Insertion of drug delivery implant into tear duct of eye
Medicare pricing data for 1,140 providers across 41 states
This procedure has a 12.7x markup — hospitals charge $213.96 but Medicare allows only $16.85. Uninsured patients may face bills 12.7 times higher than what insurance negotiates. Prices vary significantly by location — from $15 in Tennessee to $49 in South Dakota. 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
Insertion of drug delivery implant into tear duct of eye (HCPCS code 68841) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $16.85, but hospitals typically charge $213.96 — a 12.7x 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 $16.85, your out-of-pocket cost would be approximately $3.37. 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 12.7x more than what Medicare allows for this procedure. Medicare actually pays $13.44 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| South Dakota | $49 | $501 | 3 | 16 | +192.3% |
| Pennsylvania | $20 | $490 | 47 | 2,828 | +17.6% |
| Florida | $19 | $183 | 104 | 6,131 | +13.9% |
| New York | $19 | $211 | 84 | 4,521 | +11.8% |
| New Jersey | $18 | $213 | 103 | 9,902 | +6.4% |
| California | $18 | $286 | 66 | 4,309 | +4.9% |
| Connecticut | $18 | $164 | 21 | 1,373 | +4.1% |
| Texas | $17 | $259 | 78 | 4,448 | +3.6% |
| Maryland | $17 | $112 | 18 | 931 | +1.8% |
| Massachusetts | $17 | $168 | 33 | 2,543 | +1.8% |
| Illinois | $17 | $182 | 36 | 2,795 | -0.1% |
| New Hampshire | $17 | $150 | 6 | 410 | -0.4% |
| Michigan | $17 | $213 | 50 | 1,938 | -0.7% |
| Colorado | $17 | $135 | 4 | 38 | -0.8% |
| Arkansas | $17 | $126 | 6 | 251 | -2.0% |
| Rhode Island | $16 | $162 | 3 | 492 | -2.1% |
| Wyoming | $16 | $194 | 1 | 240 | -3.4% |
| Utah | $16 | $340 | 3 | 114 | -3.7% |
| Delaware | $16 | $55 | 2 | 1,003 | -4.3% |
| Kansas | $16 | $195 | 16 | 2,004 | -4.3% |
| Ohio | $16 | $341 | 51 | 1,200 | -4.6% |
| Virginia | $16 | $239 | 33 | 6,852 | -4.9% |
| Washington | $16 | $76 | 3 | 58 | -4.9% |
| Nevada | $16 | $146 | 9 | 371 | -5.2% |
| Minnesota | $16 | $307 | 4 | 217 | -5.3% |
| Arizona | $16 | $93 | 32 | 7,831 | -5.5% |
| Alabama | $16 | $204 | 14 | 607 | -5.5% |
| Georgia | $16 | $389 | 28 | 2,089 | -5.6% |
| Missouri | $16 | $426 | 23 | 1,784 | -6.3% |
| Kentucky | $16 | $396 | 14 | 859 | -7.1% |
| New Mexico | $16 | $206 | 4 | 1,299 | -7.3% |
| North Carolina | $16 | $169 | 28 | 3,283 | -8.0% |
| Oklahoma | $15 | $84 | 16 | 577 | -8.1% |
| Louisiana | $15 | $279 | 11 | 666 | -8.6% |
| Wisconsin | $15 | $174 | 28 | 1,503 | -8.7% |
| Iowa | $15 | $91 | 8 | 800 | -9.1% |
| Nebraska | $15 | $46 | 4 | 735 | -9.6% |
| South Carolina | $15 | $134 | 25 | 2,482 | -9.7% |
| Indiana | $15 | $258 | 39 | 2,717 | -9.9% |
| Mississippi | $15 | $208 | 33 | 3,243 | -11.2% |
| Tennessee | $15 | $87 | 14 | 1,117 | -11.5% |
⚠️ 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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