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Eye injection (intravitreal): what insurers pay

A drug injected into the eye, commonly for macular degeneration. The drug is billed separately. Commercial negotiated rates by hospital and market, next to Medicare for the same code.

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CPT 67028: Injection Eye Drug

89 hospitals in 31 markets. National Medicare rate $337, surgery center $64.

MarketHospitals25th pctMedian75th pctLow–high
Atlanta GA4———$1,343–$1,867
Austin TX2———$645–$2,257
Boston MA7$785$884$943$598–$1,646
Chicago IL7$360$407$752$334–$1,094
Cleveland OH5$1,676$2,123$2,123$1,226–$2,351
Dallas-Fort Worth TX3———$821–$2,196
Denver CO7$1,084$1,880$1,974$1,079–$2,096
Detroit MI6$401$434$440$210–$1,137
Georgia (statewide)1———$1,580–$1,580
Houston TX1———$2,052–$2,052
Illinois (statewide)1———$336–$336
Indianapolis IN2———$284–$284
Kansas (statewide)1———$2,255–$2,255
Las Vegas NV1———$729–$729
Los Angeles CA1———$1,211–$1,211
Nashville TN4———$328–$2,054
New York (statewide)1———$2,300–$2,300
New York City2———$436–$514
Ohio (statewide)1———$652–$652
Pennsylvania (statewide)1———$940–$940
Philadelphia PA3———$786–$1,602
Phoenix AZ3———$2,000–$2,032
Pittsburgh PA1———$2,155–$2,155
Portland OR6$978$978$1,228$978–$1,312
Research Triangle NC1———$1,350–$1,350
Richmond VA2———$1,948–$2,009
San Antonio TX1———$1,924–$1,924
Seattle-Tacoma WA6$1,133$1,170$1,250$1,009–$1,265
Tampa FL2———$1,214–$1,414
Washington DC5$996$2,092$2,098$878–$2,210
Wisconsin (statewide)1———$981–$981
HospitalMarketMedian across insurers× MedicareInsurersFile date
Corewell Health Dearborn HospitalDetroit MI$2100.6×12026-05-01
Ascension St Vincent AndersonIndianapolis IN$2840.8×12026-01-01
Ascension St Vincent CarmelIndianapolis IN$2840.8×12026-01-01
Vanderbilt University Medical CenterNashville TN$3281.0×82025-10-01
Endeavor Health Northwest Community HospitalChicago IL$3340.9×32026-04-01
Sarah Bush Lincoln Health CenterIllinois (statewide)$3360.9×22026-06-03
Loyola University Medical CenterChicago IL$3391.0×12026-03-31
Endeavor Health Edward HospitalChicago IL$3821.1×22026-04-01
Henry Ford Health Rochester HospitalDetroit MI$3921.2×22026-01-01
University of Chicago Medical CenterChicago IL$4071.1×12026-04-01
Corewell Health Beaumont Grosse Pointe HospitalDetroit MI$4291.3×22026-05-01
NYU Langone Hospitals (Orthopedic Hospital + Tisch files)New York City$4361.1×32026-01-01
Corewell Health William Beaumont University HospitDetroit MI$4401.3×22026-05-01
Corewell Health Beaumont Troy HospitalDetroit MI$4401.3×22026-05-01
Endeavor Health Evanston HospitalChicago IL$4601.3×22026-04-01
Montefiore Medical CenterNew York City$5141.3×92026-04-01
Anna Jaques HospitalBoston MA$5981.5×32026-04-01
Ascension Seton Medical Center AustinAustin TX$6451.9×22026-01-01
Bethesda NorthOhio (statewide)$6522.0×42026-04-01
Beth Israel Deaconess Medical CenterBoston MA$6911.7×12026-04-01
University Medical Center of Southern NevadaLas Vegas NV$7292.1×62026-07-01
Thomas Jefferson University HospitalPhiladelphia PA$7862.3×12026-09-15
Texas Health Presbyterian Hospital DallasDallas-Fort Worth TX$8212.5×22026-04-21
Ascension Saint Thomas RutherfordNashville TN$8312.6×22026-01-01
Medstar Georgetown University HospitalWashington DC$8782.3×12026-04-01
Winchester HospitalBoston MA$8792.2×22026-04-01
New England Baptist HospitalBoston MA$8842.2×42026-04-01
Lahey Hospital & Medical Center, BurlingtonBoston MA$9042.3×22026-04-01
Lehigh Valley HospitalPennsylvania (statewide)$9402.8×62026-07-01
Legacy Emanuel Medical CenterPortland OR$9782.7×22026-04-01
Legacy Good Samaritan Medical CenterPortland OR$9782.7×22026-04-01
Legacy Mount Hood Medical CenterPortland OR$9782.7×22026-04-01
Legacy Meridian Park Medical CenterPortland OR$9782.7×22026-04-01
Orthopaedic Hospital Of WisconsinWisconsin (statewide)$9813.0×22026-01-01
Beth Israel Deaconess Hospital - PlymouthBoston MA$9822.5×22026-04-01
Medstar Washington Hospital CenterWashington DC$9962.5×32026-04-01
Overlake Hospital Medical CenterSeattle-Tacoma WA$1,0092.6×52026-04-01
Endeavor Health Elmhurst HospitalChicago IL$1,0453.0×22026-04-01
Adventhealth PorterDenver CO$1,0793.1×42026-04-01
Adventhealth ParkerDenver CO$1,0793.1×42026-04-01
UCHealth University of Colorado HospitalDenver CO$1,0903.1×22025-11-01
Rush University Medical CenterChicago IL$1,0943.1×22026-09-25
St Clare HospitalSeattle-Tacoma WA$1,1332.9×52026-02-28
St Anthony HospitalSeattle-Tacoma WA$1,1332.9×52026-02-28
Harper University HospitalDetroit MI$1,1373.5×12026-09-02
Ascension Saint Thomas Hospital (Midtown + West)Nashville TN$1,1423.6×32026-01-01
Swedish Medical CenterSeattle-Tacoma WA$1,2063.1×42026-04-01
Keck Hospital Of UscLos Angeles CA$1,2112.9×32026-04-01
Tampa General HospitalTampa FL$1,2143.5×22026-04-01
University Hospitals - Elyria Medical CenterCleveland OH$1,2263.9×22026-07-14
Multicare Good Samaritan HospitalSeattle-Tacoma WA$1,2653.3×72026-08-27
Tacoma General Allenmore HospitalSeattle-Tacoma WA$1,2653.3×72026-08-27
Providence St Vincent Medical CenterPortland OR$1,3123.6×12026-04-01
Providence Portland Medical CenterPortland OR$1,3123.6×12026-04-01
Emory University HospitalAtlanta GA$1,3434.1×12026-04-01
North Carolina Specialty HospitalResearch Triangle NC$1,3504.1×12026-02-25
Morton Plant HospitalTampa FL$1,4144.1×22026-01-01
Riddle Memorial HospitalPhiladelphia PA$1,5594.6×22026-04-01
Emory Houston Hospital Warner RobinsGeorgia (statewide)$1,5805.5×12026-04-01
Bryn Mawr HospitalPhiladelphia PA$1,6024.7×22026-04-01
Beverly Hospital CorporationBoston MA$1,6464.2×32026-04-01
Cleveland Clinic Hillcrest HospitalCleveland OH$1,6765.4×22026-06-15
Piedmont Atlanta HospitalAtlanta GA$1,8675.6×12026-07-01
Piedmont Fayette HospitalAtlanta GA$1,8675.6×12026-07-01
Piedmont Newnan HospitalAtlanta GA$1,8675.6×12026-07-01
HCA HealthONE SwedishDenver CO$1,8805.4×32026-09-01
HCA HealthONE Presbyterian/St. Luke'sDenver CO$1,8815.4×32026-09-01
Methodist HospitalSan Antonio TX$1,9245.8×42026-09-01
Henrico Doctors' HospitalRichmond VA$1,9486.0×22026-09-01
HonorHealth Scottsdale Osborn Medical CenterPhoenix AZ$2,0005.7×52026-04-01
HonorHealth Scottsdale Shea Medical CenterPhoenix AZ$2,0005.7×52026-04-01
CJW Medical Center (Chippenham + Johnston-Willis)Richmond VA$2,0096.2×22026-09-01
HonorHealth Scottsdale Thompson Peak Medical CenterPhoenix AZ$2,0325.8×42026-04-01
Houston Methodist HospitalHouston TX$2,0526.2×12026-04-01
TriStar StoneCrest Medical CenterNashville TN$2,0546.5×32026-09-01
HCA HealthONE Sky RidgeDenver CO$2,0665.9×32026-09-01
Reston Hospital CenterWashington DC$2,0926.1×42026-09-01
Hca Healthone RoseDenver CO$2,0966.0×32026-09-01
Stonesprings Hospital CenterWashington DC$2,0986.1×42026-09-01
Cleveland Clinic Lutheran HospitalCleveland OH$2,1236.8×32026-06-15
Medina HospitalCleveland OH$2,1236.8×32026-06-15
Upmc Presbyterian ShadysidePittsburgh PA$2,1556.7×12026-03-06
Medical City PlanoDallas-Fort Worth TX$2,1966.6×42026-09-01
Medical City MckinneyDallas-Fort Worth TX$2,1966.6×42026-09-01
George Washington Univ HospitalWashington DC$2,2105.7×32026-09-01
Menorah Medical CenterKansas (statewide)$2,2557.2×42026-09-01
St David's Medical CenterAustin TX$2,2576.8×42026-09-01
Stony Brook University HospitalNew York (statewide)$2,3005.6×22026-06-10
Cleveland Clinic (main campus)Cleveland OH$2,3517.5×12026-06-16

Questions

How much do commercial insurers pay hospitals for eye injection (intravitreal)?

Across 89 hospitals in 31 metro areas that post a usable dollar rate, the median commercial rate for CPT 67028, hospital outpatient is $1,137, 3.1× the same hospital's local Medicare base rate. The middle half of hospitals runs $821 to $1,881. Figures are each hospital's median across insurers, from its federal price-transparency file.

What does Medicare pay for eye injection (intravitreal)?

Medicare's national hospital outpatient rate for CPT 67028 is $337 and its surgery-center rate is $64, before local wage adjustment.

Which hospitals post the lowest and highest commercial rates for eye injection (intravitreal)?

Lowest medians: Corewell Health Dearborn Hospital ($210), Ascension St Vincent Anderson ($284), Ascension St Vincent Carmel ($284). Highest: Cleveland Clinic (main campus) ($2,351), Stony Brook University Hospital ($2,300), St David's Medical Center ($2,257). Coverage is limited to the markets listed on this page.