CPT 21395
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Opn tx orbit periorbt w/grft
Prices here combine facility and professional fees. See them separately →Experimental
Low
$510
Average
$6.9k
Median
$6.5k
High
$27.9k
Showing only prices reported under the fee schedule methodology. Choose another in the filter below to change the chart. 1221 hospitals; the 90th percentile is 8.9× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
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Reflects negotiated fee schedule rates with commercial payers.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $5.8k | $6.5k | $2.7k | 41% | — | $1.5k – $11.2k |
| 2 | Beth Israel Deaconess Hospital - Needham Needham, MA | $10.0k | $10.0k | $1.5k | 15% | — | $8.5k – $11.5k |
| 3 | Ingalls Memorial Hospital Harvey, IL | $8.9k | $10.8k | $5.0k | 47% | — | $6.3k – $19.0k |
| 4 | USA Health University Hospital Mobile, AL | $4.3k | $4.4k | $188 | 4% | — | $4.3k – $4.8k |
| 5 | Fairview Health Services Edina, MN | $3.4k | $4.1k | $3.2k | 79% | — | $678 – $13.5k |
| 6 | Hca Florida West Hospital PENSACOLA, FL | $5.9k | $5.9k | $757 | 13% | — | $5.0k – $6.8k |
| 7 | Mayo Regional Hospital Dover Foxcroft, ME | $917 | $1.1k | $871 | 80% | — | $147 – $3.3k |
| 8 | Corewell Health Ludington Hospital Ludington, MI | $6.2k | $7.6k | $2.2k | 29% | — | $5.9k – $10.6k |
| 9 | Kettering Medical Center Miamisburg, OH | $12.3k | $12.5k | $4.3k | 34% | — | $5.9k – $20.5k |
| 10 | St Joseph Regional Health Network Reading, PA | $6.0k | $8.8k | $7.6k | 87% | — | $5.1k – $32.7k |
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