Complex GI Procedures in Massachusetts
What 38 hospitals in Massachusetts charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$25,223
Hospital list price billed
Average allowed
$5,938
Medicare's payment + patient's share
Medicare paid
$4,719
Average per service
State rank
#43 of 48
1 = lowest average payment
Hospitals in Massachusetts billed an average of $25,223 for complex gi procedures, about 4.2 times the average medicare-allowed amount of $5,938. That payment is 11% above 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 $5,938Billed $25,223
About 24¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: complex gi procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Massachusetts
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
| Massachusetts General HospitalBoston, MA | $5,719 |
|---|---|
| Lahey Clinic HospitalBurlington, MA | $5,778 |
| Umass Memorial Medical Center INCWorcester, MA | $5,806 |
| Tufts Medical CenterBoston, MA | $6,011 |
| Beth Israel Deaconess Medical CenterBoston, MA | $6,073 |
Highest
| Berkshire Medical Center INCPittsfield, MA | $6,428 |
|---|---|
| Newton-Wellesley HospitalNewton Lower Falls, MA | $6,121 |
| Cape Cod HospitalHyannis, MA | $6,121 |
| Baystate Medical CenterSpringfield, MA | $6,121 |
| Brigham and Women's HosptialBoston, MA | $6,081 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Massachusetts?
In 2024 Medicare data, complex gi procedures (APC 5331) at 38 hospitals in Massachusetts was billed at $25,223 on average, while the average medicare-allowed amount was $5,938, of which Medicare paid $4,719. 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 Massachusetts, average charges were 4.2 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.