Repair of tendon of upper eyelid
Medicare pricing data for 3,022 providers across 52 states
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
Repair of tendon of upper eyelid (HCPCS code 67904) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $731.54, but hospitals typically charge $3,581 — a 4.9x 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 $731.54, your out-of-pocket cost would be approximately $146.31. 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 4.9x more than what Medicare allows for this procedure. Medicare actually pays $578.48 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $1,015 | $3,585 | 8 | 107 | +38.8% |
| California | $878 | $5,645 | 345 | 4,605 | +20.0% |
| Alaska | $869 | $7,759 | 8 | 53 | +18.8% |
| Kentucky | $862 | $2,988 | 27 | 666 | +17.9% |
| Hawaii | $841 | $2,988 | 12 | 176 | +14.9% |
| Massachusetts | $822 | $2,964 | 66 | 955 | +12.4% |
| Connecticut | $778 | $5,160 | 27 | 268 | +6.4% |
| Nevada | $775 | $3,732 | 24 | 607 | +6.0% |
| Washington | $767 | $2,035 | 63 | 1,509 | +4.8% |
| Oregon | $761 | $2,753 | 50 | 868 | +4.0% |
| West Virginia | $756 | $2,271 | 8 | 81 | +3.3% |
| New Jersey | $755 | $4,986 | 76 | 1,475 | +3.2% |
| New Hampshire | $754 | $4,007 | 13 | 122 | +3.1% |
| Illinois | $747 | $3,676 | 86 | 1,148 | +2.1% |
| Vermont | $745 | $4,901 | 4 | 26 | +1.9% |
| Delaware | $742 | $3,398 | 3 | 36 | +1.5% |
| Colorado | $742 | $2,777 | 51 | 796 | +1.4% |
| Wisconsin | $740 | $7,041 | 50 | 750 | +1.2% |
| New York | $740 | $2,681 | 133 | 2,724 | +1.1% |
| Pennsylvania | $739 | $3,468 | 165 | 2,884 | +1.1% |
| Maryland | $733 | $2,718 | 65 | 1,011 | +0.1% |
| Virginia | $732 | $2,554 | 60 | 1,357 | +0.1% |
| Minnesota | $731 | $4,182 | 64 | 909 | -0.0% |
| Iowa | $728 | $3,299 | 32 | 529 | -0.5% |
| Michigan | $725 | $2,520 | 91 | 2,172 | -0.9% |
| North Carolina | $725 | $2,722 | 96 | 2,309 | -0.9% |
| Rhode Island | $715 | $2,777 | 5 | 22 | -2.3% |
| Georgia | $713 | $3,750 | 87 | 2,069 | -2.5% |
| Nebraska | $711 | $2,855 | 20 | 446 | -2.7% |
| Montana | $711 | $2,311 | 17 | 186 | -2.9% |
| Indiana | $710 | $4,477 | 44 | 1,138 | -2.9% |
| New Mexico | $710 | $2,006 | 8 | 232 | -2.9% |
| Florida | $709 | $3,146 | 281 | 4,733 | -3.1% |
| Arizona | $709 | $3,239 | 64 | 2,006 | -3.1% |
| Missouri | $708 | $3,020 | 60 | 793 | -3.2% |
| South Dakota | $707 | $2,507 | 15 | 391 | -3.3% |
| Louisiana | $706 | $3,201 | 47 | 449 | -3.4% |
| South Carolina | $702 | $3,265 | 50 | 1,547 | -4.0% |
| North Dakota | $702 | $2,843 | 10 | 142 | -4.1% |
| Idaho | $701 | $2,370 | 37 | 380 | -4.2% |
| Texas | $698 | $5,160 | 210 | 4,573 | -4.5% |
| Kansas | $698 | $4,048 | 34 | 479 | -4.6% |
| Oklahoma | $684 | $4,015 | 39 | 1,243 | -6.5% |
| Ohio | $682 | $2,727 | 113 | 2,230 | -6.8% |
| Utah | $673 | $4,667 | 32 | 921 | -7.9% |
| Alabama | $670 | $2,500 | 38 | 621 | -8.5% |
| Arkansas | $669 | $1,999 | 26 | 830 | -8.5% |
| Maine | $662 | $2,519 | 10 | 159 | -9.5% |
| Tennessee | $656 | $2,959 | 73 | 2,227 | -10.3% |
| Mississippi | $655 | $3,479 | 31 | 1,399 | -10.5% |
| Wyoming | $635 | $2,369 | 2 | 36 | -13.2% |
| Puerto Rico | $577 | $727 | 16 | 63 | -21.1% |
⚠️ 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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