What 6 hospitals in North Dakota charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Hospitals in North Dakota billed an average of $29,556 for complex gi procedures, about 5.5 times the average medicare-allowed amount of $5,383. 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.
About 18¢ was paid for every $1 hospitals in North Dakota billed for this service.
Every North Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Sanford Medical Center FargoFargo | 103 | $27,662 | $5,343 | $4,257 |
| Altru Health SystemGrand Forks | 12 | $45,815 | $5,723 | $4,560 |
| St Alexius Medical CenterBismarck | – | – | – | – |
| Trinity HospitalsMinot | – | – | – | – |
| Sanford Medical Center BismarckBismarck | – | – | – | – |
| Essentia Health-FargoFargo | – | – | – | – |
In 2024 Medicare data, complex gi procedures (APC 5331) at 6 hospitals in North Dakota was billed at $29,556 on average, while the average medicare-allowed amount was $5,383, of which Medicare paid $4,289. Your own cost depends on your insurance, deductible and the hospital.
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 North Dakota, average charges were 5.5 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.