66180

Creation of shunt to improve eye fluid flow using tissue graft

Medicare pricing data for 2,289 providers across 48 states

🤖AI Overview

Prices vary significantly by location — from $698 in District of Columbia to $2,024 in Hawaii. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Creation of shunt to improve eye fluid flow using tissue graft (HCPCS code 66180) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,562, but hospitals typically charge $4,694 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$312.36

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,562, your out-of-pocket cost would be approximately $312.36. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,562
Average Hospital Charge
$4,694
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,693.54
Medicare Allowed$1,561.81
Medicare Payment$1,241.33

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $1,241 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$2,024$4,708827+29.6%
Delaware$1,897$3,6076104+21.5%
Nevada$1,889$5,40815201+20.9%
New Jersey$1,855$4,36453405+18.8%
Idaho$1,815$3,8391068+16.2%
California$1,811$6,0903151,706+16.0%
Arizona$1,806$4,15541229+15.6%
Maine$1,761$4,075836+12.8%
Washington$1,749$3,32652274+12.0%
South Dakota$1,718$4,232956+10.0%
Arkansas$1,713$3,01213121+9.6%
Virginia$1,709$4,60756460+9.4%
Kansas$1,693$4,50321127+8.4%
Indiana$1,690$12,35628226+8.2%
Texas$1,681$6,9501611,024+7.7%
South Carolina$1,674$3,38322272+7.2%
Florida$1,638$4,5502011,458+4.9%
Connecticut$1,633$6,01929138+4.5%
Tennessee$1,629$4,43043258+4.3%
New York$1,620$5,781144847+3.8%
Georgia$1,614$4,49358379+3.4%
Colorado$1,608$4,35931157+3.0%
Mississippi$1,589$3,54918175+1.8%
New Hampshire$1,584$4,8251487+1.4%
Louisiana$1,584$3,92930201+1.4%
Montana$1,575$4,24210116+0.8%
Illinois$1,557$4,15277494-0.3%
Nebraska$1,547$4,55513118-1.0%
Kentucky$1,540$4,6151693-1.4%
Wisconsin$1,495$8,16131162-4.3%
Utah$1,494$5,27622104-4.3%
Oklahoma$1,484$4,21315157-5.0%
Maryland$1,473$3,03958471-5.7%
Oregon$1,447$4,3163199-7.4%
Pennsylvania$1,444$3,625102740-7.5%
Iowa$1,444$5,35615131-7.6%
Ohio$1,437$4,81785561-8.0%
Alabama$1,435$2,85628221-8.1%
Massachusetts$1,401$3,38484373-10.3%
New Mexico$1,399$2,955953-10.4%
North Dakota$1,376$3,959852-11.9%
Michigan$1,295$3,64576345-17.1%
Missouri$1,273$3,45842256-18.5%
North Carolina$1,265$3,40269580-19.0%
Rhode Island$1,218$3,114617-22.0%
West Virginia$1,132$3,256628-27.5%
Minnesota$745$2,40342485-52.3%
District of Columbia$698$1,607626-55.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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