Njx pst chmbr eye medication
Eye medication injections into the posterior chamber range from $1,214 at surgery centers to $2,281 at hospital outpatient facilities, making it essential to verify your facility type before treatment.
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
This procedure involves injecting medication directly into the posterior chamber of the eye, typically performed for patients with retinal conditions like macular degeneration or diabetic retinopathy. From a billing perspective, code 0699T is a Category III CPT code, which means reimbursement policies vary significantly between payers and may require prior authorization documentation.
Non-facility rate
$99
Office setting benchmark
Data sources
4
23 data points
Key insights for CPT 0699T
ASC vs hospital outpatient savings
$1,066Having this done at an ambulatory surgery center costs $1,214 vs $2,281 at a hospital outpatient
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $2,281 | +2204% |
| Ambulatory surgery (ASC) | $1,214 | +1127% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use