Imaging of retina with remote review by physician
Medicare pricing data for 2,132 providers across 38 states
Prices vary significantly by location — from $13 in Montana to $28 in Virginia. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Imaging of retina with remote review by physician (HCPCS code 92228) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $22.93, but hospitals typically charge $74.49 — a 3.2x 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 $22.93, your out-of-pocket cost would be approximately $4.59. 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 3.2x more than what Medicare allows for this procedure. Medicare actually pays $15.15 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Virginia | $28 | $81 | 10 | 43 | +23.1% |
| Pennsylvania | $28 | $86 | 191 | 1,823 | +21.0% |
| Indiana | $27 | $48 | 5 | 14 | +19.6% |
| Maryland | $27 | $99 | 18 | 101 | +19.4% |
| Delaware | $27 | $60 | 10 | 32 | +16.7% |
| Georgia | $27 | $92 | 70 | 363 | +16.4% |
| New Jersey | $27 | $91 | 85 | 248 | +16.4% |
| Arizona | $26 | $64 | 179 | 566 | +14.8% |
| Kansas | $26 | $62 | 12 | 19 | +14.7% |
| New York | $26 | $99 | 107 | 413 | +14.4% |
| Florida | $26 | $68 | 59 | 138 | +13.5% |
| Utah | $26 | $59 | 76 | 173 | +13.2% |
| Mississippi | $26 | $54 | 6 | 52 | +12.7% |
| South Carolina | $26 | $70 | 120 | 364 | +12.7% |
| Ohio | $26 | $111 | 17 | 103 | +12.4% |
| Alabama | $26 | $72 | 6 | 14 | +12.2% |
| Illinois | $25 | $56 | 59 | 332 | +10.8% |
| Nebraska | $25 | $86 | 6 | 13 | +10.6% |
| Massachusetts | $24 | $72 | 25 | 61 | +4.5% |
| Arkansas | $24 | $75 | 7 | 58 | +4.5% |
| Wyoming | $24 | $72 | 4 | 11 | +4.1% |
| Oregon | $24 | $101 | 40 | 80 | +4.1% |
| Tennessee | $23 | $68 | 24 | 88 | +0.3% |
| Michigan | $22 | $65 | 72 | 272 | -3.3% |
| Idaho | $22 | $53 | 38 | 188 | -4.1% |
| Texas | $20 | $73 | 134 | 719 | -10.9% |
| California | $20 | $78 | 173 | 909 | -10.9% |
| Kentucky | $19 | $65 | 18 | 53 | -16.2% |
| Connecticut | $19 | $48 | 14 | 38 | -17.0% |
| Wisconsin | $19 | $58 | 7 | 14 | -17.7% |
| Washington | $19 | $63 | 111 | 207 | -18.0% |
| Louisiana | $19 | $73 | 68 | 304 | -18.1% |
| Nevada | $18 | $43 | 11 | 32 | -23.0% |
| North Carolina | $18 | $73 | 159 | 1,033 | -23.5% |
| New Mexico | $17 | $45 | 12 | 102 | -27.5% |
| Missouri | $15 | $55 | 82 | 525 | -35.7% |
| Colorado | $14 | $53 | 48 | 74 | -40.3% |
| Montana | $13 | $32 | 30 | 60 | -42.7% |
⚠️ 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