Complex GI Procedures in Montana
What 9 hospitals in Montana charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$23,457
Hospital list price billed
Average allowed
$5,342
Medicare's payment + patient's share
Medicare paid
$4,256
Average per service
State rank
#33 of 48
1 = lowest average payment
Hospitals in Montana billed an average of $23,457 for complex gi procedures, about 4.4 times the average medicare-allowed amount of $5,342. That payment is about the same as 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 $5,342Billed $23,457
About 23¢ was paid for every $1 hospitals in Montana billed for this service.
Montana hospitals: complex gi procedures
Every Montana hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| St Patrick Hospital and Health Sciences CenterMissoula | 25 | $17,629 | $5,343 | $4,257 |
| Logan Health Medical CenterKalispell | 22 | $19,588 | $5,723 | $4,560 |
| Bozeman Deaconess HospitalBozeman | 20 | $39,486 | $5,723 | $4,560 |
| Benefis Hospitals INCGreat Falls | 16 | $25,307 | $4,341 | $3,459 |
| Billings Clinic HospitalBillings | 14 | $14,931 | $5,343 | $4,257 |
| St Peter's HospitalHelena | – | – | – | – |
| St James HealthcareButte | – | – | – | – |
| St Vincent HealthcareBillings | – | – | – | – |
| Great Falls Clinic Medical CenterGreat Falls | – | – | – | – |
Lowest and highest allowed amounts in Montana
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
| Benefis Hospitals INCGreat Falls, MT | $4,341 |
|---|---|
| Billings Clinic HospitalBillings, MT | $5,343 |
| St Patrick Hospital and Health Sciences CenterMissoula, MT | $5,343 |
| Logan Health Medical CenterKalispell, MT | $5,723 |
| Bozeman Deaconess HospitalBozeman, MT | $5,723 |
Highest
| Logan Health Medical CenterKalispell, MT | $5,723 |
|---|---|
| Bozeman Deaconess HospitalBozeman, MT | $5,723 |
| Billings Clinic HospitalBillings, MT | $5,343 |
| St Patrick Hospital and Health Sciences CenterMissoula, MT | $5,343 |
| Benefis Hospitals INCGreat Falls, MT | $4,341 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Montana?
In 2024 Medicare data, complex gi procedures (APC 5331) at 9 hospitals in Montana was billed at $23,457 on average, while the average medicare-allowed amount was $5,342, of which Medicare paid $4,256. 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 Montana, average charges were 4.4 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.