Level 4 Extraocular, Repair, and Plastic Eye Procedures in Massachusetts
What 13 hospitals in Massachusetts charged and were paid for level 4 extraocular, repair, and plastic eye procedures (APC 5504), from 2024 Medicare claims.
Average charge
$12,848
Hospital list price billed
Average allowed
$4,108
Medicare's payment + patient's share
Medicare paid
$3,262
Average per service
State rank
#31 of 34
1 = lowest average payment
Hospitals in Massachusetts billed an average of $12,848 for level 4 extraocular, repair, and plastic eye procedures, about 3.1 times the average medicare-allowed amount of $4,108. That payment is 10% above 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 $4,108Billed $12,848
About 32¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 4 extraocular, repair, and plastic eye procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Massachusetts Eye and Ear InfirmaryBoston | 119 | $12,597 | $4,152 | $3,307 |
| Tufts Medical CenterBoston | 17 | $11,049 | $3,958 | $3,114 |
| Healthalliance Hospitals, INCLeominster | 12 | $17,886 | $3,877 | $3,033 |
| Holyoke Medical CenterHolyoke | – | – | – | – |
| Boston Medical Center CorporationBoston | – | – | – | – |
| Lowell General HospitalLowell | – | – | – | – |
| Massachusetts General HospitalBoston | – | – | – | – |
| Baystate Medical CenterSpringfield | – | – | – | – |
| Emerson HospitalConcord | – | – | – | – |
| South Shore HospitalSouth Weymouth | – | – | – | – |
| Newton-Wellesley HospitalNewton Lower Falls | – | – | – | – |
| Umass Memorial Medical Center INCWorcester | – | – | – | – |
| Lahey Clinic HospitalBurlington | – | – | – | – |
Lowest and highest allowed amounts in Massachusetts
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
| Healthalliance Hospitals, INCLeominster, MA | $3,877 |
|---|---|
| Tufts Medical CenterBoston, MA | $3,958 |
| Massachusetts Eye and Ear InfirmaryBoston, MA | $4,152 |
Highest
| Massachusetts Eye and Ear InfirmaryBoston, MA | $4,152 |
|---|---|
| Tufts Medical CenterBoston, MA | $3,958 |
| Healthalliance Hospitals, INCLeominster, MA | $3,877 |
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 Massachusetts?
In 2024 Medicare data, level 4 extraocular, repair, and plastic eye procedures (APC 5504) at 13 hospitals in Massachusetts was billed at $12,848 on average, while the average medicare-allowed amount was $4,108, of which Medicare paid $3,262. 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 Massachusetts, average charges were 3.1 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.