Complex GI Procedures in New Jersey
What 43 hospitals in New Jersey charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$34,703
Hospital list price billed
Average allowed
$5,910
Medicare's payment + patient's share
Medicare paid
$4,698
Average per service
State rank
#42 of 48
1 = lowest average payment
Hospitals in New Jersey billed an average of $34,703 for complex gi procedures, about 5.9 times the average medicare-allowed amount of $5,910. That payment is 10% 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 $5,910Billed $34,703
About 17¢ was paid for every $1 hospitals in New Jersey billed for this service.
New Jersey hospitals: complex gi procedures
Every New Jersey hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in New Jersey
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
| Monmouth Medical CenterLong Branch, NJ | $4,466 |
|---|---|
| Jersey Shore University Medical CenterNeptune City, NJ | $5,037 |
| Jfk Medical CenterEdison, NJ | $5,598 |
| Englewood Hospital and Medical CenterEnglewood, NJ | $5,601 |
| Umdnj University HospitalNewark, NJ | $5,612 |
Highest
| Hackensack University Medical CenterHackensack, NJ | $6,485 |
|---|---|
| Valley HospitalRidgewood, NJ | $6,485 |
| St Joseph's Regional Medical CenterPaterson, NJ | $6,485 |
| Overlook HospitalSummit, NJ | $6,414 |
| Morristown Memorial HospitalMorristown, NJ | $6,347 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in New Jersey?
In 2024 Medicare data, complex gi procedures (APC 5331) at 43 hospitals in New Jersey was billed at $34,703 on average, while the average medicare-allowed amount was $5,910, of which Medicare paid $4,698. 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 New Jersey, average charges were 5.9 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.