Complex GI Procedures in Maine
What 10 hospitals in Maine charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$28,122
Hospital list price billed
Average allowed
$5,066
Medicare's payment + patient's share
Medicare paid
$4,006
Average per service
State rank
#24 of 48
1 = lowest average payment
Hospitals in Maine billed an average of $28,122 for complex gi procedures, about 5.6 times the average medicare-allowed amount of $5,066. That payment is 6% 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 $5,066Billed $28,122
About 18¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: complex gi procedures
Every Maine hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Maine Medical CenterPortland | 54 | $31,764 | $5,119 | $4,029 |
| Central Maine Medical CenterLewiston | 20 | $21,303 | $5,004 | $3,981 |
| Eastern Maine Medical CenterBangor | 16 | $24,357 | $4,965 | $3,956 |
| St Joseph HospitalBangor | – | – | – | – |
| Mercy HospitalPortland | – | – | – | – |
| York HospitalYork | – | – | – | – |
| St Marys Regional Medical CenterLewiston | – | – | – | – |
| Maine General Medical CenterWaterville | – | – | – | – |
| Maine Coast Memorial HospitalEllsworth | – | – | – | – |
| Penobscot Bay Medical CenterRockport | – | – | – | – |
Lowest and highest allowed amounts in Maine
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
| Eastern Maine Medical CenterBangor, ME | $4,965 |
|---|---|
| Central Maine Medical CenterLewiston, ME | $5,004 |
| Maine Medical CenterPortland, ME | $5,119 |
Highest
| Maine Medical CenterPortland, ME | $5,119 |
|---|---|
| Central Maine Medical CenterLewiston, ME | $5,004 |
| Eastern Maine Medical CenterBangor, ME | $4,965 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Maine?
In 2024 Medicare data, complex gi procedures (APC 5331) at 10 hospitals in Maine was billed at $28,122 on average, while the average medicare-allowed amount was $5,066, of which Medicare paid $4,006. 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 Maine, average charges were 5.6 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.