00103

Anesthesia for procedure on eyelid

Medicare pricing data for 19,661 providers across 52 states

🤖AI Overview

This procedure has a 8.8x markup — hospitals charge $1,264 but Medicare allows only $143.43. Uninsured patients may face bills 8.8 times higher than what insurance negotiates. Prices vary significantly by location — from $94 in Alabama to $238 in Puerto Rico. 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

Anesthesia for procedure on eyelid (HCPCS code 00103) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $143.43, but hospitals typically charge $1,264 — a 8.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$28.69

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $143.43, your out-of-pocket cost would be approximately $28.69. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$143.43
Average Hospital Charge
$1,264
Markup Ratio
8.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,264.43
Medicare Allowed$143.43
Medicare Payment$112.23

Hospitals charge 8.8x more than what Medicare allows for this procedure. Medicare actually pays $112.23 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$238$3621681+65.9%
Alaska$230$1,20235127+60.5%
Wyoming$228$1,6381654+59.0%
Hawaii$199$1,77533387+38.6%
Idaho$181$92373468+26.3%
California$179$1,3231,5839,432+24.7%
Washington$175$9793632,193+21.9%
Arizona$174$1,6333122,854+21.3%
Utah$173$1,007190980+20.6%
Montana$173$1,10058299+20.4%
Louisiana$170$1,1932111,016+18.5%
Nebraska$170$924164965+18.5%
Maine$169$1,14083404+18.1%
Iowa$168$9181891,074+17.3%
Oklahoma$168$8711621,933+16.8%
Delaware$165$1,28748542+15.1%
Maryland$164$1,5002991,999+14.6%
New Jersey$161$1,7893731,758+12.1%
Nevada$160$1,147101800+11.6%
North Dakota$154$93084440+7.3%
Arkansas$153$7721411,154+6.7%
Florida$150$1,2941,2869,400+4.6%
New York$150$1,7278644,755+4.3%
Colorado$147$1,3082601,731+2.8%
Oregon$147$8322311,044+2.6%
Mississippi$145$7351941,531+1.3%
South Dakota$144$71747718+0.5%
Kansas$144$7832561,586+0.3%
Rhode Island$143$1,11043236+0.0%
District of Columbia$143$1,45470156-0.4%
Missouri$143$1,0764242,191-0.5%
Massachusetts$142$1,3814532,216-1.3%
Indiana$140$1,1203891,866-2.1%
Illinois$140$1,3528092,863-2.6%
Tennessee$140$1,1825373,526-2.7%
New Hampshire$139$1,352126700-2.8%
New Mexico$139$1,01268317-2.9%
Kentucky$137$1,1073291,650-4.1%
Ohio$137$8677404,028-4.5%
Texas$133$1,6971,5827,686-6.9%
Virginia$133$1,2674713,193-7.0%
Vermont$132$90230109-7.8%
West Virginia$128$1,064146518-10.5%
Michigan$124$1,2417673,804-13.6%
South Carolina$123$1,2434373,145-14.6%
Minnesota$122$9836172,702-15.0%
Pennsylvania$120$1,2171,1435,337-16.1%
Wisconsin$118$1,7546221,988-17.4%
Georgia$115$1,2606854,116-19.9%
North Carolina$114$1,3318334,357-20.2%
Connecticut$113$1,362245976-21.4%
Alabama$94$9063682,170-34.6%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber