92286

Imaging of front third of eye using a special microscope

Medicare pricing data for 3,192 providers across 50 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

Imaging of front third of eye using a special microscope (HCPCS code 92286) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $38.80, but hospitals typically charge $165.78 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.76

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $38.80, your out-of-pocket cost would be approximately $7.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$38.80
Average Hospital Charge
$165.78
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$165.78
Medicare Allowed$38.80
Medicare Payment$28.92

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $28.92 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$46$273427+18.2%
District of Columbia$43$17610349+11.2%
Maryland$43$163762,531+10.5%
New York$42$18248529,267+9.4%
New Jersey$42$1731485,658+7.8%
Connecticut$41$23331406+6.9%
California$41$1752497,756+6.4%
Hawaii$41$216171,256+4.8%
Delaware$39$19015638+1.3%
Rhode Island$39$135774+0.7%
Nevada$39$1081185+0.1%
North Dakota$38$1701283-0.9%
Oregon$38$21424395-1.5%
Virginia$38$16242590-2.0%
Illinois$38$214891,574-2.0%
Montana$38$65676-2.3%
Florida$38$14730510,601-2.7%
Washington$38$12244669-2.8%
Pennsylvania$38$1471462,992-2.8%
Minnesota$38$151581,060-3.3%
Michigan$37$146761,272-3.6%
Texas$37$1613167,346-4.3%
South Dakota$37$16919347-4.7%
Colorado$37$13835315-5.8%
Massachusetts$36$1941042,161-6.1%
South Carolina$36$14337686-6.5%
New Hampshire$36$1256182-6.5%
Missouri$36$119821,715-6.5%
Puerto Rico$36$7612299-6.5%
Maine$36$138119-6.6%
Indiana$36$104492,269-7.0%
Nebraska$36$17324499-7.1%
New Mexico$36$63846-7.1%
Idaho$36$14310208-7.5%
Georgia$36$189641,071-7.6%
Kentucky$36$14030179-7.7%
Kansas$36$141381,630-7.8%
Utah$35$12721210-8.6%
Louisiana$35$10233352-8.7%
West Virginia$35$109368-9.3%
Oklahoma$35$9643910-9.4%
Tennessee$35$179762,078-9.5%
Alabama$35$229251,469-10.7%
Wisconsin$34$28128224-12.3%
Mississippi$34$18025632-12.8%
Iowa$32$121331,334-17.8%
Ohio$31$222571,054-19.7%
North Carolina$31$117582,855-20.2%
Arkansas$25$12117692-35.4%
Arizona$25$129591,549-36.5%

⚠️ 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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