Level 4 Extraocular, Repair, and Plastic Eye Procedures in West Virginia
What 5 hospitals in West Virginia charged and were paid for level 4 extraocular, repair, and plastic eye procedures (APC 5504), from 2024 Medicare claims.
Average charge
$18,940
Hospital list price billed
Average allowed
$3,116
Medicare's payment + patient's share
Medicare paid
$2,459
Average per service
State rank
#4 of 34
1 = lowest average payment
Hospitals in West Virginia billed an average of $18,940 for level 4 extraocular, repair, and plastic eye procedures, about 6.1 times the average medicare-allowed amount of $3,116. That payment is 17% 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 $3,116Billed $18,940
About 16¢ was paid for every $1 hospitals in West Virginia billed for this service.
West Virginia hospitals: level 4 extraocular, repair, and plastic eye procedures
Every West 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 |
|---|---|---|---|---|
| West Virginia University HospitalsMorgantown | 21 | $18,940 | $3,116 | $2,459 |
| United Hospital CenterBridgeport | – | – | – | – |
| Berkeley Medical CenterMartinsburg | – | – | – | – |
| Reynolds Memorial HospitalGlen Dale | – | – | – | – |
| Thomas Memorial HospitalSouth Charleston | – | – | – | – |
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 West Virginia?
In 2024 Medicare data, level 4 extraocular, repair, and plastic eye procedures (APC 5504) at 5 hospitals in West Virginia was billed at $18,940 on average, while the average medicare-allowed amount was $3,116, of which Medicare paid $2,459. 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 West 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.