CPT 67405 Surgery - Eye

How Much Does Explore/drain Eye Socket Cost?

Also known as: Explore/drain eye socket (CPT 67405)

The total estimated cost of Explore/drain Eye Socket (CPT 67405) is $2,020 to $3,282, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $802.

Total Estimated Cost of Care

$2,020 — $3,282

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$802
Hospital Facility Fee
$1,603
Anesthesia (est.)
$120
Important: The physician fee of $802 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$802
Physician component only — CMS PFS 2026

Procedures Commonly Done Together

These procedures are frequently performed alongside Explore/drain eye socket

Loading related procedures...

How to Reduce Your Cost for Explore/drain eye socket

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

8.97
Work RVU
14.32
Practice Expense RVU
0.71
Malpractice RVU
24.00
Total RVU

Payment = Total RVU (24.00) x CF ($33.40) = $802

Frequently Asked Questions

How much does Explore/drain eye socket cost?

The Medicare facility rate for Explore/drain eye socket is $802. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Explore/drain eye socket cost without insurance?

Without insurance, the cost of Explore/drain eye socket can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Explore/drain eye socket?

Most commercial health insurance plans and Medicare cover Explore/drain eye socket when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

Share This Cost Information

My Cost List

0 procedures

No procedures added yet

Click "Add to My List" on any procedure to start building your estimate.