facebook tracking Level 3 Extraocular, Repair, and Plastic Eye Procedures cost in Wisconsin: 35 hospitals compared (APC 5503)

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

What 35 hospitals in Wisconsin 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 $12,377 Hospital list price billed
Average allowed $2,170 Medicare's payment + patient's share
Medicare paid $1,724 Average per service
State rank #28 of 45 1 = lowest average payment

Hospitals in Wisconsin billed an average of $12,377 for level 3 extraocular, repair, and plastic eye procedures, about 5.7 times the average medicare-allowed amount of $2,170. That payment is 3% 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 $2,170Billed $12,377

About 18¢ was paid for every $1 hospitals in Wisconsin billed for this service.

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

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

Hospital Services Avg charge Avg allowed Medicare paid
Froedtert Mem Lutheran HsptlMilwaukee 230 $14,200 $2,191 $1,743
University of Wi Hospitals & Clinics AuthorityMadison 184 $11,967 $2,172 $1,726
Gundersen Luth Med CtrLa Crosse 113 $12,144 $2,171 $1,722
Aurora Baycare Med CtrGreen Bay 54 $13,423 $2,104 $1,666
SSM Health St Mary's Hospital - JanesvilleJanesville 35 $8,610 $2,198 $1,751
Oakleaf Surgical HospitalEau Claire 32 $8,850 $2,048 $1,619
Marshfield Medical CenterMarshfield 28 $9,371 $2,240 $1,780
Aspirus Rhinelander HospitalRhinelander 15 $7,555 $2,239 $1,784
Ascension SE Wisconsin HospitalMilwaukee 15 $13,388 $2,129 $1,696
St Elizabeth HsptlAppleton 13 $11,830 $2,106 $1,676
Luther Hospital Mayo Health SystemEau Claire 13 $13,925 $2,217 $1,762
Aspirus Wausau HospitalWausau 11 $10,636 $2,091 $1,659
Aurora Sheboygan Mem Med CtrSheboygan 11 $14,040 $2,129 $1,696
Ministry St Michaels Hospital of Stevens PointStevens Point – – – –
Mayo Clinic Health System-Franciscan Medical CenterLa Crosse – – – –
Waukesha Memorial HospitalWaukesha – – – –
Monroe ClinicMonroe – – – –
Thedacare Regional Med Ctr - NeenahNeenah – – – –
Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee – – – –
Aurora Memorial Hsptl BurlingtonBurlington – – – –
St Josephs Com Hsptl West BendWest Bend – – – –
Mercy Hlth Sys CorpJanesville – – – –
St Vincent HsptlGreen Bay – – – –
St Mary's HospitalMadison – – – –
St Agnes HsptlFond du Lac – – – –
Meriter HsptlMadison – – – –
Wheaton Franciscan Healthcare- All SaintsRacine – – – –
Beloit Mem HsptlBeloit – – – –
Community Mem HsptlMenomonee Falls – – – –
UW Hlth Partners - Watertown Regional Medical CtrWatertown – – – –
Aurora St Lukes Medical CenterMilwaukee – – – –
Aurora Med Ctr KenoshaKenosha – – – –
Aurora Med Ctr OshkoshOshkosh – – – –
Aurora Medical CenterSummit – – – –
Marshfield Medical Center - Eau ClaireEau Claire – – – –
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Lowest and highest allowed amounts in Wisconsin

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

Oakleaf Surgical HospitalEau Claire, WI$2,048
Aspirus Wausau HospitalWausau, WI$2,091
Aurora Baycare Med CtrGreen Bay, WI$2,104
St Elizabeth HsptlAppleton, WI$2,106
Aurora Sheboygan Mem Med CtrSheboygan, WI$2,129

Highest

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 Wisconsin?

In 2024 Medicare data, level 3 extraocular, repair, and plastic eye procedures (APC 5503) at 35 hospitals in Wisconsin was billed at $12,377 on average, while the average medicare-allowed amount was $2,170, of which Medicare paid $1,724. 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 Wisconsin, average charges were 5.7 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.