 of 45 1 = lowest average payment

Hospitals in Maine billed an average of $14,134 for level 3 extraocular, repair, and plastic eye procedures, about 6.6 times the average medicare-allowed amount of $2,149. That payment is 4% below the U.S. average 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 $2,149Billed $14,134

About 15¢ was paid for every $1 hospitals in Maine billed for this service.

Maine hospitals: level 3 extraocular, repair, and plastic eye procedures

Every Maine hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
Maine Medical CenterPortland 44 $10,285 $2,196 $1,749
Northern Light Inland HospitalWaterville 19 $23,046 $2,040 $1,623
Mercy HospitalPortland – – – –
Northern Light a R Gould HospitalPresque Isle – – – –
Mid Coast HospitalBrunswick – – – –
Cary Medical CenterCaribou – – – –
Eastern Maine Medical CenterBangor – – – –
Maine General Medical CenterWaterville – – – –
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Level 3 Extraocular, Repair, and Plastic Eye Procedures in other states

Questions

How much does level 3 extraocular, repair, and plastic eye procedures cost in Maine?

In 2024 Medicare data, level 3 extraocular, repair, and plastic eye procedures (APC 5503) at 8 hospitals in Maine was billed at $14,134 on average, while the average medicare-allowed amount was $2,149, of which Medicare paid $1,711. Your own cost depends on your insurance, deductible and the hospital.

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 Maine, average charges were 6.6 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.