0509T

Pattern recording of retinal electrical responses to external stimuli with interpretation and report

Medicare pricing data for 333 providers across 29 states

🤖AI Overview

Prices vary significantly by location — from $43 in Indiana to $89 in Virginia. 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

Pattern recording of retinal electrical responses to external stimuli with interpretation and report (HCPCS code 0509T) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $71.83, but hospitals typically charge $189.46 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.37

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $71.83, your out-of-pocket cost would be approximately $14.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$71.83
Average Hospital Charge
$189.46
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$189.46
Medicare Allowed$71.83
Medicare Payment$53.36

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $53.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Virginia$89$1998345+23.5%
New Jersey$85$185151,128+18.3%
New York$85$29212193+17.8%
Massachusetts$80$158430+11.6%
Oregon$79$265697+10.0%
California$77$140261,707+6.8%
Connecticut$77$221544+6.6%
Arizona$75$1827143+4.2%
Missouri$73$3198257+1.8%
Maine$72$234492+0.8%
Florida$72$146472,171+0.2%
Washington$70$1875150-1.9%
Delaware$69$186329-3.6%
Texas$68$325331,557-5.5%
Oklahoma$68$17815499-5.7%
Illinois$67$18415735-6.1%
Alabama$67$250412-7.3%
Pennsylvania$66$17536692-7.8%
Mississippi$66$175314-8.7%
Michigan$65$1636289-9.4%
Iowa$65$193513-9.9%
Puerto Rico$65$761101-10.1%
Minnesota$64$197759-10.2%
Louisiana$64$1679114-10.6%
North Carolina$63$742245-11.7%
Arkansas$60$1523186-16.1%
New Mexico$59$148144-17.3%
Ohio$59$17415472-17.3%
Indiana$43$12010116-40.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber