67113

Complex repair of detached retina and drainage of eye fluid between lens and retina

Medicare pricing data for 2,730 providers across 49 states

🤖AI Overview

Prices vary significantly by location — from $645 in District of Columbia to $2,068 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 repair of detached retina and drainage of eye fluid between lens and retina (HCPCS code 67113) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,343, but hospitals typically charge $5,720 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$268.65

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,343, your out-of-pocket cost would be approximately $268.65. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,343
Average Hospital Charge
$5,720
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,720.43
Medicare Allowed$1,343.25
Medicare Payment$1,068.10

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $1,068 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$2,068$25,044224+53.9%
South Dakota$1,533$4,3781075+14.1%
Connecticut$1,514$10,37422104+12.7%
Montana$1,506$3,947864+12.2%
New Jersey$1,494$5,93169323+11.3%
Indiana$1,487$13,89538282+10.7%
Maine$1,482$5,8591176+10.3%
Minnesota$1,476$7,82733258+9.9%
Arizona$1,460$3,00058754+8.7%
California$1,455$5,8713181,562+8.4%
New Hampshire$1,454$5,151723+8.3%
Florida$1,449$6,2752171,401+7.9%
South Carolina$1,421$7,00341234+5.8%
Colorado$1,418$6,82249254+5.6%
Kansas$1,414$6,87634220+5.3%
Texas$1,395$8,4132091,499+3.8%
Washington$1,392$4,06858434+3.6%
New York$1,389$5,957156685+3.4%
Hawaii$1,380$4,9701353+2.7%
Utah$1,371$6,50631185+2.0%
Nevada$1,368$4,9382095+1.8%
Louisiana$1,367$5,27841228+1.8%
Nebraska$1,358$5,4171580+1.1%
Delaware$1,358$2,450517+1.1%
Georgia$1,357$5,94355207+1.0%
Rhode Island$1,356$3,401724+0.9%
Maryland$1,315$4,76774434-2.1%
Mississippi$1,314$4,18424272-2.2%
Tennessee$1,313$6,29164496-2.3%
Idaho$1,307$3,7971058-2.7%
Missouri$1,304$4,50655412-2.9%
Oregon$1,298$3,51943169-3.3%
Pennsylvania$1,293$5,261109623-3.8%
Oklahoma$1,286$5,13017205-4.3%
Massachusetts$1,262$4,47283324-6.0%
Ohio$1,245$4,391120756-7.3%
Kentucky$1,238$4,56134225-7.9%
Virginia$1,233$4,19269314-8.2%
Alabama$1,190$4,00635182-11.4%
North Carolina$1,177$3,73677378-12.3%
Arkansas$1,131$4,1631772-15.8%
Iowa$1,131$5,40737259-15.8%
West Virginia$1,128$4,174943-16.0%
Michigan$1,103$3,61996387-17.9%
Wisconsin$1,096$11,15339201-18.4%
Illinois$1,087$4,21797602-19.1%
New Mexico$1,086$2,32613146-19.1%
North Dakota$953$2,789529-29.1%
District of Columbia$645$4,171528-52.0%

⚠️ 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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