Incision to improve eye fluid flow
Medicare pricing data for 4,185 providers across 51 states
Prices vary significantly by location — from $193 in Minnesota to $1,552 in Idaho. 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
Incision to improve eye fluid flow (HCPCS code 65820) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,028, but hospitals typically charge $2,982 — a 2.9x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,028, your out-of-pocket cost would be approximately $205.69. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $817.53 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Idaho | $1,552 | $2,722 | 10 | 90 | +50.9% |
| Wyoming | $1,439 | $3,046 | 5 | 104 | +39.9% |
| Delaware | $1,435 | $2,713 | 8 | 206 | +39.5% |
| California | $1,405 | $4,323 | 395 | 5,418 | +36.6% |
| Maryland | $1,393 | $3,058 | 92 | 2,188 | +35.5% |
| New Mexico | $1,381 | $4,877 | 7 | 34 | +34.3% |
| New Jersey | $1,368 | $4,461 | 146 | 3,121 | +33.0% |
| Nevada | $1,352 | $4,041 | 31 | 478 | +31.4% |
| Virginia | $1,343 | $3,926 | 99 | 2,816 | +30.6% |
| New Hampshire | $1,326 | $4,882 | 13 | 401 | +28.9% |
| Vermont | $1,322 | $2,095 | 5 | 72 | +28.5% |
| Washington | $1,312 | $3,398 | 69 | 953 | +27.6% |
| New York | $1,273 | $3,383 | 298 | 5,041 | +23.8% |
| Arkansas | $1,272 | $2,204 | 22 | 280 | +23.7% |
| Massachusetts | $1,261 | $2,995 | 99 | 1,347 | +22.6% |
| Montana | $1,256 | $4,350 | 5 | 67 | +22.2% |
| Alaska | $1,251 | $5,752 | 10 | 111 | +21.6% |
| Oregon | $1,241 | $3,730 | 43 | 350 | +20.6% |
| North Dakota | $1,234 | $3,151 | 10 | 180 | +20.0% |
| South Carolina | $1,222 | $3,252 | 83 | 1,709 | +18.8% |
| Arizona | $1,212 | $3,093 | 66 | 930 | +17.8% |
| Maine | $1,212 | $3,124 | 15 | 246 | +17.8% |
| Colorado | $1,195 | $3,489 | 44 | 615 | +16.2% |
| South Dakota | $1,187 | $3,191 | 14 | 216 | +15.4% |
| Texas | $1,182 | $4,653 | 311 | 4,596 | +14.9% |
| Florida | $1,171 | $2,933 | 319 | 5,104 | +13.9% |
| Georgia | $1,130 | $2,910 | 118 | 2,070 | +9.9% |
| Pennsylvania | $1,125 | $2,890 | 211 | 2,753 | +9.4% |
| Hawaii | $1,111 | $2,202 | 10 | 60 | +8.0% |
| Nebraska | $1,106 | $3,520 | 29 | 574 | +7.5% |
| Tennessee | $1,101 | $3,118 | 68 | 832 | +7.0% |
| Connecticut | $1,100 | $4,457 | 41 | 489 | +7.0% |
| Louisiana | $1,084 | $2,658 | 56 | 486 | +5.4% |
| Illinois | $1,079 | $2,995 | 151 | 2,624 | +4.9% |
| Michigan | $1,075 | $2,687 | 155 | 2,186 | +4.5% |
| Indiana | $1,049 | $3,182 | 89 | 1,684 | +2.0% |
| Utah | $1,000 | $3,004 | 38 | 411 | -2.8% |
| Mississippi | $972 | $2,263 | 49 | 869 | -5.5% |
| Oklahoma | $964 | $2,303 | 67 | 639 | -6.2% |
| Kansas | $943 | $3,131 | 57 | 712 | -8.3% |
| Missouri | $938 | $3,727 | 119 | 1,991 | -8.8% |
| North Carolina | $923 | $2,280 | 112 | 1,989 | -10.2% |
| District of Columbia | $911 | $2,165 | 12 | 113 | -11.5% |
| Rhode Island | $902 | $2,284 | 16 | 217 | -12.3% |
| Iowa | $878 | $3,776 | 49 | 653 | -14.7% |
| West Virginia | $870 | $2,318 | 18 | 132 | -15.4% |
| Alabama | $764 | $2,158 | 48 | 915 | -25.8% |
| Ohio | $601 | $1,632 | 165 | 4,149 | -41.6% |
| Wisconsin | $331 | $1,515 | 68 | 2,322 | -67.8% |
| Kentucky | $220 | $671 | 56 | 2,445 | -78.6% |
| Minnesota | $193 | $611 | 75 | 4,061 | -81.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber