Complex GI Procedures in Delaware
What 3 hospitals in Delaware charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$18,676
Hospital list price billed
Average allowed
$5,253
Medicare's payment + patient's share
Medicare paid
$4,148
Average per service
State rank
#31 of 48
1 = lowest average payment
Hospitals in Delaware billed an average of $18,676 for complex gi procedures, about 3.6 times the average medicare-allowed amount of $5,253. That payment is 2% below the U.S. average of $5,364.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $5,253Billed $18,676
About 28¢ was paid for every $1 hospitals in Delaware billed for this service.
Delaware hospitals: complex gi procedures
Every Delaware hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Christiana Care Health Services, INC.Newark | 27 | $15,939 | $4,960 | $3,881 |
| Beebe Medical CenterLewes | 17 | $23,022 | $5,718 | $4,573 |
| Bayhealth - Kent General HospitalDover | – | – | – | – |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Delaware?
In 2024 Medicare data, complex gi procedures (APC 5331) at 3 hospitals in Delaware was billed at $18,676 on average, while the average medicare-allowed amount was $5,253, of which Medicare paid $4,148. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in Delaware, average charges were 3.6 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.