Cataract surgery: $8,691 or $618?
by Denise Early on Nov. 07, 2009, under HealthHow much does cataract surgery cost? It depends on your insurance coverage and whether or not you go to a doctor “in-network”.
The information below is from a recent survey of America’s Health Insurance Plan members. The “billed amount” is what doctors try to get from insurance companies when the patient is out-of-network. It is also the amount you might have to pay if you don’t have insurance.
The “Medicare fee” column shows how much Medicare pays for the service. Private insurance companies usually pay an amount that is somewhat higher than what Medicare pays, but much less than the charges for “out-of-network” services.
VARIOUS OUT-OF-NETWORK PHYSICIAN CLAIMS
FILED IN THE STATE OF ARIZONA IN 2008
| Code | Service | Amt Billed |
Medicare fee |
| 99215 | Outpatient office visits of moderate to high severityrequiring 2 out of 3: comprehensive history,comprehensive exam and high complexity medical | $ 2,000.00 | $ 120.02 |
| 66984 | Cataract surgery with insertion of artificial lens | $ 8,691.00 | $ 618.60 |
| 36471 | Chemical injection to kill leg veins | $ 2,200.00 | $ 165.20 |
| 27130 | Total hip replacement | $ 17,357.00 | $ 1,315.60 |
| 29881 | Minimally invasive knee meniscus surgery | $ 6,577.08 | $ 578.18 |
| 22612 | Lower back spinal fusion | $ 14,000.00 | $ 1,439.69 |
| 47562 | Laparoscopic gallbladder removal | $ 4,500.00 | $ 632.56 |
| 99244 | Outpatient office consults of moderate to high severity requiring a comprehensive history, comprehensive examand moderate complexity medical decision‐making |
$ 1,190.00 |
$ 176.83 |
