66989

Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye

Medicare pricing data for 2,372 providers across 44 states

🤖AI Overview

Prices vary significantly by location — from $62 in North Carolina to $2,246 in Nevada. 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

Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye (HCPCS code 66989) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $806.00, but hospitals typically charge $2,563 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$161.20

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $806.00, your out-of-pocket cost would be approximately $161.20. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$806.00
Average Hospital Charge
$2,563
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,563.18
Medicare Allowed$806.00
Medicare Payment$640.68

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $640.68 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nevada$2,246$7,1991755+178.7%
Oregon$2,246$5,2083077+178.7%
Delaware$2,174$6,8161159+169.7%
California$2,134$7,8303221,527+164.7%
Maryland$2,052$4,22332159+154.6%
New Jersey$2,019$6,01596438+150.5%
Arizona$2,014$4,76647126+149.8%
Idaho$1,980$4,9651557+145.7%
New Hampshire$1,959$6,4901357+143.1%
Arkansas$1,839$4,1091751+128.2%
Georgia$1,810$4,35659178+124.5%
Colorado$1,790$5,5912768+122.1%
Connecticut$1,787$6,1072796+121.7%
Florida$1,750$5,329145377+117.1%
Washington$1,713$4,24156124+112.5%
Nebraska$1,662$5,2632469+106.2%
Tennessee$1,656$5,17840127+105.4%
Utah$1,651$7,69726100+104.9%
Texas$1,631$5,910105269+102.4%
Indiana$1,631$5,43942136+102.3%
Illinois$1,611$6,88546116+99.8%
Mississippi$1,610$4,01325103+99.7%
South Dakota$1,572$3,8501677+95.0%
Michigan$1,557$5,40345146+93.1%
Pennsylvania$1,544$4,401129411+91.6%
Missouri$1,521$5,05346127+88.7%
South Carolina$1,513$4,3842655+87.7%
Oklahoma$1,478$4,2132884+83.4%
North Dakota$1,438$5,3271344+78.4%
Montana$1,418$3,8041553+75.9%
West Virginia$1,233$2,9291226+53.0%
Rhode Island$1,199$3,6831237+48.7%
Massachusetts$1,177$3,07481461+46.1%
Iowa$1,146$3,42944155+42.2%
New Mexico$1,134$2,3261261+40.7%
Louisiana$1,131$4,3862357+40.4%
New York$1,125$3,3101341,015+39.6%
Kansas$935$4,1572599+15.9%
Virginia$902$1,96843194+11.9%
Ohio$729$2,10760343-9.5%
Alabama$598$1,25920157-25.9%
Wisconsin$155$894481,100-80.8%
Minnesota$130$518642,054-83.9%
North Carolina$62$200843,878-92.3%

⚠️ 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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