Price Checker / CPT 23616

How much does Optx Prx Hmrl Fx Fix Rpr Rpl cost?

CPT 23616 · Based on 2026 Medicare rates and hospital-published pricing

Severe overcharge

The average hospital charge is around 14x the fair price — among the most extreme markups. Dispute this.

Fair price

$1,700–$3,350

What this should cost

With insurance

~$7,050

Typical out-of-pocket

Overcharged if over

$4,200

Push back above this

The average hospital charge of $35,246 is $32,696 over the fair price (about 14x the fair rate).

What hospitals charge for Optx Prx Hmrl Fx Fix Rpr Rpl

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
PeaceHealth St. John Medical Center

LONGVIEW, WA

$34,67410795%
Sanford Bemidji Medical Center

Bemidji, MN

10639%
Lincoln Health

Damariscotta, ME

9707%
Sanford Worthington Medical Center

Worthington, MN

8096%
Waldo County General Hospital

Belfast, ME

7956%
Stephens Memorial Hospital

Norway, ME

7443%
Antioch Medical Center

ANTIOCH, CA

$27,6005690%
Fremont Medical Center

FREMONT, CA

$27,6005690%
Fresno Medical Center

FRESNO, CA

$27,6005690%
Oakland Medical Center

Oakland, CA

$27,6005690%
Redwood City Medical Center

Redwood City, CA

$27,6005690%
Richmond Medical Center

Richmond, CA

$27,6005690%
Roseville Medical Center

ROSEVILLE, CA

$27,6005690%
Sacramento Medical Center

SACRAMENTO, CA

$27,6005690%
San Francisco Medical Center

SAN FRANCISCO, CA

$27,6005690%

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About Optx Prx Hmrl Fx Fix Rpr Rpl

CPT code 23616 refers to optx prx hmrl fx fix rpr rpl (billing description: "Optx prx hmrl fx fix rpr rpl"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $1,122 in a facility (hospital or surgery center) and $1,122 in a doctor's office.

The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.

What to do if you were overcharged

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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