67036

Removal of eye fluid (vitreous) between lens and retina

Medicare pricing data for 3,404 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $275 in District of Columbia to $1,878 in Alaska. 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

Removal of eye fluid (vitreous) between lens and retina (HCPCS code 67036) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,124, but hospitals typically charge $4,462 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$224.90

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,124, your out-of-pocket cost would be approximately $224.90. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,124
Average Hospital Charge
$4,462
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,461.77
Medicare Allowed$1,124.49
Medicare Payment$893.73

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $893.73 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,878$11,639582+67.0%
South Dakota$1,335$3,50414201+18.8%
New Hampshire$1,315$5,6231176+17.0%
Colorado$1,295$5,004671,060+15.2%
Arizona$1,285$3,541651,170+14.3%
South Carolina$1,283$4,59347770+14.1%
Washington$1,270$3,23074836+13.0%
Minnesota$1,253$6,48740404+11.5%
Idaho$1,234$3,63317285+9.7%
Indiana$1,224$6,76750632+8.9%
Hawaii$1,222$3,99617168+8.7%
Florida$1,219$4,6712643,030+8.4%
Montana$1,216$3,06614102+8.1%
California$1,204$5,3794133,185+7.1%
Connecticut$1,200$6,32443277+6.7%
Georgia$1,188$4,57567471+5.7%
Oregon$1,170$2,73253539+4.0%
Rhode Island$1,160$3,0131056+3.2%
Texas$1,157$6,1142392,610+2.8%
Utah$1,155$5,00739521+2.7%
New Mexico$1,122$2,48117216-0.2%
Louisiana$1,119$3,84953435-0.4%
Nebraska$1,112$3,56721185-1.1%
New Jersey$1,110$5,01394722-1.3%
New York$1,099$4,7792221,805-2.3%
Kentucky$1,092$4,36038643-2.9%
Kansas$1,088$4,74836414-3.2%
Mississippi$1,083$2,60927471-3.7%
Oklahoma$1,068$4,46224256-5.0%
Tennessee$1,064$4,29778799-5.4%
North Dakota$1,062$3,938769-5.6%
Virginia$1,061$3,72282718-5.7%
Maryland$1,060$5,13888719-5.8%
Vermont$1,054$4,281640-6.2%
Delaware$1,047$1,853661-6.9%
Missouri$1,045$3,59668684-7.0%
Nevada$1,043$4,19528219-7.2%
Pennsylvania$1,042$3,4621451,113-7.3%
Ohio$1,023$3,7411421,497-9.0%
Massachusetts$992$3,265118735-11.8%
Illinois$968$3,474121915-13.9%
North Carolina$955$2,93786666-15.0%
Maine$948$5,0851588-15.7%
Alabama$906$2,89548410-19.5%
West Virginia$898$2,6651182-20.2%
Michigan$897$2,643102564-20.2%
Iowa$889$4,43935398-20.9%
Arkansas$834$2,52520133-25.8%
Wisconsin$834$6,83452361-25.9%
District of Columbia$275$2,534464-75.5%

⚠️ 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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