92020

Exam of the internal drainage system of eye

Medicare pricing data for 20,238 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

Exam of the internal drainage system of eye (HCPCS code 92020) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.41, but hospitals typically charge $68.91 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.68

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.41, your out-of-pocket cost would be approximately $5.68. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.41
Average Hospital Charge
$68.91
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$68.91
Medicare Allowed$28.41
Medicare Payment$20.66

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $20.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$34$133811,160+21.1%
District of Columbia$31$90494,034+9.2%
New York$31$801,629104,240+9.0%
California$31$741,837100,786+8.1%
New Jersey$31$7475549,652+7.4%
Maryland$30$6342630,057+4.5%
Connecticut$30$9129911,241+3.9%
Hawaii$29$831325,061+2.1%
Rhode Island$28$671081,869-0.3%
Massachusetts$28$8161412,891-0.4%
Washington$28$6348711,324-0.8%
Virginia$28$6155521,428-2.3%
Delaware$28$68662,910-2.7%
Pennsylvania$28$601,03239,069-2.9%
New Hampshire$28$661453,425-3.1%
Illinois$27$7381828,773-3.4%
Nevada$27$661185,720-3.8%
Oregon$27$692724,340-4.1%
Florida$27$591,32159,971-4.1%
Puerto Rico$27$30861,078-4.3%
Wyoming$27$8931324-4.6%
Colorado$27$682704,148-4.8%
Texas$27$691,26141,168-4.9%
Minnesota$27$833784,799-5.2%
Michigan$27$6056216,515-5.3%
South Dakota$27$56771,356-5.5%
Arizona$27$5638513,207-5.6%
Montana$27$54761,454-6.2%
Georgia$26$7050912,441-6.8%
North Carolina$26$5858115,426-7.8%
Missouri$26$614349,158-7.8%
Maine$26$601132,122-8.2%
Indiana$26$543887,715-8.4%
Kansas$26$582045,878-8.8%
South Carolina$26$593027,975-8.8%
Utah$26$611231,438-9.3%
New Mexico$26$531281,911-9.4%
Nebraska$26$681342,391-9.5%
Ohio$26$6872520,228-10.0%
Iowa$26$672023,868-10.1%
Kentucky$26$572364,638-10.1%
Oklahoma$25$592595,688-10.5%
Tennessee$25$564387,660-10.6%
Alabama$25$522505,747-10.9%
Idaho$25$6790786-11.2%
Wisconsin$25$953635,032-11.3%
Vermont$25$63611,513-11.4%
Louisiana$25$702526,030-12.0%
Mississippi$25$631734,362-12.4%
Arkansas$25$542055,447-12.5%
North Dakota$25$5658867-13.3%
West Virginia$25$601102,691-13.5%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber