facebook tracking Level 3 Intraocular Procedures cost in Rhode Island: 2 hospitals compared (APC 5493)

Level 3 Intraocular Procedures in Rhode Island

What 2 hospitals in Rhode Island charged and were paid for level 3 intraocular procedures (APC 5493), from 2024 Medicare claims.

APC 5493 Outpatient 2024 Medicare data
Average charge $12,939 Hospital list price billed
Average allowed $5,304 Medicare's payment + patient's share
Medicare paid $4,226 Average per service
Volume 12 Medicare services

Hospitals in Rhode Island billed an average of $12,939 for level 3 intraocular procedures, about 2.4 times the average medicare-allowed amount of $5,304. That payment is 5% above the U.S. average of $5,041.

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 $5,304Billed $12,939

About 41¢ was paid for every $1 hospitals in Rhode Island billed for this service.

Rhode Island hospitals: level 3 intraocular procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Westerly HospitalWesterly 12 $12,939 $5,304 $4,226
Rhode Island HospitalProvidence – – – –
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Level 3 Intraocular Procedures in other states

Questions

How much does level 3 intraocular procedures cost in Rhode Island?

In 2024 Medicare data, level 3 intraocular procedures (APC 5493) at 2 hospitals in Rhode Island was billed at $12,939 on average, while the average medicare-allowed amount was $5,304, of which Medicare paid $4,226. 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 Rhode Island, average charges were 2.4 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.