Level 4 Extraocular, Repair, and Plastic Eye Procedures in Wisconsin
What 11 hospitals in Wisconsin charged and were paid for level 4 extraocular, repair, and plastic eye procedures (APC 5504), from 2024 Medicare claims.
Average charge
$23,854
Hospital list price billed
Average allowed
$3,475
Medicare's payment + patient's share
Medicare paid
$2,738
Average per service
State rank
#21 of 34
1 = lowest average payment
Hospitals in Wisconsin billed an average of $23,854 for level 4 extraocular, repair, and plastic eye procedures, about 6.9 times the average medicare-allowed amount of $3,475. That payment is 7% 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 $3,475Billed $23,854
About 15¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 4 extraocular, repair, and plastic eye procedures
Every Wisconsin hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Froedtert Mem Lutheran HsptlMilwaukee | 40 | $24,904 | $3,495 | $2,754 |
| University of Wi Hospitals & Clinics AuthorityMadison | 37 | $22,719 | $3,454 | $2,720 |
| St Elizabeth HsptlAppleton | – | – | – | – |
| Froedtert SouthKenosha | – | – | – | – |
| Aspirus Wausau HospitalWausau | – | – | – | – |
| Thedacare Regional Med Ctr - NeenahNeenah | – | – | – | – |
| Luther Hospital Mayo Health SystemEau Claire | – | – | – | – |
| Gundersen Luth Med CtrLa Crosse | – | – | – | – |
| Aurora Baycare Med CtrGreen Bay | – | – | – | – |
| Oakleaf Surgical HospitalEau Claire | – | – | – | – |
| SSM Health St Mary's Hospital - JanesvilleJanesville | – | – | – | – |
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 Wisconsin?
In 2024 Medicare data, level 4 extraocular, repair, and plastic eye procedures (APC 5504) at 11 hospitals in Wisconsin was billed at $23,854 on average, while the average medicare-allowed amount was $3,475, of which Medicare paid $2,738. 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 Wisconsin, average charges were 6.9 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.