Extended exam of the back part of the eye with retinal drawing
Medicare pricing data for 5,764 providers across 51 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
Extended exam of the back part of the eye with retinal drawing (HCPCS code 92201) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $25.80, but hospitals typically charge $86.44 — a 3.4x 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 $25.80, your out-of-pocket cost would be approximately $5.16. 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 3.4x more than what Medicare allows for this procedure. Medicare actually pays $19.16 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $32 | $118 | 12 | 135 | +23.6% |
| New York | $28 | $113 | 776 | 89,477 | +7.8% |
| District of Columbia | $28 | $117 | 12 | 484 | +7.1% |
| New Jersey | $27 | $93 | 396 | 39,865 | +4.5% |
| California | $27 | $93 | 658 | 73,532 | +3.9% |
| Massachusetts | $26 | $95 | 180 | 13,409 | +1.7% |
| Maryland | $26 | $93 | 132 | 25,396 | +1.3% |
| Connecticut | $26 | $105 | 101 | 4,597 | +1.0% |
| Virginia | $26 | $91 | 138 | 12,911 | +0.6% |
| Hawaii | $26 | $113 | 31 | 1,809 | -1.2% |
| Colorado | $25 | $75 | 52 | 2,860 | -1.6% |
| Washington | $25 | $55 | 76 | 2,187 | -1.6% |
| Illinois | $25 | $56 | 243 | 29,951 | -2.6% |
| Rhode Island | $25 | $65 | 21 | 331 | -3.2% |
| Pennsylvania | $25 | $80 | 275 | 11,038 | -3.9% |
| New Hampshire | $25 | $59 | 41 | 1,287 | -4.0% |
| Florida | $25 | $73 | 440 | 39,608 | -4.7% |
| Oregon | $25 | $69 | 62 | 740 | -4.8% |
| Montana | $25 | $80 | 20 | 455 | -4.8% |
| Delaware | $25 | $61 | 19 | 652 | -4.9% |
| Michigan | $24 | $62 | 233 | 13,633 | -5.3% |
| Nevada | $24 | $81 | 25 | 3,178 | -5.3% |
| Puerto Rico | $24 | $37 | 100 | 2,209 | -5.8% |
| Wisconsin | $24 | $119 | 98 | 3,242 | -5.9% |
| Ohio | $24 | $82 | 151 | 6,910 | -6.2% |
| Minnesota | $24 | $88 | 44 | 634 | -6.3% |
| Missouri | $24 | $56 | 129 | 10,045 | -6.5% |
| Texas | $24 | $65 | 306 | 31,431 | -6.6% |
| Tennessee | $24 | $79 | 49 | 979 | -7.4% |
| Arizona | $24 | $41 | 78 | 8,956 | -7.4% |
| Vermont | $24 | $68 | 17 | 682 | -7.8% |
| Georgia | $24 | $91 | 109 | 2,698 | -7.9% |
| North Carolina | $24 | $82 | 121 | 6,610 | -8.0% |
| Maine | $24 | $79 | 14 | 359 | -8.1% |
| Kentucky | $24 | $113 | 36 | 1,702 | -8.8% |
| South Dakota | $24 | $64 | 6 | 58 | -8.8% |
| Kansas | $23 | $60 | 31 | 3,745 | -9.2% |
| New Mexico | $23 | $116 | 7 | 124 | -9.3% |
| Indiana | $23 | $116 | 99 | 6,265 | -9.4% |
| Utah | $23 | $70 | 48 | 2,562 | -9.7% |
| Nebraska | $23 | $58 | 15 | 230 | -9.8% |
| South Carolina | $23 | $62 | 37 | 2,078 | -10.1% |
| Oklahoma | $23 | $62 | 37 | 5,437 | -10.2% |
| West Virginia | $23 | $61 | 20 | 187 | -10.3% |
| Louisiana | $23 | $94 | 62 | 5,352 | -10.5% |
| Iowa | $23 | $67 | 60 | 1,169 | -10.7% |
| Mississippi | $23 | $57 | 18 | 777 | -11.2% |
| Idaho | $23 | $53 | 22 | 215 | -11.4% |
| Alabama | $23 | $53 | 28 | 391 | -12.0% |
| Arkansas | $23 | $61 | 39 | 1,028 | -12.1% |
| North Dakota | $22 | $68 | 3 | 19 | -13.3% |
⚠️ 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