65210

Removal of foreign body from external eye (conjunctiva or sclera)

Medicare pricing data for 4,683 providers across 51 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 or sclera) (HCPCS code 65210) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $38.56, but hospitals typically charge $153.33 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.71

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $38.56, your out-of-pocket cost would be approximately $7.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$38.56
Average Hospital Charge
$153.33
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$153.33
Medicare Allowed$38.56
Medicare Payment$28.01

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $28.01 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Ohio$49$711401,056+26.9%
Alaska$47$2951019+22.9%
District of Columbia$43$2211015+11.8%
New York$42$203310908+10.0%
New Jersey$41$191170379+7.4%
Maryland$41$14496259+6.9%
California$41$1834803,023+6.5%
Connecticut$41$23559105+6.4%
Massachusetts$41$21490179+5.8%
Washington$40$14694169+4.4%
New Hampshire$40$1463246+3.3%
Illinois$40$169145272+2.6%
Delaware$39$1952170+1.7%
Montana$39$1203253+0.9%
Colorado$39$1486594+0.5%
Pennsylvania$39$164186365+0.2%
Maine$39$1672636+0.2%
Minnesota$38$1647296-0.4%
South Dakota$38$1172964-0.7%
Vermont$38$1702139-1.5%
Oregon$38$13566122-1.5%
Texas$38$149258451-1.7%
North Dakota$38$1622127-1.8%
Virginia$38$145119257-1.8%
Wyoming$38$1172036-2.3%
Arizona$38$12679176-2.7%
Idaho$37$1453165-3.0%
New Mexico$37$1171827-3.2%
Hawaii$37$1363555-3.2%
Rhode Island$37$1631628-3.3%
Michigan$37$182111201-3.6%
Nevada$37$1651943-3.7%
South Carolina$37$15165127-4.3%
North Carolina$37$144132205-4.5%
Georgia$37$159122291-4.6%
Missouri$37$148100167-4.7%
Wisconsin$37$28175124-5.2%
Louisiana$36$15693150-5.4%
Nebraska$36$1444890-5.6%
Oklahoma$36$13967107-5.8%
Arkansas$36$13366169-5.8%
West Virginia$36$1382137-5.9%
Kentucky$36$10970103-6.3%
Utah$36$1335399-6.6%
Kansas$36$15183154-6.7%
Iowa$36$144102189-6.8%
Indiana$36$15385131-6.9%
Alabama$36$11089164-7.6%
Mississippi$35$14970175-8.2%
Tennessee$35$11790155-8.9%
Florida$30$1223622,126-21.8%

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