Level 4 Extraocular, Repair, and Plastic Eye Procedures in Kentucky
What 8 hospitals in Kentucky charged and were paid for level 4 extraocular, repair, and plastic eye procedures (APC 5504), from 2024 Medicare claims.
Average charge
$18,358
Hospital list price billed
Average allowed
$3,339
Medicare's payment + patient's share
Medicare paid
$2,653
Average per service
State rank
#11 of 34
1 = lowest average payment
Hospitals in Kentucky billed an average of $18,358 for level 4 extraocular, repair, and plastic eye procedures, about 5.5 times the average medicare-allowed amount of $3,339. That payment is 11% below the U.S. average 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 $3,339Billed $18,358
About 18¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: level 4 extraocular, repair, and plastic eye procedures
Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University of Kentucky HospLexington | 26 | $20,187 | $3,348 | $2,660 |
| St Elizabeth Med Center-SouthEdgewood | 14 | $16,793 | $3,328 | $2,652 |
| Jewish HospitalLouisville | 13 | $16,385 | $3,331 | $2,640 |
| King's Daughters' Medical CenterAshland | – | – | – | – |
| Pikeville Medical CenterPikeville | – | – | – | – |
| Norton Healthcare PavilionLouisville | – | – | – | – |
| Western Baptist HospitalPaducah | – | – | – | – |
| University of Louisville HospitalLouisville | – | – | – | – |
Lowest and highest allowed amounts in Kentucky
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
| St Elizabeth Med Center-SouthEdgewood, KY | $3,328 |
|---|---|
| Jewish HospitalLouisville, KY | $3,331 |
| University of Kentucky HospLexington, KY | $3,348 |
Highest
| University of Kentucky HospLexington, KY | $3,348 |
|---|---|
| Jewish HospitalLouisville, KY | $3,331 |
| St Elizabeth Med Center-SouthEdgewood, KY | $3,328 |
Level 4 Extraocular, Repair, and Plastic Eye Procedures in other states
Questions
How much does level 4 extraocular, repair, and plastic eye procedures cost in Kentucky?
In 2024 Medicare data, level 4 extraocular, repair, and plastic eye procedures (APC 5504) at 8 hospitals in Kentucky was billed at $18,358 on average, while the average medicare-allowed amount was $3,339, of which Medicare paid $2,653. 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 Kentucky, average charges were 5.5 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.