Price Checker / CPT 67042
How much does Vit For Macular Hole cost?
CPT 67042 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is about 3.3x the fair price. You have grounds to ask for a reduction.
Fair price
$1,450–$2,850
What this should cost
With insurance
~$3,600
Typical out-of-pocket
Overcharged if over
$3,550
Push back above this
The average hospital charge of $6,992 is $4,842 over the fair price (about 3.3x the fair rate).
What hospitals charge for Vit For Macular Hole
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Wyoming County Community Health System Warsaw, NY | $6,992 | — | 162% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Vit For Macular Hole
CPT code 67042 refers to vit for macular hole (billing description: "Vit for macular hole"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $955 in a facility (hospital or surgery center) and $955 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
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.