66982

Complex removal of cataract with insertion of prosthetic lens

Medicare pricing data for 15,446 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $60 in Kentucky to $978 in Alaska. 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

Complex removal of cataract with insertion of prosthetic lens (HCPCS code 66982) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $362.75, but hospitals typically charge $1,481 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$72.55

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $362.75, your out-of-pocket cost would be approximately $72.55. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$362.75
Average Hospital Charge
$1,481
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,481.32
Medicare Allowed$362.75
Medicare Payment$287.18

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $287.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$978$5,97440609+169.7%
California$972$4,4651,29624,271+167.8%
Hawaii$906$3,60871840+149.8%
New Jersey$895$4,68043610,153+146.8%
Maryland$875$2,4422756,968+141.3%
Delaware$867$3,212501,884+139.1%
Washington$865$2,4113685,509+138.3%
Nevada$856$4,652821,695+136.0%
New Mexico$821$2,519501,328+126.2%
Oregon$821$2,2922452,620+126.2%
Colorado$811$3,1072602,921+123.6%
Florida$806$2,94686915,120+122.2%
District of Columbia$802$2,43330275+121.1%
Arizona$799$2,3092345,063+120.2%
Vermont$788$2,85018479+117.3%
Texas$783$4,21196813,109+115.9%
Idaho$763$1,829102988+110.4%
Pennsylvania$763$2,7127179,555+110.3%
Utah$749$3,2831552,421+106.5%
Puerto Rico$723$8613697+99.4%
Kansas$693$2,6021842,569+90.9%
Louisiana$692$2,5831872,126+90.9%
Arkansas$680$2,0502102,460+87.5%
Mississippi$679$2,5621912,396+87.3%
Michigan$678$2,4475456,705+86.9%
Nebraska$675$2,5661522,844+86.0%
Wyoming$671$2,85938633+84.9%
Montana$666$1,7361061,685+83.6%
Indiana$662$2,8374187,428+82.4%
Connecticut$626$2,9711723,245+72.5%
Oklahoma$612$2,4942913,795+68.8%
South Dakota$598$2,0521121,395+65.0%
New York$598$2,38678123,809+64.8%
Missouri$564$2,1933285,218+55.6%
Massachusetts$551$1,71137013,330+52.0%
North Dakota$540$2,1411091,358+48.8%
New Hampshire$464$2,804642,414+28.0%
Iowa$460$1,8453236,555+26.7%
South Carolina$356$1,4792245,833-2.0%
West Virginia$289$909872,600-20.4%
Georgia$260$1,18037315,288-28.3%
Tennessee$254$1,05936415,725-30.0%
Virginia$194$60238225,330-46.5%
Ohio$185$69658132,967-49.0%
Illinois$179$80457240,952-50.7%
Rhode Island$143$454573,454-60.6%
Alabama$124$52024313,781-65.9%
Maine$90$278805,740-75.2%
Minnesota$78$30736833,323-78.6%
Wisconsin$77$63835836,662-78.7%
North Carolina$73$28054855,989-79.8%
Kentucky$60$25630435,265-83.5%

⚠️ 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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