Level 4 Extraocular, Repair, and Plastic Eye Procedures
What 554 hospitals in the U.S. charged and were paid for level 4 extraocular, repair, and plastic eye procedures (APC 5504), from 2024 Medicare claims.
Average charge
$27,173
Hospital list price billed
Average allowed
$3,737
Medicare's payment + patient's share
Medicare paid
$2,969
Average per service
Volume
3,051
Medicare services
Hospitals in the U.S. billed an average of $27,173 for level 4 extraocular, repair, and plastic eye procedures, about 7.3 times the average medicare-allowed amount of $3,737.
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 $3,737Billed $27,173
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
| Barnes-Jewish West County HospitalSt Louis, MO | $1,868 |
|---|---|
| MUSC Medical CenterCharleston, SC | $2,364 |
| UAB Callahan Eye Hospital AuthorityBirmingham, AL | $3,095 |
| West Virginia University HospitalsMorgantown, WV | $3,116 |
| University of Kansas HospitalKansas City, KS | $3,186 |
| Cleveland Clinic - Main CampusCleveland, OH | $3,218 |
| Centennial Medical CenterNashville, TN | $3,225 |
| Vanderbilt University HospitalNashville, TN | $3,231 |
| Baptist Health Medical Center-Little RockLittle Rock, AR | $3,235 |
| Texas Health Presbyterian Hospital DallasDallas, TX | $3,258 |
Highest
| Stanford HospitalPalo Alto, CA | $5,445 |
|---|---|
| UCSF Medical CenterSan Francisco, CA | $5,444 |
| University of California Davis Medical CenterSacramento, CA | $4,819 |
| University of California San Diego Medical CenterSan Diego, CA | $4,754 |
| USC University HospitalLos Angeles, CA | $4,754 |
| UCI Health-OrangeOrange, CA | $4,712 |
| UCLA Medical CenterLos Angeles, CA | $4,692 |
| Ny Eye and Ear InfirmaryNew York, NY | $4,400 |
| New York-Presbyterian HospitalNew York, NY | $4,400 |
| NYU Hospitals CenterNew York, NY | $4,231 |
Level 4 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 | 7 | $11,554 | $3,095 | $3,095 – $3,095 |
| Alaska | 1 | – | – | – |
| Arizona | 11 | $47,176 | $3,770 | $3,770 – $3,770 |
| Arkansas | 3 | $20,051 | $3,235 | $3,235 – $3,235 |
| California | 60 | $42,165 | $4,934 | $4,692 – $5,445 |
| Colorado | 8 | $26,090 | $3,681 | $3,681 – $3,681 |
| Connecticut | 7 | – | – | – – – |
| Florida | 25 | $43,842 | $3,484 | $3,476 – $3,502 |
| Georgia | 24 | $24,523 | $3,405 | $2,926 – $3,588 |
| Hawaii | 2 | – | – | – – – |
| Idaho | 5 | – | – | – – – |
| Illinois | 21 | $36,142 | $3,642 | $3,408 – $3,760 |
| Indiana | 22 | $19,773 | $3,450 | $3,413 – $3,492 |
| Iowa | 7 | $23,567 | $3,451 | $3,451 – $3,451 |
| Kansas | 7 | $21,914 | $3,186 | $3,186 – $3,186 |
| Kentucky | 8 | $18,358 | $3,339 | $3,328 – $3,348 |
| Louisiana | 15 | – | – | – – – |
| Maine | 4 | $28,351 | $3,375 | $3,375 – $3,375 |
| Massachusetts | 13 | $12,848 | $4,108 | $3,877 – $4,152 |
| Michigan | 15 | $25,351 | $3,245 | $2,868 – $3,311 |
| Minnesota | 13 | $23,161 | $3,905 | $3,905 – $3,905 |
| Mississippi | 4 | $17,005 | $3,237 | $3,237 – $3,237 |
| Missouri | 12 | $22,021 | $2,868 | $1,868 – $3,280 |
| Montana | 4 | – | – | – – – |
| Nebraska | 7 | $13,433 | $3,443 | $3,443 – $3,443 |
| Nevada | 1 | – | – | – |
| New Hampshire | 2 | $27,265 | $3,950 | $3,950 – $3,950 |
| New Jersey | 14 | $22,631 | $4,351 | $4,351 – $4,351 |
| New Mexico | 2 | – | – | – – – |
| New York | 28 | $25,373 | $4,343 | $4,099 – $4,400 |
| North Carolina | 20 | $21,114 | $3,407 | $3,105 – $3,487 |
| North Dakota | 2 | $11,660 | $3,497 | $3,497 – $3,497 |
| Ohio | 17 | $29,078 | $3,342 | $3,218 – $3,470 |
| Oklahoma | 8 | $40,593 | $3,331 | $3,331 – $3,331 |
| Oregon | 13 | $14,181 | $4,057 | $4,057 – $4,057 |
| Pennsylvania | 33 | $27,803 | $3,669 | $3,453 – $3,756 |
| Rhode Island | 1 | $9,879 | $3,924 | – |
| South Carolina | 7 | $25,983 | $2,897 | $2,364 – $3,335 |
| South Dakota | 2 | – | – | – – – |
| Tennessee | 9 | $35,143 | $3,237 | $3,225 – $3,263 |
| Texas | 40 | $28,922 | $3,485 | $3,258 – $3,585 |
| Utah | 7 | $11,701 | $3,399 | $3,351 – $3,464 |
| Vermont | 1 | – | – | – |
| Virginia | 12 | $20,790 | $3,430 | $3,364 – $3,626 |
| Washington | 11 | $23,662 | $3,890 | $3,880 – $3,949 |
| West Virginia | 5 | $18,940 | $3,116 | $3,116 – $3,116 |
| Wisconsin | 11 | $23,854 | $3,475 | $3,454 – $3,495 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Univ of Michigan HospitalsAnn Arbor, MI | 132 | $23,720 | $3,311 |
| Massachusetts Eye and Ear InfirmaryBoston, MA | 119 | $12,597 | $4,152 |
| Univ of Miami Hosp & ClinicsMiami, FL | 105 | $38,611 | $3,476 |
| Wills Eye HospitalPhiladelphia, PA | 99 | $20,367 | $3,756 |
| UCI Health-OrangeOrange, CA | 92 | $21,634 | $4,712 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 81 | $23,161 | $3,905 |
| UAB Callahan Eye Hospital AuthorityBirmingham, AL | 76 | $11,554 | $3,095 |
| Duke University Medical CenterDurham, NC | 73 | $25,736 | $3,487 |
| OHSU Hospital and ClinicsPortland, OR | 72 | $14,181 | $4,057 |
| Stanford HospitalPalo Alto, CA | 71 | $88,624 | $5,445 |
| The Nebraska Medical CenterOmaha, NE | 67 | $13,433 | $3,443 |
| University of California San Diego Medical CenterSan Diego, CA | 64 | $34,201 | $4,754 |
| New York-Presbyterian HospitalNew York, NY | 64 | $33,904 | $4,400 |
| UCLA Medical CenterLos Angeles, CA | 62 | $18,732 | $4,692 |
| Harborview Medical CenterSeattle, WA | 52 | $24,811 | $3,880 |
Questions
How much does level 4 extraocular, repair, and plastic eye procedures cost in the U.S.?
In 2024 Medicare data, level 4 extraocular, repair, and plastic eye procedures (APC 5504) at 554 hospitals in the U.S. was billed at $27,173 on average, while the average medicare-allowed amount was $3,737, of which Medicare paid $2,969. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 4 extraocular, repair, and plastic eye procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($4,934), New Jersey ($4,351), New York ($4,343) and lowest in Missouri ($2,868), South Carolina ($2,897), Alabama ($3,095).
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 7.3 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.