Cost analysis for CPT J3490 — Unclassified drugs
Average Medicare Payment
N/A
Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 3458.5x more than the cheapest for this procedure. WV averages $1990.96 vs GU at $0.58.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| WV | $1990.96 | $231.0K | 116 | 3 |
| UT | $1695.63 | $5.0M | 2.9K | 25 |
| CT | $1381.33 | $1.5M | 1.1K | 20 |
| SD | $1335.08 | $742.3K | 556 | 5 |
| DE | $984.01 | $456.6K | 464 | 7 |
| ID | $882.69 | $1.6M | 1.8K | 9 |
| OR | $643.14 | $2.3M | 3.5K | 53 |
| LA | $624.22 | $933.8K | 1.5K | 19 |
| OH | $561.50 | $3.9M | 7.0K | 54 |
| SC | $509.13 | $3.1M | 6.1K | 54 |
| TX | $476.56 | $19.1M | 40.1K | 351 |
| NY | $467.57 | $6.1M | 13.0K | 120 |
| MD | $450.99 | $6.4M | 14.2K | 103 |
| NC | $448.08 | $1.8M | 4.0K | 75 |
| TN | $395.60 | $2.7M | 6.8K | 64 |
| ME | $392.16 | $203.5K | 519 | 7 |
| MA | $378.73 | $1.0M | 2.7K | 21 |
| KY | $368.12 | $380.6K | 1.0K | 14 |
| GA | $318.86 | $1.1M | 3.3K | 53 |
| OK | $314.03 | $639.4K | 2.0K | 26 |
| CO | $287.70 | $1.5M | 5.1K | 64 |
| VA | $281.69 | $2.2M | 7.7K | 106 |
| FL | $279.11 | $16.0M | 57.4K | 183 |
| WI | $264.23 | $224.3K | 849 | 10 |
| MT | $233.47 | $78.7K | 337 | 6 |
| NJ | $231.14 | $3.5M | 15.2K | 116 |
| IL | $212.22 | $2.7M | 12.7K | 139 |
| KS | $202.65 | $492.4K | 2.4K | 21 |
| CA | $190.77 | $15.9M | 83.3K | 323 |
| IN | $184.20 | $474.1K | 2.6K | 37 |
| NE | $156.29 | $384.9K | 2.5K | 34 |
| NM | $153.69 | $368.2K | 2.4K | 22 |
| MS | $151.96 | $357.0K | 2.3K | 20 |
| MO | $149.19 | $1.1M | 7.1K | 75 |
| MI | $119.88 | $344.1K | 2.9K | 48 |
| MN | $108.92 | $349.1K | 3.2K | 70 |
| ND | $106.50 | $61.7K | 579 | 5 |
| NV | $92.40 | $585.9K | 6.3K | 46 |
| AZ | $91.57 | $1.7M | 18.8K | 101 |
| IA | $80.95 | $166.0K | 2.0K | 28 |
| PA | $72.37 | $3.0M | 40.8K | 106 |
| RI | $70.34 | $12.9K | 184 | 1 |
| AR | $70.24 | $657.8K | 9.4K | 58 |
| HI | $63.82 | $35.6K | 558 | 4 |
| WA | $47.10 | $3.3M | 70.6K | 65 |
| PR | $35.33 | $4.7K | 134 | 3 |
| WY | $8.66 | $2.7K | 317 | 4 |
| AK | $1.14 | $1.7K | 1.5K | 10 |
| VT | $0.60 | $523.84 | 877 | 3 |
| AL | $0.58 | $2.2K | 3.8K | 43 |
| GU | $0.58 | $63.90 | 111 | 2 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| David Warrow | Ophthalmology | MD | $2.7M | 1.4K | $1936.89 |
| Boris Havkin | Urology | FL | $1.7M | 19.6K | $89.36 |
| Jason Ysasaga | Ophthalmology | TX | $1.7M | 986 | $1759.73 |
| Alexander Eaton | Ophthalmology | FL | $1.7M | 1.1K | $1500.52 |
| Antonio Aragon | Ophthalmology | TX | $1.4M | 824 | $1736.15 |
| Hussein Wafapoor | Ophthalmology | FL | $1.4M | 978 | $1454.91 |
| Ryan Rush | Ophthalmology | TX | $1.2M | 692 | $1778.32 |
| Allen Hu | Ophthalmology | MD | $984.2K | 524 | $1878.28 |
| Sunil Gupta | Ophthalmology | FL | $974.5K | 553 | $1762.19 |
| Mitchell Goff | Ophthalmology | UT | $957.8K | 428 | $2237.90 |
| David Brown | Ophthalmology | TX | $934.0K | 465 | $2008.53 |
| Eric Jablon | Ophthalmology | SC | $918.5K | 519 | $1769.67 |
| Nathan Steinle | Ophthalmology | CA | $887.9K | 561 | $1582.77 |
| Michael Kaplan | Otolaryngology | TX | $861.0K | 131 | $6572.66 |
| Robert Reinauer | Ophthalmology | TX | $832.2K | 887 | $938.26 |
| Charles Wykoff | Ophthalmology | TX | $831.4K | 419 | $1984.20 |
| Lee Erlendson | Anesthesiology | CA | $830.4K | 262 | $3169.29 |
| Jose Martinez | Ophthalmology | TX | $800.6K | 417 | $1919.91 |
| David Faber | Ophthalmology | UT | $762.6K | 351 | $2172.60 |
| David Boyer | Ophthalmology | CA | $670.9K | 389 | $1724.79 |
The data suggests significant pricing inconsistencies for CPT J3490. With a 3458.5x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
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.