Level 4 Extraocular, Repair, and Plastic Eye Procedures in Virginia
What 12 hospitals in Virginia charged and were paid for level 4 extraocular, repair, and plastic eye procedures (APC 5504), from 2024 Medicare claims.
Average charge
$20,790
Hospital list price billed
Average allowed
$3,430
Medicare's payment + patient's share
Medicare paid
$2,732
Average per service
State rank
#17 of 34
1 = lowest average payment
Hospitals in Virginia billed an average of $20,790 for level 4 extraocular, repair, and plastic eye procedures, about 6.1 times the average medicare-allowed amount of $3,430. That payment is 8% 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 $3,430Billed $20,790
About 16¢ was paid for every $1 hospitals in Virginia billed for this service.
Virginia hospitals: level 4 extraocular, repair, and plastic eye procedures
Every Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Sentara Leigh HospitalNorfolk | 21 | $20,412 | $3,364 | $2,680 |
| Sentara Norfolk General HospitalNorfolk | 12 | $31,202 | $3,364 | $2,680 |
| Inova Fairfax HospitalFalls Church | 11 | $10,153 | $3,626 | $2,889 |
| Winchester Medical Center INCWinchester | – | – | – | – |
| University of Virginia Medical CenterCharlottesville | – | – | – | – |
| Augusta HealthFishersville | – | – | – | – |
| Carilion Medical CenterRoanoke | – | – | – | – |
| Medical College of Virginia HospitalsRichmond | – | – | – | – |
| Virginia Hospital Center - ArlingtonArlington | – | – | – | – |
| Riverside Regional Medical CenterNewport News | – | – | – | – |
| Bon Secours - St Marys Hospital of RichmondRichmond | – | – | – | – |
| Inova Fair Oaks HospitalFairfax | – | – | – | – |
Lowest and highest allowed amounts in Virginia
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
| Sentara Norfolk General HospitalNorfolk, VA | $3,364 |
|---|---|
| Sentara Leigh HospitalNorfolk, VA | $3,364 |
| Inova Fairfax HospitalFalls Church, VA | $3,626 |
Highest
| Inova Fairfax HospitalFalls Church, VA | $3,626 |
|---|---|
| Sentara Norfolk General HospitalNorfolk, VA | $3,364 |
| Sentara Leigh HospitalNorfolk, VA | $3,364 |
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 Virginia?
In 2024 Medicare data, level 4 extraocular, repair, and plastic eye procedures (APC 5504) at 12 hospitals in Virginia was billed at $20,790 on average, while the average medicare-allowed amount was $3,430, of which Medicare paid $2,732. 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 Virginia, average charges were 6.1 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.