67917

Extensive repair of turning-outward eyelid defect

Medicare pricing data for 3,305 providers across 50 states

🤖AI Overview

This procedure has a 5.4x markup — hospitals charge $3,041 but Medicare allows only $559.51. Uninsured patients may face bills 5.4 times higher than what insurance negotiates. 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

Extensive repair of turning-outward eyelid defect (HCPCS code 67917) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $559.51, but hospitals typically charge $3,041 — a 5.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$111.90

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $559.51, your out-of-pocket cost would be approximately $111.90. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$559.51
Average Hospital Charge
$3,041
Markup Ratio
5.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,040.54
Medicare Allowed$559.51
Medicare Payment$442.77

Hospitals charge 5.4x more than what Medicare allows for this procedure. Medicare actually pays $442.77 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$725$6,2721026+29.7%
California$664$3,5363651,979+18.7%
Delaware$645$2,460699+15.3%
New Jersey$638$4,74595475+14.1%
Vermont$631$2,1704104+12.9%
Connecticut$631$3,93944228+12.7%
Oregon$613$2,30653499+9.5%
New Mexico$610$1,583996+9.0%
Massachusetts$607$2,10080684+8.5%
Nevada$602$3,74223211+7.7%
Maryland$601$2,40874688+7.4%
South Dakota$599$2,13817186+7.1%
Washington$594$1,946801,117+6.1%
Virginia$585$2,18667469+4.5%
Montana$585$1,84119142+4.5%
Hawaii$584$2,661619+4.3%
Kansas$583$4,66535325+4.2%
Maine$581$2,12413185+3.9%
North Dakota$575$2,19621127+2.8%
Colorado$570$2,84867502+1.8%
New York$566$3,0061341,108+1.2%
Arizona$566$2,72777800+1.1%
Louisiana$565$2,61149396+0.9%
Pennsylvania$564$2,679132888+0.9%
Idaho$562$1,79937233+0.5%
Minnesota$560$3,15175631+0.1%
Illinois$558$2,729115613-0.3%
New Hampshire$553$2,9661163-1.1%
Nebraska$551$2,11729160-1.5%
Georgia$550$3,39294816-1.7%
North Carolina$549$2,078104886-1.9%
Iowa$547$2,47931272-2.2%
Missouri$546$2,46174701-2.4%
Texas$540$5,2482282,207-3.4%
Oklahoma$539$3,82746589-3.6%
District of Columbia$538$2,615423-3.9%
Florida$532$3,3292913,046-4.9%
Utah$532$2,80444591-4.9%
Tennessee$531$2,50989885-5.1%
Michigan$527$2,19587661-5.9%
Arkansas$524$1,40326299-6.3%
Indiana$515$4,58048568-8.0%
Alabama$514$2,13534240-8.1%
Ohio$510$2,400106894-8.9%
South Carolina$502$2,15157573-10.3%
Rhode Island$480$2,550665-14.3%
Mississippi$478$2,87434311-14.5%
West Virginia$470$1,66820119-16.0%
Wisconsin$452$4,81244298-19.2%
Kentucky$432$1,92838379-22.8%

⚠️ 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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