Removal of membrane of retina
Medicare pricing data for 2,311 providers across 51 states
Prices vary significantly by location — from $253 in District of Columbia to $1,901 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
Removal of membrane of retina (HCPCS code 67041) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,310, but hospitals typically charge $4,715 — a 3.6x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,310, your out-of-pocket cost would be approximately $262.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $1,041 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $1,901 | $14,744 | 4 | 77 | +45.1% |
| New Hampshire | $1,598 | $5,883 | 9 | 71 | +22.0% |
| Arizona | $1,499 | $3,145 | 52 | 979 | +14.4% |
| South Dakota | $1,489 | $4,252 | 10 | 194 | +13.6% |
| Delaware | $1,488 | $2,605 | 3 | 22 | +13.5% |
| Colorado | $1,448 | $4,320 | 46 | 238 | +10.5% |
| Vermont | $1,444 | $4,911 | 4 | 39 | +10.2% |
| Maine | $1,435 | $4,220 | 12 | 97 | +9.5% |
| Montana | $1,432 | $2,779 | 9 | 94 | +9.3% |
| Wyoming | $1,400 | $7,672 | 2 | 29 | +6.8% |
| Idaho | $1,395 | $3,543 | 12 | 170 | +6.5% |
| Rhode Island | $1,390 | $3,302 | 8 | 24 | +6.1% |
| Florida | $1,384 | $5,073 | 198 | 1,528 | +5.6% |
| Georgia | $1,375 | $7,357 | 42 | 290 | +4.9% |
| New Jersey | $1,374 | $5,063 | 68 | 446 | +4.9% |
| New Mexico | $1,369 | $2,630 | 10 | 140 | +4.5% |
| Mississippi | $1,351 | $3,462 | 17 | 292 | +3.1% |
| California | $1,345 | $4,712 | 279 | 1,870 | +2.6% |
| Pennsylvania | $1,336 | $3,796 | 95 | 571 | +1.9% |
| Connecticut | $1,299 | $6,286 | 26 | 154 | -0.9% |
| Ohio | $1,297 | $4,695 | 93 | 599 | -1.0% |
| Minnesota | $1,296 | $5,072 | 35 | 346 | -1.1% |
| Tennessee | $1,294 | $4,896 | 50 | 330 | -1.2% |
| Maryland | $1,291 | $3,458 | 64 | 469 | -1.5% |
| New York | $1,290 | $5,854 | 140 | 717 | -1.6% |
| Illinois | $1,287 | $4,252 | 75 | 499 | -1.8% |
| Texas | $1,285 | $6,391 | 172 | 1,274 | -1.9% |
| Michigan | $1,281 | $3,193 | 63 | 283 | -2.3% |
| Virginia | $1,281 | $3,233 | 66 | 538 | -2.3% |
| Utah | $1,272 | $5,719 | 14 | 246 | -2.9% |
| South Carolina | $1,265 | $4,759 | 30 | 247 | -3.4% |
| Louisiana | $1,261 | $4,663 | 34 | 150 | -3.7% |
| Indiana | $1,260 | $4,854 | 35 | 389 | -3.8% |
| Nebraska | $1,256 | $3,457 | 15 | 148 | -4.2% |
| Washington | $1,254 | $2,861 | 26 | 100 | -4.3% |
| Missouri | $1,246 | $4,495 | 44 | 276 | -4.9% |
| Massachusetts | $1,243 | $3,353 | 84 | 365 | -5.2% |
| Kansas | $1,233 | $6,042 | 30 | 321 | -5.9% |
| Oklahoma | $1,232 | $4,770 | 16 | 166 | -6.0% |
| Puerto Rico | $1,207 | $1,482 | 10 | 20 | -7.9% |
| West Virginia | $1,199 | $2,941 | 7 | 26 | -8.5% |
| North Carolina | $1,192 | $3,680 | 70 | 417 | -9.0% |
| Iowa | $1,178 | $5,303 | 24 | 106 | -10.1% |
| Oregon | $1,174 | $3,010 | 38 | 262 | -10.4% |
| Kentucky | $1,168 | $4,230 | 32 | 369 | -10.9% |
| Nevada | $1,160 | $5,402 | 10 | 75 | -11.5% |
| Alabama | $1,152 | $3,241 | 31 | 254 | -12.1% |
| Wisconsin | $1,144 | $8,601 | 37 | 428 | -12.7% |
| Hawaii | $1,118 | $3,572 | 8 | 24 | -14.7% |
| Arkansas | $1,017 | $3,139 | 15 | 141 | -22.4% |
| District of Columbia | $253 | $3,187 | 4 | 38 | -80.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber