92071

Fitting of contact lens for treatment of eye surface disease

Medicare pricing data for 9,543 providers across 51 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

Fitting of contact lens for treatment of eye surface disease (HCPCS code 92071) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $37.33, but hospitals typically charge $108.28 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.47

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $37.33, your out-of-pocket cost would be approximately $7.47. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$37.33
Average Hospital Charge
$108.28
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$108.28
Medicare Allowed$37.33
Medicare Payment$28.10

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $28.10 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$46$11523150+23.4%
District of Columbia$43$911324+15.3%
New York$41$1665033,093+8.9%
Maryland$40$128176861+8.3%
California$40$1146914,008+7.1%
New Jersey$40$1162491,024+6.8%
Massachusetts$39$1732331,074+5.5%
Connecticut$39$118118558+5.2%
Colorado$39$99184748+4.2%
Hawaii$39$1243075+3.5%
Texas$38$1006723,720+1.7%
Washington$38$92221866+1.3%
Rhode Island$37$10450165-0.4%
Florida$37$1007255,191-0.5%
Minnesota$37$113174635-0.6%
New Hampshire$37$11655235-0.9%
Illinois$37$1134081,930-1.1%
North Dakota$37$11659292-1.2%
Delaware$37$9422121-1.2%
Virginia$37$1202751,155-1.6%
New Mexico$37$8736221-1.7%
South Dakota$37$8245163-1.7%
Michigan$37$1022761,100-1.8%
Arizona$37$882101,223-1.9%
Tennessee$37$1082581,317-1.9%
Montana$37$7643269-2.1%
Nevada$36$9885448-2.6%
Pennsylvania$36$973851,579-2.7%
Missouri$36$110202657-2.9%
Wyoming$36$9042157-3.2%
Utah$36$7868209-4.2%
Kentucky$36$91157707-4.3%
Georgia$36$104228773-4.5%
North Carolina$36$912611,022-4.7%
Oregon$36$81134449-4.9%
Mississippi$35$91125511-5.3%
Vermont$35$892598-5.5%
Iowa$35$86167577-5.7%
Ohio$35$1233481,125-5.7%
South Carolina$35$90142471-6.5%
Wisconsin$35$127159531-6.5%
Idaho$35$10664218-6.9%
Alabama$35$82169733-6.9%
Indiana$35$88241737-7.0%
Kansas$35$84141568-7.1%
Oklahoma$35$77147567-7.3%
Arkansas$34$81105386-7.7%
Nebraska$34$8093439-7.9%
West Virginia$34$9960243-8.1%
Maine$34$8859184-8.4%
Louisiana$34$88119450-10.2%

⚠️ 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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