65205

Removal of foreign body from external eye (conjunctiva)

Medicare pricing data for 8,441 providers across 52 states

🤖AI Overview

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

Removal of foreign body from external eye (conjunctiva) (HCPCS code 65205) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.07, but hospitals typically charge $132.82 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.07, your out-of-pocket cost would be approximately $5.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.07
Average Hospital Charge
$132.82
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$132.82
Medicare Allowed$28.07
Medicare Payment$19.91

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $19.91 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$34$2333062+21.6%
District of Columbia$32$103916+15.2%
Massachusetts$30$164233408+8.6%
Puerto Rico$30$451318+7.9%
Connecticut$30$15688224+7.8%
Maryland$30$128142268+7.7%
Washington$30$115155279+5.3%
Nebraska$30$13589187+5.2%
New York$29$1854502,510+4.9%
Colorado$29$107130214+2.7%
Florida$29$1205841,698+2.2%
New Jersey$29$141257699+2.2%
Illinois$29$136308608+1.9%
Oregon$29$14895156+1.8%
Arizona$29$1121721,063+1.8%
Pennsylvania$29$133419777+1.6%
Virginia$28$118264473+1.4%
Texas$28$136528969+1.3%
New Hampshire$28$13461140+1.0%
Rhode Island$28$1203044+0.7%
Vermont$28$1122546+0.6%
Wyoming$28$902648+0.5%
Montana$28$12643115+0.3%
Georgia$28$185218527-0.3%
Michigan$28$121232333-0.3%
Minnesota$28$146156251-0.7%
Maine$28$954362-1.1%
North Dakota$28$1224872-1.1%
Ohio$28$136252401-1.2%
Utah$28$10557101-1.5%
Delaware$28$1043156-1.5%
New Mexico$27$1184568-2.1%
Wisconsin$27$224165252-2.1%
Missouri$27$109163298-2.4%
Iowa$27$133157340-2.5%
North Carolina$27$140299523-2.5%
Nevada$27$964365-2.8%
South Carolina$27$138134261-2.9%
South Dakota$27$9163109-2.9%
Kentucky$27$12296158-3.0%
Louisiana$27$133115211-3.1%
West Virginia$27$1144670-3.2%
Oklahoma$27$101107174-3.4%
Kansas$27$108128245-4.1%
Tennessee$27$112224403-4.8%
California$27$986913,004-4.9%
Alabama$27$96132239-5.4%
Mississippi$26$137118219-5.6%
Arkansas$26$145102235-5.9%
Hawaii$26$10751128-6.2%
Idaho$26$1206089-8.1%
Indiana$24$115168337-14.1%

⚠️ 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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