Dilation of tear drainage opening
Medicare pricing data for 3,203 providers across 50 states
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
Dilation of tear drainage opening (HCPCS code 68801) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $97.51, but hospitals typically charge $287.45 — 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 $97.51, your out-of-pocket cost would be approximately $19.50. 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 $72.81 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New Jersey | $126 | $307 | 108 | 476 | +29.1% |
| Hawaii | $119 | $304 | 14 | 78 | +21.7% |
| South Dakota | $118 | $615 | 19 | 92 | +20.7% |
| Alaska | $114 | $489 | 15 | 40 | +17.4% |
| Maryland | $114 | $311 | 34 | 127 | +16.9% |
| Texas | $113 | $246 | 207 | 894 | +16.1% |
| Maine | $113 | $289 | 11 | 94 | +15.7% |
| Delaware | $112 | $345 | 10 | 12 | +14.6% |
| Pennsylvania | $112 | $316 | 143 | 781 | +14.4% |
| Michigan | $111 | $355 | 93 | 493 | +14.0% |
| Wisconsin | $109 | $777 | 58 | 241 | +11.3% |
| Washington | $109 | $344 | 88 | 270 | +11.3% |
| Montana | $108 | $176 | 35 | 120 | +10.6% |
| Colorado | $106 | $280 | 50 | 218 | +8.9% |
| Connecticut | $105 | $284 | 33 | 150 | +7.7% |
| North Carolina | $102 | $304 | 93 | 455 | +4.9% |
| Massachusetts | $102 | $278 | 46 | 188 | +4.5% |
| Minnesota | $101 | $377 | 54 | 126 | +3.7% |
| Idaho | $101 | $194 | 31 | 107 | +3.7% |
| Louisiana | $101 | $365 | 54 | 258 | +3.4% |
| New Mexico | $100 | $226 | 16 | 39 | +2.3% |
| North Dakota | $99 | $292 | 11 | 36 | +1.5% |
| Arkansas | $97 | $270 | 34 | 102 | -0.3% |
| Missouri | $97 | $246 | 61 | 187 | -0.6% |
| Virginia | $97 | $277 | 73 | 270 | -0.6% |
| California | $97 | $287 | 323 | 2,520 | -0.8% |
| Oregon | $96 | $271 | 76 | 238 | -1.1% |
| Florida | $95 | $235 | 199 | 1,579 | -2.2% |
| Nebraska | $95 | $348 | 30 | 91 | -2.5% |
| Mississippi | $95 | $246 | 42 | 191 | -2.6% |
| Ohio | $95 | $194 | 77 | 183 | -2.7% |
| Indiana | $94 | $226 | 64 | 146 | -3.2% |
| Tennessee | $94 | $260 | 61 | 229 | -3.3% |
| New York | $94 | $285 | 211 | 1,815 | -3.5% |
| Puerto Rico | $93 | $102 | 10 | 52 | -4.6% |
| Georgia | $93 | $264 | 65 | 226 | -4.8% |
| Kentucky | $92 | $248 | 33 | 61 | -5.3% |
| Illinois | $92 | $279 | 101 | 595 | -6.0% |
| Vermont | $91 | $222 | 8 | 12 | -6.8% |
| West Virginia | $90 | $323 | 16 | 51 | -7.2% |
| Utah | $89 | $226 | 45 | 216 | -8.7% |
| Oklahoma | $88 | $185 | 48 | 81 | -9.4% |
| Iowa | $88 | $212 | 65 | 262 | -9.7% |
| Alabama | $85 | $213 | 48 | 227 | -12.6% |
| Wyoming | $84 | $136 | 8 | 29 | -13.9% |
| South Carolina | $81 | $301 | 64 | 397 | -16.4% |
| New Hampshire | $78 | $216 | 16 | 91 | -20.1% |
| Kansas | $78 | $212 | 40 | 221 | -20.3% |
| Arizona | $77 | $303 | 55 | 1,066 | -20.7% |
| Nevada | $76 | $239 | 17 | 55 | -22.1% |
⚠️ 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