Cost analysis for CPT 65855 — Laser repair to improve eye fluid flow
Average Medicare Payment
$168.10
2023 data
Total Payments (2023)
$21.6M
Services (2023)
133.1K
Price Change (2014–2023)
-32.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $249.48 | $37.2M | 155.2K | — |
| 2015 | $240.31 | $36.7M | 158.5K | -3.7% |
| 2016 | $193.61 | $31.0M | 164.7K | -19.4% |
| 2017 | $166.37 | $25.5M | 159.4K | -14.1% |
| 2018 | $169.55 | $24.3M | 149.0K | +1.9% |
| 2019 | $173.70 | $24.7M | 147.5K | +2.4% |
| 2020 | $172.29 | $20.4M | 122.1K | -0.8% |
| 2021 | $174.72 | $22.7M | 133.9K | +1.4% |
| 2022 | $168.74 | $21.1M | 128.8K | -3.4% |
| 2023 | $168.10 | $21.6M | 133.1K | -0.4% |
The most expensive state pays 2.1x more than the cheapest for this procedure. AK averages $241.79 vs ID at $115.49.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $241.79 | $28.0K | 116 | 4 |
| CT | $207.90 | $224.3K | 1.1K | 28 |
| DC | $207.26 | $115.2K | 556 | 8 |
| CA | $188.23 | $2.9M | 15.6K | 297 |
| RI | $184.95 | $38.7K | 209 | 6 |
| NY | $179.25 | $1.2M | 6.6K | 146 |
| NJ | $176.63 | $897.7K | 5.1K | 95 |
| IL | $173.86 | $788.8K | 4.5K | 99 |
| NH | $173.48 | $200.5K | 1.2K | 25 |
| NC | $172.37 | $551.6K | 3.2K | 72 |
| MN | $172.26 | $229.1K | 1.3K | 36 |
| MD | $171.47 | $569.1K | 3.3K | 73 |
| VT | $171.43 | $28.8K | 168 | 7 |
| WY | $171.30 | $61.3K | 358 | 5 |
| VA | $167.80 | $845.7K | 5.0K | 88 |
| MI | $164.68 | $517.1K | 3.1K | 79 |
| OK | $164.54 | $286.3K | 1.7K | 29 |
| PA | $164.12 | $1.2M | 7.3K | 170 |
| WI | $162.42 | $257.4K | 1.6K | 39 |
| UT | $162.14 | $119.2K | 735 | 22 |
| IA | $161.45 | $94.0K | 582 | 19 |
| KY | $160.67 | $148.0K | 921 | 33 |
| WA | $160.57 | $473.2K | 2.9K | 80 |
| SC | $159.85 | $388.8K | 2.4K | 58 |
| AL | $158.64 | $226.1K | 1.4K | 34 |
| MA | $158.46 | $923.2K | 5.8K | 104 |
| FL | $158.10 | $2.2M | 13.7K | 233 |
| TX | $157.16 | $1.1M | 6.8K | 151 |
| HI | $157.15 | $108.0K | 687 | 13 |
| WV | $154.35 | $86.7K | 562 | 15 |
| CO | $153.71 | $261.8K | 1.7K | 43 |
| MO | $153.27 | $255.2K | 1.7K | 42 |
| SD | $153.23 | $95.0K | 620 | 11 |
| OR | $152.90 | $147.9K | 967 | 30 |
| NM | $148.95 | $82.1K | 551 | 14 |
| MT | $148.32 | $84.7K | 571 | 12 |
| DE | $146.68 | $91.4K | 623 | 13 |
| NV | $145.01 | $205.8K | 1.4K | 20 |
| GA | $144.54 | $523.7K | 3.6K | 76 |
| KS | $141.91 | $295.6K | 2.1K | 28 |
| LA | $141.49 | $186.5K | 1.3K | 33 |
| AZ | $140.88 | $678.9K | 4.8K | 75 |
| IN | $140.66 | $439.8K | 3.1K | 69 |
| ME | $139.24 | $26.7K | 192 | 8 |
| NE | $137.03 | $146.5K | 1.1K | 26 |
| OH | $135.78 | $604.0K | 4.4K | 105 |
| ND | $132.93 | $33.4K | 251 | 10 |
| TN | $130.81 | $234.5K | 1.8K | 44 |
| AR | $129.59 | $180.0K | 1.4K | 24 |
| MS | $128.92 | $181.9K | 1.4K | 31 |
| ID | $115.49 | $76.1K | 659 | 12 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Scott Greenbaum | Ophthalmology | NY | $86.7K | 763 | $113.60 |
| Andrew Cho | Ophthalmology | CA | $84.9K | 407 | $208.55 |
| Richard Weise | Ophthalmology | CA | $81.4K | 465 | $174.99 |
| Amber Dobler-Dixon | Ophthalmology | TX | $80.1K | 436 | $183.77 |
| Sok Nam | Ophthalmology | CA | $80.1K | 375 | $213.58 |
| Joshua Kim | Ophthalmology | FL | $79.4K | 307 | $258.47 |
| David Sutton | Ophthalmology | NC | $78.6K | 426 | $184.45 |
| Anthony Economou | Ophthalmology | OK | $73.6K | 427 | $172.27 |
| Jeffrey Sedgewick | Ophthalmology | VA | $69.3K | 376 | $184.32 |
| Idida Kaplan | Ophthalmology | NY | $68.9K | 303 | $227.47 |
| Douglas Grayson | Ophthalmology | NJ | $68.0K | 327 | $207.86 |
| Lisa Bunin | Ophthalmology | PA | $67.6K | 371 | $182.21 |
| Keshav Narain | Ophthalmology | CA | $60.4K | 265 | $227.98 |
| Thomas Newsom | Ophthalmology | FL | $59.5K | 388 | $153.34 |
| Reena Patel | Ophthalmology | KS | $56.6K | 255 | $221.87 |
| Mark Cabin | Ophthalmology | IL | $56.3K | 334 | $168.48 |
| Salim Butrus | Ophthalmology | DC | $54.7K | 255 | $214.57 |
| Foothill Surgery Center Lp | Ambulatory Surgical Center | CA | $54.7K | 480 | $113.96 |
| Kirk Sturridge | Ophthalmology | AL | $52.7K | 309 | $170.56 |
| Timothy Mclaughlin | Ophthalmology | FL | $48.7K | 263 | $185.17 |
The data suggests significant pricing inconsistencies for CPT 65855. With a 2.1x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
While costs have decreased 32.6% since 2014, the wide state-by-state variation suggests the pricing formula may not adequately account for regional differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.