Procedure Pricing – Indiana Medicaid
Procedure Pricing by CPT Code
Use this chart to find the average reimbursement patients can expect to receive from Indiana Medicaid.
| CPT Code | Treatment Description | Indiana Medicaid Allowable |
|---|---|---|
| 66984 | Extracapsular cataract removal with insertion of intraocular lens | $1,106.60 |
| 66821 | “Discission of secondary membranous cataract, eg YAG laser | $443.28 |
| 66982 | Extracapsular cataract removal with insertion of intraocular lens, complex | $1,106.60 |
| 66988 | Extracapsular cataract removal with insertion of intraocular lens with trabeculoplasty | $3,346.60 |
| 67040 | Vitrectomy, mechanical, with endolaser panretinal photocoagulation | $1,014.81 |
| 67041 | Vitrectomy, mechanical, with removal preretinal cellular membrane | $1,106.60 |
| 67042 | Vitrectomy, mechanical, with removal of internal limiting membrane | $1,106.60 |
| 67108 | Repair retinal detachment, with vitrectomy, and method | $1,014.81 |
| 67113 | Repair complex retinal detachment | $1,014.81 |
| 66711 | Ciliary body destruction, cyclophotocoagulation | $443.28 |
| 66682 | Suture of iris, ciliary body, with retrieval of suture | $443.28 |
| 65810 | Paracentesis of anterior chamber of eye with removal of vitreous | $488.57 |
| 65426 | Excision of transposition of pterygium with graft | $800.42 |
| 66183 | Insertion of anterior segment aqueous drainage device | $2,226.60 |
| 65855 | Trabeculoplasty by laser surgery | $329.12 |
| 65820 | Goniotomy | $582.98 |
| 65755 | Keratoplasty (corneal transplant); penetrating | $1,014.81 |
| 65756 | Keratoplasty (corneal transplant) endothelial | $1,014.81 |
| 66985 | Insertion of intraocular lens prosthesis – secondary implant – not associated with concurrent cataract removal | $1,079.83 |
| 66986 | Exchange Intraocular lens | $1,079.83 |
| 66761 | Iridotomy/iridectomy by laser surgery | $800.42 |