65855

Laser repair to improve eye fluid flow

Medicare pricing data for 8,161 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

Laser repair to improve eye fluid flow (HCPCS code 65855) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $215.06, but hospitals typically charge $1,022 — a 4.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$43.01

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $215.06, your out-of-pocket cost would be approximately $43.01. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$215.06
Average Hospital Charge
$1,022
Markup Ratio
4.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,022.48
Medicare Allowed$215.06
Medicare Payment$163.39

Hospitals charge 4.8x more than what Medicare allows for this procedure. Medicare actually pays $163.39 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$297$2,46627243+38.2%
District of Columbia$272$1,14128641+26.7%
Connecticut$266$1,439951,386+23.8%
California$247$95688618,794+14.7%
Puerto Rico$242$28728110+12.6%
New York$238$1,2155278,520+10.7%
Rhode Island$236$84726338+9.7%
New Jersey$234$1,4362766,067+8.9%
Vermont$233$91616216+8.3%
Maryland$231$6881743,866+7.5%
New Hampshire$231$1,619411,250+7.4%
Wyoming$228$1,54224443+5.9%
Virginia$225$7992105,615+4.5%
Illinois$225$1,2352805,640+4.4%
Michigan$220$8652854,230+2.4%
Pennsylvania$218$1,1634358,869+1.6%
North Carolina$218$9611723,929+1.3%
Wisconsin$217$2,6611392,116+1.1%
Kentucky$217$8331161,345+0.9%
Iowa$217$96156777+0.7%
West Virginia$215$79939709+0.0%
Utah$215$875821,054-0.1%
Washington$213$7261863,510-0.9%
Massachusetts$213$1,1482606,633-1.0%
Oklahoma$213$6641402,266-1.1%
South Carolina$212$1,0491232,753-1.5%
Hawaii$211$88946867-1.8%
Texas$209$1,0375138,748-2.6%
Florida$209$80660215,619-2.7%
Colorado$206$9331422,157-4.0%
Missouri$205$1,3221342,248-4.9%
South Dakota$204$71323681-5.2%
Oregon$204$9051231,401-5.4%
Minnesota$200$1,1031472,196-6.8%
Montana$198$69639711-7.7%
New Mexico$198$59726600-7.7%
Louisiana$198$1,0101361,855-8.1%
Alabama$197$858971,837-8.4%
Georgia$193$1,0622064,352-10.1%
Nevada$193$758411,526-10.1%
Delaware$193$1,34423653-10.2%
Maine$188$86334323-12.5%
Kansas$188$1,377732,310-12.7%
Indiana$188$9731943,759-12.7%
Arizona$185$8771585,275-14.0%
Ohio$185$8982935,443-14.1%
Nebraska$184$909561,242-14.5%
North Dakota$184$96527318-14.6%
Arkansas$179$890791,764-16.9%
Tennessee$177$8811592,418-17.7%
Mississippi$175$1,156741,627-18.5%
Idaho$161$54140815-25.3%

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

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