Complex GI Procedures in Pennsylvania
What 78 hospitals in Pennsylvania charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$46,761
Hospital list price billed
Average allowed
$5,177
Medicare's payment + patient's share
Medicare paid
$4,116
Average per service
State rank
#29 of 48
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $46,761 for complex gi procedures, about 9.0 times the average medicare-allowed amount of $5,177. That payment is 3% 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 $5,177Billed $46,761
About 11¢ was paid for every $1 hospitals in Pennsylvania billed for this service.
Pennsylvania hospitals: complex gi procedures
Every Pennsylvania hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Thomas Jefferson University HospitalPhiladelphia | 135 | $51,680 | $5,435 | $4,331 |
| Hospital of the Univ of PaPhiladelphia | 102 | $35,667 | $5,517 | $4,395 |
| Milton S Hershey Medical CenterHershey | 67 | $59,243 | $5,364 | $4,273 |
| St Luke's Hospital BethlehemBethlehem | 65 | $50,399 | $4,827 | $3,816 |
| Fox Chase Cancer CenterPhiladelphia | 48 | $73,781 | $5,537 | $4,412 |
| Geisinger Medical CenterDanville | 42 | $67,999 | $5,090 | $4,051 |
| Lehigh Valley HospitalAllentown | 42 | $70,839 | $4,659 | $3,691 |
| Main Line Hospital LankenauWynnewood | 39 | $30,941 | $5,498 | $4,381 |
| Allegheny General HospitalPittsburgh | 38 | $37,813 | $5,090 | $4,056 |
| Lewistown HospitalLewistown | 35 | $31,297 | $4,671 | $3,722 |
| UPMC Presbyterian ShadysidePittsburgh | 35 | $51,704 | $5,090 | $4,056 |
| Wilkes-Barre General HospitalWilkes-Barre | 32 | $56,545 | $4,074 | $3,169 |
| Lancaster General HospitalLancaster | 24 | $26,051 | $5,080 | $4,048 |
| Robert Packer HospitalSayre | 23 | $23,538 | $5,235 | $4,171 |
| West Penn HospitalPittsburgh | 22 | $31,970 | $5,090 | $4,050 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre | 19 | $58,768 | $4,663 | $3,629 |
| Doylestown HospitalDoylestown | 18 | $30,501 | $5,498 | $4,381 |
| York HospitalYork | 17 | $30,066 | $5,364 | $4,274 |
| Albert Einstein Medical CenterPhiladelphia | 16 | $21,620 | $5,537 | $4,412 |
| UPMC Pinnacle HospitalsHarrisburg | 15 | $23,839 | $5,107 | $4,063 |
| Abington Memorial HospitalAbington | 15 | $37,424 | $5,347 | $4,260 |
| Geisinger-Community Medical CenterScranton | 14 | $63,713 | $5,091 | $4,042 |
| UPMC PassavantPittsburgh | 12 | $37,061 | $5,091 | $4,040 |
| Reading Hospital and Med CtrWest Reading | 11 | $22,511 | $5,207 | $4,149 |
| Williamsport Hospital & Medical CenterWilliamsport | 11 | $41,662 | $4,628 | $3,687 |
| Bloomsburg HospitalBloomsburg | – | – | – | – |
| Saint Vincent Health CenterErie | – | – | – | – |
| Temple University HospitalPhiladelphia | – | – | – | – |
| UPMC MercyPittsburgh | – | – | – | – |
| Schuylkill Medical Center - South Jackson StreetPottsville | – | – | – | – |
| Grand View HospitalSellersville | – | – | – | – |
| Hamot Medical CenterErie | – | – | – | – |
| Good Samaritan HospitalLebanon | – | – | – | – |
| Dubois Regional Medical CenterDubois | – | – | – | – |
| Clarion HospitalClarion | – | – | – | – |
| St Joseph Medical CenterReading | – | – | – | – |
| Holy Redeemer Hosp and Med CtrJenkintown | – | – | – | – |
| UPMC St MargaretPittsburgh | – | – | – | – |
| Conemaugh Valley Memorial HospitalJohnstown | – | – | – | – |
| Meadville Medical CenterMeadville | – | – | – | – |
| Jefferson Health- NortheastPhiladelphia | – | – | – | – |
| UPMC BedfordEverett | – | – | – | – |
| Pottstown Memorial Med CenterPottstown | – | – | – | – |
| Wayne Memorial HospitalHonesdale | – | – | – | – |
| Excela Health Westmoreland Regional HospitalGreensburg | – | – | – | – |
| Warren General HospitalWarren | – | – | – | – |
| Chambersburg HospitalChambersburg | – | – | – | – |
| Main Line Hospital PaoliPaoli | – | – | – | – |
| Mercy Health SystemConshohocken | – | – | – | – |
| Canonsburg General HospitalCanonsburg | – | – | – | – |
| Easton HospitalEaston | – | – | – | – |
| Butler Health SystemButler | – | – | – | – |
| Chester County HospitalWest Chester | – | – | – | – |
| St Luke's Miners Memorial HospitalCoaldale | – | – | – | – |
| Hazleton General HospitalHazleton | – | – | – | – |
| Pocono Medical CenterEast Stroudsburg | – | – | – | – |
| Excela Health Frick HospitalMt Pleasant | – | – | – | – |
| Latrobe Area HospitalLatrobe | – | – | – | – |
| Riddle Memorial HospitalMedia | – | – | – | – |
| Penn Presbyterian Medical CenterPhiladelphia | – | – | – | – |
| Ephrata Community HospitalEphrata | – | – | – | – |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia | – | – | – | – |
| St Clair Memorial HospitalPittsburgh | – | – | – | – |
| Hanover HospitalHanover | – | – | – | – |
| Mercy Hospital ScrantonScranton | – | – | – | – |
| St Mary Medical CenterLanghorne | – | – | – | – |
| Jefferson Regional Medical CenterClairton | – | – | – | – |
| Grove City Medical CenterGrove City | – | – | – | – |
| Western Pennsylvania Hosp Forbes Regional CampusMonroeville | – | – | – | – |
| Mount Nittany Medical CenterState College | – | – | – | – |
| St Luke's Hospital - Anderson CampusEaston | – | – | – | – |
| UPMC EastMonroeville | – | – | – | – |
| Jefferson Einstein Montgomery HospitalEast Norriton | – | – | – | – |
| St Luke's Hospital - Monroe CampusStroudsburg | – | – | – | – |
| Geisinger St. Luke's HospitalOrwigsburg | – | – | – | – |
| AHN Wexford HospitalWexford | – | – | – | – |
| Geisinger Medical Center MuncyMuncy | – | – | – | – |
| Penn State Health Lancaster Medical CenterLancaster | – | – | – | – |
Lowest and highest allowed amounts in Pennsylvania
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
| Wilkes-Barre General HospitalWilkes-Barre, PA | $4,074 |
|---|---|
| Williamsport Hospital & Medical CenterWilliamsport, PA | $4,628 |
| Lehigh Valley HospitalAllentown, PA | $4,659 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre, PA | $4,663 |
| Lewistown HospitalLewistown, PA | $4,671 |
Highest
| Albert Einstein Medical CenterPhiladelphia, PA | $5,537 |
|---|---|
| Fox Chase Cancer CenterPhiladelphia, PA | $5,537 |
| Hospital of the Univ of PaPhiladelphia, PA | $5,517 |
| Main Line Hospital LankenauWynnewood, PA | $5,498 |
| Doylestown HospitalDoylestown, PA | $5,498 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Pennsylvania?
In 2024 Medicare data, complex gi procedures (APC 5331) at 78 hospitals in Pennsylvania was billed at $46,761 on average, while the average medicare-allowed amount was $5,177, of which Medicare paid $4,116. 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 Pennsylvania, average charges were 9.0 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.