Impression and custom preparation; orbital prosthesis Facility (CPT 21077)
21077 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.
Name shown as it appears in hospital billing files.
123 of 4255 hospitals post a price for this code. Hospitals that don't post one are left out. We never guess a number.
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| Hospital | Location | Posted cash | Posted gross | Medicare pays | × Medicare |
|---|---|---|---|---|---|
| Washington County Hospital and Nursing Home likely a partial charge, not the full procedure |
Chatom, AL | $54.17 | — | $5,344.78 | 0.0× |
| Akron Children's Hospital likely a partial charge, not the full procedure |
Akron, OH | $108.75 | $145 | $5,600.62 | 0.0× |
| Cedar-sinai Marina Del Rey Hospital range across 10 matching MRF lines |
Marina Del Rey, CA | $655.63–$18,447.52 | $1,008.66–$28,380.80 | $7,613.89 | varies |
| Cedars-sinai Medical Center range across 9 matching MRF lines |
Los Angeles, CA | $936.62–$24,184.55 | $1,440.95–$37,207 | $7,613.89 | varies |
| Erie County Medical Center likely a partial charge, not the full procedure |
Buffalo, NY | $954 | $10,500 | $7,389.63 | 0.1× |
| Westfield Memorial Hospital, Inc likely a partial charge, not the full procedure |
Westfield, NY | $1,090.10 | $4,955 | $7,389.63 | 0.1× |
| Huntington Hospital range across 9 matching MRF lines |
Pasadena, CA | $1,147.80–$15,116.08 | $1,765.84–$23,255.50 | $7,613.89 | varies |
| Nacogdoches Memorial Hospital likely a partial charge, not the full procedure |
Nacogdoches, TX | $1,194 | $3,980 | $5,946.81 | 0.2× |
| Torrance Memorial Medical Center range across 7 matching MRF lines |
Torrance, CA | $1,589.98–$31,644.62 | $1,939–$38,591 | $7,613.89 | varies |
| East Carroll Parish Hospital unusually low: confirm this is the full procedure |
Lake Providence, LA | $1,911 | $2,548 | $5,389.78 | 0.4× |
| Touro unusually low: confirm this is the full procedure |
New Orleans, LA | $2,055.90 | $14,685 | $5,556.71 | 0.4× |
| Concord Hospital unusually low: confirm this is the full procedure |
Concord, NH | $2,124 | $7,080 | $6,320.94 | 0.3× |
| Concord Hospital – Laconia unusually low: confirm this is the full procedure |
Laconia, NH | $2,124 | $7,080 | $6,320.94 | 0.3× |
| Concord Hospital – Franklin unusually low: confirm this is the full procedure |
Franklin, NH | $2,124 | $7,080 | $6,320.94 | 0.3× |
| Bayside Community Hospital unusually low: confirm this is the full procedure |
Anahuac, TX | $2,628 | $2,628 | $5,946.81 | 0.4× |
| Artesia General Hospital unusually low: confirm this is the full procedure |
Artesia, NM | $2,642.40 | $4,404 | $5,860.44 | 0.5× |
| Vanderbilt Bedford Hospital unusually low: confirm this is the full procedure |
Shelbyville, TN | $2,808.65 | $9,685 | $5,652.87 | 0.5× |
| Vanderbilt Tullahoma-Harton Hospital unusually low: confirm this is the full procedure |
Tullahoma, TN | $2,808.65 | $9,685 | $5,619.85 | 0.5× |
| Vanderbilt Wilson County Hospital unusually low: confirm this is the full procedure |
Lebanon, TN | $2,808.65 | $9,685 | $5,679.36 | 0.5× |
| John H Stroger Jr Hospital unusually low: confirm this is the full procedure |
Chicago, IL | $2,975 | $4,250 | $6,343.80 | 0.5× |
| Provident Hospital of Chicago unusually low: confirm this is the full procedure |
Chicago, IL | $2,975 | $4,250 | $6,343.80 | 0.5× |
| University Medical Center New Orleans | New Orleans, LA | $3,586.88 | $16,304 | $5,360.39 | 0.7× |
| Manning Family Children's | New Orleans, LA | $3,660.93 | $13,559 | $5,556.71 | 0.7× |
| Nebraska Medical Center range across 3 matching MRF lines |
Omaha, NE | $3,832.40–$8,052.20 | $5,896–$12,388 | $6,147.12 | varies |
| Bellevue Medical Center range across 3 matching MRF lines |
Bellevue, NE | $3,832.40–$8,052.20 | $5,896–$12,388 | $6,147.12 | varies |
| Washington Regional Medical Center | Fayetteville, AR | $3,957.75 | $5,277 | $5,581.02 | 0.7× |
| Hurley Medical Center | Flint, MI | $4,030 | $4,030 | $5,898.54 | 0.7× |
| Spanish Peaks Regional Health Center | Walsenburg, CO | $4,034.70 | $4,483 | $6,244.73 | 0.6× |
| DeSoto Regional Health System | Mansfield, LA | $4,256 | $6,080 | $5,360.39 | 0.8× |
| Sidney Health Center | Sidney, MT | $4,303.44 | $6,950 | $6,048.05 | 0.7× |
| Summit Surgical, LLC | Hutchinson, KS | $4,696.04 | $5,870.05 | $5,444.21 | 0.9× |
| Waverly Health Center | Waverly, IA | $4,868.76 | $9,363 | $5,690.97 | 0.9× |
| Titus Regional Medical Center | Mount Pleasant, TX | $5,201.40 | $8,669 | $5,946.81 | 0.9× |
| Vanderbilt University Hospital | Nashville, TN | $5,229.90 | $9,685 | $5,811.09 | 0.9× |
| Montefiore Medical Center | Bronx, NY | $5,241.91 | $8,015.16 | $7,389.63 | 0.7× |
| Baylor Scott & White Medical Center -taylor | Taylor, TX | $5,289.89 | $8,816.49 | $5,946.81 | 0.9× |
| Scott & White Hospital-round Rock | Round Rock, TX | $5,289.89 | $8,816.49 | $5,946.81 | 0.9× |
| Baylor Scott & White Medical Center - Pflugerville | Pflugerville, TX | $5,289.89 | $8,816.49 | $5,946.81 | 0.9× |
| Baylor Scott & White Medical Center - Buda | Buda, TX | $5,289.89 | $8,816.49 | $5,946.81 | 0.9× |
| Baylor Scott & White Medical Center- Austin | Austin, TX | $5,289.89 | $8,816.49 | $5,946.81 | 0.9× |
| Treasure Valley Hospital | Boise, ID | $5,341.42 | — | $5,981.28 | 0.9× |
| Northwest Hills Surgical Hospital | Austin, TX | $5,690.88 | $15,808 | $5,946.81 | 1.0× |
| Baylor Scott & White Medical Center - Temple | Temple, TX | $5,827.35 | $9,712.25 | $5,946.81 | 1.0× |
| Baylor Scott & White Medical Center - Hillcrest | Waco, TX | $5,827.35 | $9,712.25 | $5,946.81 | 1.0× |
| Baylor Scott & White Medical Center- College Stati | College Station, TX | $5,827.35 | $9,712.25 | $5,946.81 | 1.0× |
| Baylor Scott & White Medical Center - Marble Falls | Marble Falls, TX | $5,827.35 | $9,712.25 | $5,946.81 | 1.0× |
| Baylor Scott & White Hospital Brenham | Brenham, TX | $5,827.35 | $9,712.25 | $5,946.81 | 1.0× |
| Lakeside Medical Center | Belle Glade, FL | $5,938.02 | — | $6,181.95 | 1.0× |
| St. Joseph's Medical Center | Yonkers, NY | $6,048.05 | — | $7,389.63 | 0.8× |
| Lima Memorial Health System | Lima, OH | $6,382.80 | $7,092 | $5,652.51 | 1.1× |
| Our Lady of the Lake Surgical Hospital | Slidell, LA | $6,495.68 | — | $5,375.99 | 1.2× |
| MUSC Health University Medical Center | Charleston, SC | $6,571.50 | $13,143 | $5,505.90 | 1.2× |
| City of Hope Helford Clinical Research Hospital | Duarte, CA | $6,897 | $13,794 | $7,613.89 | 0.9× |
| Texas Scottish Rite Hospital For Children | Dallas, TX | $6,980 | $6,980 | $5,946.81 | 1.2× |
| Lincoln Medical & Mental Health Center | Bronx, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Jacobi Medical Center | Bronx, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Elmhurst Hospital Center | Elmhurst, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| NYC Health + Hospitals/South Brooklyn Health | Brooklyn, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Metropolitan Hospital Center | New York, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Kings County Hospital Center | Brooklyn, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Bellevue Hospital Center | New York, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Queens Hospital Center | Jamaica, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Harlem Hospital Center | New York, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Woodhull Medical & Mental Health Center | Brooklyn, NY | $7,000.36 | — | $7,389.63 | 0.9× |
| Highland Hospital | Rochester, NY | $7,026.75 | — | $7,389.63 | 1.0× |
| Strong Memorial Hospital | Rochester, NY | $7,026.75 | — | $7,389.63 | 1.0× |
| Griffin Hospital | Derby, CT | $7,072.05 | — | $7,096.78 | 1.0× |
| Valleywise Health Medical Center | Phoenix, AZ | $7,264.49 | — | $6,316.95 | 1.1× |
| Nyack Hospital | Nyack, NY | $7,389.63 | — | $7,389.63 | 1.0× |
| Montefiore St. Luke's Cornwall | Newburgh, NY | $7,389.63 | — | $7,389.63 | 1.0× |
| Saint Thomas Hospital for Specialty Surgery | Nashville, TN | $7,401.56 | — | $5,679.36 | 1.3× |
| Mount Sinai Hospital | New York, NY | $7,659 | $8,510 | $7,389.63 | 1.0× |
| Mount Sinai West | New York, NY | $7,659 | $8,510 | $7,389.63 | 1.0× |
| Mount Sinai Brooklyn | Brooklyn, NY | $7,659 | $8,510 | $7,389.63 | 1.0× |
| Henry Ford Macomb Hospital | Clinton Township, MI | $8,139.99 | — | $5,898.54 | 1.4× |
| Henry Ford Hospital | Detroit, MI | $8,139.99 | — | $5,898.54 | 1.4× |
| Henry Ford Wyandotte Hospital | Wyandotte, MI | $8,139.99 | — | $5,898.54 | 1.4× |
| Henry Ford West Bloomfield Hospital | West Bloomfield, MI | $8,139.99 | — | $5,898.54 | 1.4× |
| Hilton Head Medical Center | Hilton Head Island, SC | $8,912.72 | — | $5,505.90 | 1.6× |
| East Cooper Medical Center | Mount Pleasant, SC | $8,912.72 | — | $5,505.90 | 1.6× |
| Coastal Carolina Medical Center | Hardeeville, SC | $8,912.72 | — | $5,505.90 | 1.6× |
| Dunes Surgical Hospital | Dakota Dunes, SD | $8,963.81 | — | $6,048.05 | 1.5× |
| Memorial Sloan Kettering Cancer Center | New York, NY | $9,332 | $9,332 | $7,389.63 | 1.3× |
| Omega Hospital range across 2 matching MRF lines |
Metairie, LA | $9,505.34–$22,351.37 | $16,294.86–$38,316.63 | $5,556.71 | varies |
| Mercyhealth Fhn Hospital | Freeport, IL | $9,506.40 | $11,883 | $6,343.80 | 1.5× |
| McKenzie County Healthcare Systems Inc | Watford City, ND | $9,579.05 | $14,737 | $6,048.05 | 1.6× |
| Kaiser Foundation Hospital - South San Francisco | South San Francisco, CA | $11,933.60 | $21,310 | $8,595.49 | 1.4× |
| Kaiser Foundation Hospital-santa Clara | Santa Clara, CA | $11,933.60 | $21,310 | $8,557.02 | 1.4× |
| Kaiser Foundation Hospital - Walnut Creek | Walnut Creek, CA | $11,933.60 | $21,310 | $8,405.34 | 1.4× |
| Kaiser Foundation Hospital and Rehab Center | Vallejo, CA | $11,933.60 | $21,310 | $8,697.10 | 1.4× |
| Kaiser Foundation Hospital - Oakland/richmond | Oakland, CA | $11,933.60 | $21,310 | $8,659.72 | 1.4× |
| Kaiser Foundation Hospital - San Francisco | San Francisco, CA | $11,933.60 | $21,310 | $8,557.02 | 1.4× |
| Kaiser Foundation Hospital - Sacramento | Sacramento, CA | $11,933.60 | $21,310 | $8,405.34 | 1.4× |
| Kaiser Foundation Hospital | San Rafael, CA | $11,933.60 | $21,310 | $8,396.63 | 1.4× |
| Kaiser Foundation Hospital - Fremont | Fremont, CA | $11,933.60 | $21,310 | $8,557.02 | 1.4× |
| Kaiser Foundation Hospital - Redwood City | Redwood City, CA | $11,933.60 | $21,310 | $8,595.49 | 1.4× |
| Kaiser Foundation Hospital-san Jose | San Jose, CA | $11,933.60 | $21,310 | $8,707.26 | 1.4× |
| Kaiser Foundation Hosp So Sacramento | Sacramento, CA | $11,933.60 | $21,310 | $8,405.34 | 1.4× |
| Kaiser Foundation Hospital-santa Rosa | Santa Rosa, CA | $11,933.60 | $21,310 | $8,140.43 | 1.5× |
| Kaiser Foundation Hospital - Fresno | Fresno, CA | $11,933.60 | $21,310 | $7,613.89 | 1.6× |
| Kaiser Foundation Hospital Manteca | Manteca, CA | $11,933.60 | $21,310 | $8,295.38 | 1.4× |
| Kaiser Foundation Hospital - Antioch | Antioch, CA | $11,933.60 | $21,310 | $8,359.25 | 1.4× |
| Kaiser Foundation Hospital - Vacaville | Vacaville, CA | $11,933.60 | $21,310 | $8,697.10 | 1.4× |
| Kaiser Foundation Hospital - Roseville | Roseville, CA | $11,933.60 | $21,310 | $7,682.84 | 1.6× |
| Kaiser Foundation Hospital - San Leandro | San Leandro, CA | $11,933.60 | $21,310 | $8,558.11 | 1.4× |
| Duncan Regional Hospital, Inc | Duncan, OK | $12,060.84 | — | $5,693.51 | 2.1× |
| St. Luke's Magic Valley Medical Center | Twin Falls, ID | $15,519 | $15,519 | $6,171.07 | 2.5× |
| St. Luke's Boise Medical Center | Boise, ID | $15,519 | $15,519 | $6,392.06 | 2.4× |
| St. Luke's Nampa Medical Center | Nampa, ID | $15,519 | $15,519 | $5,981.28 | 2.6× |
| St. Luke's Jerome Medical Center | Jerome, ID | $15,519 | $15,519 | $5,874.23 | 2.6× |
| St. Luke's Elmore Medical Center | Mountain Home, ID | $15,519 | $15,519 | $5,848.46 | 2.7× |
| St. Luke's McCall Medical Center | McCall, ID | $15,519 | $15,519 | $5,848.46 | 2.7× |
| St. Luke's Wood River Medical Center | Ketchum, ID | $15,519 | $15,519 | $5,848.46 | 2.7× |
| Roswell Park Comprehensive Cancer Center | Buffalo, NY | $16,415.61 | $16,415.61 | $7,389.63 | 2.2× |
| Northwest Surgical Hospital | Oklahoma City, OK | $17,080.53 | — | $5,693.51 | 3.0× |
| Community Hospital, LLC | Oklahoma City, OK | $17,080.53 | — | $5,693.51 | 3.0× |
| Cleveland Clinic | Cleveland, OH | $17,687.80 | $27,212 | $5,600.62 | 3.2× |
| Alaska Native Medical Center | Anchorage, AK | $18,412 | $18,412 | $6,569.88 | 2.8× |
| Graham Hospital Association | Canton, IL | — | $5,349.61 | $6,343.80 | — |
| Ohio State University Hospitals | Columbus, OH | — | $11,175 | $5,832.86 | — |
| James Cancer Hospital & Solove Research Institute | Columbus, OH | — | $11,175 | $5,708.03 | — |
| UAB Hospital | Birmingham, AL | — | $12,805 | $5,414.82 | — |
| University of Texas M D Anderson Cancer Center | Houston, TX | — | $18,100 | $5,946.81 | — |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
"Medicare pays" is the facility (technical) rate, matching the posted facility charge; the doctor's separate professional fee is excluded throughout. "—" means Medicare has no comparable facility rate.