Complex GI Procedures in Washington
What 31 hospitals in Washington charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$31,020
Hospital list price billed
Average allowed
$5,713
Medicare's payment + patient's share
Medicare paid
$4,544
Average per service
State rank
#38 of 48
1 = lowest average payment
Hospitals in Washington billed an average of $31,020 for complex gi procedures, about 5.4 times the average medicare-allowed amount of $5,713. That payment is 7% 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 $5,713Billed $31,020
About 18¢ was paid for every $1 hospitals in Washington billed for this service.
Washington hospitals: complex gi procedures
Every Washington hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Washington
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
| Confluence Health HospitalWenatchee, WA | $5,349 |
|---|---|
| University of Washington Medical CtrSeattle, WA | $5,551 |
| Tacoma General HospitalTacoma, WA | $5,578 |
| Providence Sacred Heart Medical CenterSpokane, WA | $5,582 |
| Virginia Mason Medical CenterSeattle, WA | $5,621 |
Highest
| St Michael Medical CenterBremerton, WA | $6,147 |
|---|---|
| Peacehealth St Joseph Medical CenterBellingham, WA | $6,126 |
| Swedish Medical CenterSeattle, WA | $5,937 |
| St Joseph Medical CenterTacoma, WA | $5,872 |
| Providence Regional Medical Center EverettEverett, WA | $5,821 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Washington?
In 2024 Medicare data, complex gi procedures (APC 5331) at 31 hospitals in Washington was billed at $31,020 on average, while the average medicare-allowed amount was $5,713, of which Medicare paid $4,544. 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 Washington, average charges were 5.4 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.