Complex GI Procedures in Kentucky
What 29 hospitals in Kentucky charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$28,628
Hospital list price billed
Average allowed
$4,113
Medicare's payment + patient's share
Medicare paid
$3,270
Average per service
State rank
#2 of 48
1 = lowest average payment
Hospitals in Kentucky billed an average of $28,628 for complex gi procedures, about 7.0 times the average medicare-allowed amount of $4,113. That payment is 23% 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 $4,113Billed $28,628
About 14¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: complex gi procedures
Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Kentucky
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
| University of Kentucky HospLexington, KY | $2,951 |
|---|---|
| Jewish HospitalLouisville, KY | $3,631 |
| Ephraim McDowell Regional Medical CenterDanville, KY | $4,730 |
| Norton Healthcare PavilionLouisville, KY | $4,888 |
| Lourdes HospitalPaducah, KY | $4,907 |
Highest
| Owensboro Medical Health SystemOwensboro, KY | $5,273 |
|---|---|
| Saint Joseph HospitalLexington, KY | $4,936 |
| Central Baptist HospitalLexington, KY | $4,936 |
| Lourdes HospitalPaducah, KY | $4,907 |
| Norton Healthcare PavilionLouisville, KY | $4,888 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Kentucky?
In 2024 Medicare data, complex gi procedures (APC 5331) at 29 hospitals in Kentucky was billed at $28,628 on average, while the average medicare-allowed amount was $4,113, of which Medicare paid $3,270. 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 Kentucky, average charges were 7.0 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.