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
HB Rpr Blepharoptosis Levator Rescj/Advmnt Xtrnl
Low
$1
Average
$1.7k
Median
$1.8k
High
$10.7k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 29.1× 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.
Filter by billing methodology
Filter by billing class
38 hospital rates
iThe hospitals that file a Medicaid rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | 1–10 | $2.3k – $2.3k |
| 2 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN fee schedule · outpatient | 2 | $2.5k | $2.5k | $227 | 9% | 1–10 | $2.3k – $2.7k |
| 3 | Tufts Medical Center BOSTON, MA other · both | 1 | $12.0k | $12.0k | — | — | 1–10 | $12.0k – $12.0k |
| 4 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 5 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $469 | $469 | — | — | — | $469 – $469 |
| 7 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $863 | $863 | — | — | — | $863 – $863 |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 9 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · fee schedule · outpatient | 1 | $560 | $560 | — | — | — | $560 – $560 |
| 10 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 11 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN fee schedule · outpatient | 2 | $2.5k | $2.5k | $227 | 9% | — | $2.3k – $2.7k |
| 12 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $411 | $411 | — | — | — | $411 – $411 |
| 13 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 14 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Greater Baltimore Medical Center Towson, MD professional · fee schedule · inpatient | 1 | $471 | $471 | — | — | — | $471 – $471 |
| 18 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 19 | IOM Health System LP Fort Wayne, IN facility · other · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 20 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $2.1k | $1.8k | $1.1k | 62% | — | $320 – $3.0k |
| 21 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $2.1k | $1.8k | $1.1k | 62% | — | $320 – $3.0k |
| 22 | Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · fee schedule · outpatient | 3 | $2.1k | $1.8k | $1.1k | 64% | — | $250 – $3.0k |
| 23 | Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient | 2 | $1.2k | $1.2k | $879 | 73% | — | $320 – $2.1k |
| 24 | Mercy Hospital Springfield Ozark, MO facility · fee schedule · outpatient | 3 | $2.1k | $1.8k | $1.1k | 62% | — | $320 – $3.0k |
| 25 | Mercy Hospital Springfield Springfield, MO facility · fee schedule · outpatient | 3 | $2.1k | $1.8k | $1.1k | 62% | — | $320 – $3.0k |
← Payers reporting CPT 67904 · Snapshot 20261111T120946Z-9134e7f7