facebook tracking Level 4 Extraocular, Repair, and Plastic Eye Procedures cost in Pennsylvania: 33 hospitals compared (APC 5504)

Level 4 Extraocular, Repair, and Plastic Eye Procedures in Pennsylvania

What 33 hospitals in Pennsylvania charged and were paid for level 4 extraocular, repair, and plastic eye procedures (APC 5504), from 2024 Medicare claims.

APC 5504 Outpatient 2024 Medicare data
Average charge $27,803 Hospital list price billed
Average allowed $3,669 Medicare's payment + patient's share
Medicare paid $2,919 Average per service
State rank #25 of 34 1 = lowest average payment

Hospitals in Pennsylvania billed an average of $27,803 for level 4 extraocular, repair, and plastic eye procedures, about 7.6 times the average medicare-allowed amount of $3,669. That payment is 2% 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 $3,669Billed $27,803

About 13¢ was paid for every $1 hospitals in Pennsylvania billed for this service.

Pennsylvania hospitals: level 4 extraocular, repair, and plastic eye procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Wills Eye HospitalPhiladelphia 99 $20,367 $3,756 $2,993
Geisinger Medical CenterDanville 15 $53,742 $3,453 $2,751
UPMC Presbyterian ShadysidePittsburgh 14 $50,077 $3,453 $2,751
Main Line Hospital LankenauWynnewood 14 $17,510 $3,518 $2,760
Milton S Hershey Medical CenterHershey 11 $44,102 $3,639 $2,900
Geisinger-Community Medical CenterScranton – – – –
Chestnut Hill HospitalPhiladelphia – – – –
Temple University HospitalPhiladelphia – – – –
UPMC MercyPittsburgh – – – –
Reading Hospital and Med CtrWest Reading – – – –
Lewistown HospitalLewistown – – – –
Allegheny General HospitalPittsburgh – – – –
Grand View HospitalSellersville – – – –
UPMC LititzLititz – – – –
Altoona Regional Health SystemAltoona – – – –
Robert Packer HospitalSayre – – – –
UPMC St MargaretPittsburgh – – – –
Hospital of the Univ of PaPhiladelphia – – – –
Magee Womens Hospital of UPMC Health SystemPittsburgh – – – –
Lehigh Valley HospitalAllentown – – – –
Chambersburg HospitalChambersburg – – – –
Indiana Regional Medical CenterIndiana – – – –
Thomas Jefferson University HospitalPhiladelphia – – – –
Crozer Chester Medical CenterChester – – – –
Excela Health Frick HospitalMt Pleasant – – – –
Riddle Memorial HospitalMedia – – – –
Penn Presbyterian Medical CenterPhiladelphia – – – –
Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia – – – –
St Clair Memorial HospitalPittsburgh – – – –
Mercy Hospital ScrantonScranton – – – –
Geisinger Wyoming Vly Med CtrWilkes-Barre – – – –
UPMC EastMonroeville – – – –
Geisinger Medical Center MuncyMuncy – – – –
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Lowest and highest allowed amounts in Pennsylvania

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

Geisinger Medical CenterDanville, PA$3,453
UPMC Presbyterian ShadysidePittsburgh, PA$3,453
Main Line Hospital LankenauWynnewood, PA$3,518
Milton S Hershey Medical CenterHershey, PA$3,639
Wills Eye HospitalPhiladelphia, PA$3,756

Highest

Wills Eye HospitalPhiladelphia, PA$3,756
Milton S Hershey Medical CenterHershey, PA$3,639
Main Line Hospital LankenauWynnewood, PA$3,518
Geisinger Medical CenterDanville, PA$3,453
UPMC Presbyterian ShadysidePittsburgh, PA$3,453

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 Pennsylvania?

In 2024 Medicare data, level 4 extraocular, repair, and plastic eye procedures (APC 5504) at 33 hospitals in Pennsylvania was billed at $27,803 on average, while the average medicare-allowed amount was $3,669, of which Medicare paid $2,919. 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 Pennsylvania, average charges were 7.6 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.