Complex GI Procedures in Iowa
What 16 hospitals in Iowa charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$33,968
Hospital list price billed
Average allowed
$4,769
Medicare's payment + patient's share
Medicare paid
$3,763
Average per service
State rank
#11 of 48
1 = lowest average payment
Hospitals in Iowa billed an average of $33,968 for complex gi procedures, about 7.1 times the average medicare-allowed amount of $4,769. That payment is 11% 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 $4,769Billed $33,968
About 14¢ was paid for every $1 hospitals in Iowa billed for this service.
Iowa hospitals: complex gi procedures
Every Iowa hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University of Iowa Hospital & ClinicsIowa City | 153 | $35,666 | $4,832 | $3,801 |
| Iowa Methodist Medical CenterDes Moines | 56 | $33,747 | $4,650 | $3,690 |
| Mercy Medical Center - Cedar RapidsCedar Rapids | 14 | $16,295 | $4,564 | $3,636 |
| Trinity Regional Medical CenterFort Dodge | – | – | – | – |
| Mercy HospitalIowa City | – | – | – | – |
| Mary Greeley Medical CenterAmes | – | – | – | – |
| Genesis Medical Center-DavenportDavenport | – | – | – | – |
| St Lukes HospitalCedar Rapids | – | – | – | – |
| Mercy Medical Center-North IowaMason City | – | – | – | – |
| Mercyone Waterloo Medical CenterWaterloo | – | – | – | – |
| Mercy Medical Center-DubuqueDubuque | – | – | – | – |
| Mercy Medical Center-Des MoinesDes Moines | – | – | – | – |
| Ottumwa Regional Health CenterOttumwa | – | – | – | – |
| Allen Memorial HospitalWaterloo | – | – | – | – |
| Spencer Municipal HospitalSpencer | – | – | – | – |
| The Finley HospitalDubuque | – | – | – | – |
Lowest and highest allowed amounts in Iowa
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Mercy Medical Center - Cedar RapidsCedar Rapids, IA | $4,564 |
|---|---|
| Iowa Methodist Medical CenterDes Moines, IA | $4,650 |
| University of Iowa Hospital & ClinicsIowa City, IA | $4,832 |
Highest
| University of Iowa Hospital & ClinicsIowa City, IA | $4,832 |
|---|---|
| Iowa Methodist Medical CenterDes Moines, IA | $4,650 |
| Mercy Medical Center - Cedar RapidsCedar Rapids, IA | $4,564 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Iowa?
In 2024 Medicare data, complex gi procedures (APC 5331) at 16 hospitals in Iowa was billed at $33,968 on average, while the average medicare-allowed amount was $4,769, of which Medicare paid $3,763. 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 Iowa, average charges were 7.1 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.