Medicare and More

by medicareblogger on Nov.07, 2009, under Health

Cataract surgery: $8,691 or $618?

How 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