92202

Extended exam of the back part of the eye with optic nerve drawing

Medicare pricing data for 4,380 providers across 49 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

Extended exam of the back part of the eye with optic nerve drawing (HCPCS code 92202) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $16.25, but hospitals typically charge $77.51 — a 4.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.25

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $16.25, your out-of-pocket cost would be approximately $3.25. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$16.25
Average Hospital Charge
$77.51
Markup Ratio
4.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$77.51
Medicare Allowed$16.25
Medicare Payment$12.08

Hospitals charge 4.8x more than what Medicare allows for this procedure. Medicare actually pays $12.08 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$17$11551,947+7.0%
New York$17$94973129,009+6.9%
Maryland$17$1099751,576+4.5%
New Jersey$17$9136059,501+4.4%
California$17$8847672,973+3.1%
Colorado$16$88294,105+1.4%
Connecticut$16$717711,835+1.1%
Massachusetts$16$8711511,354+0.6%
Washington$16$57568,479-0.2%
Virginia$16$889238,036-0.3%
Hawaii$16$107267,735-0.4%
Rhode Island$16$52131,785-1.6%
Pennsylvania$16$741518,392-2.3%
New Hampshire$16$4131578-3.4%
Illinois$16$5117034,373-3.5%
Kansas$16$4411724-3.8%
Nevada$16$75132,968-3.9%
Minnesota$16$7815919-4.0%
Montana$16$809999-4.1%
Florida$15$5237767,887-4.9%
Tennessee$15$83355,100-5.0%
Oregon$15$5121462-5.2%
West Virginia$15$455323-5.2%
Delaware$15$3171,165-5.7%
Puerto Rico$15$181193,643-5.7%
Wyoming$15$216605-5.8%
Texas$15$5821837,832-6.2%
Arizona$15$38608,345-6.3%
Maine$15$565372-6.6%
Vermont$15$746379-7.0%
Missouri$15$588921,112-7.0%
Michigan$15$7111010,196-7.1%
North Carolina$15$73838,730-7.2%
Kentucky$15$103341,872-7.3%
Ohio$15$589810,765-7.8%
Georgia$15$47271,774-8.3%
Utah$15$68213,270-8.5%
South Carolina$15$5125882-8.7%
Indiana$15$317611,713-8.9%
New Mexico$15$48124,218-9.0%
Iowa$15$4220432-9.4%
Louisiana$15$66554,942-9.6%
Idaho$15$547926-9.7%
Alabama$15$28161,427-10.3%
Wisconsin$15$103462,892-10.5%
Oklahoma$15$33224,331-10.6%
Arkansas$14$51273,915-11.1%
Nebraska$14$44787-11.4%
Mississippi$14$140131,237-12.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber