Here is the average 2007 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient), and average payment (Medicare payments divided by allowed services, not including co-pays and deductibles paid by patient) for two ophthalmology procedures commonly performed in ASCs.
1. Post-cataract laser surgery (CPT 66821)
– average sub charge: $1,006
– average allow charge $307
– average payment: $241
2. Cataract removal, insertion of lens (CPT 66984)
– average sub charge: $2,827
– average allow charge $966
– average payment: $766
