Complex GI Procedures in West Virginia
What 13 hospitals in West Virginia charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$25,685
Hospital list price billed
Average allowed
$4,661
Medicare's payment + patient's share
Medicare paid
$3,680
Average per service
State rank
#7 of 48
1 = lowest average payment
Hospitals in West Virginia billed an average of $25,685 for complex gi procedures, about 5.5 times the average medicare-allowed amount of $4,661. That payment is 13% 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 $4,661Billed $25,685
About 18¢ was paid for every $1 hospitals in West Virginia billed for this service.
West Virginia hospitals: complex gi procedures
Every West Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| West Virginia University HospitalsMorgantown | 65 | $20,772 | $4,431 | $3,507 |
| Cabell-Huntington Hospital INCHuntington | 46 | $29,179 | $4,518 | $3,531 |
| United Hospital CenterBridgeport | 26 | $19,506 | $5,444 | $4,338 |
| Charleston Area Medical CenterCharleston | 21 | $40,349 | $4,831 | $3,846 |
| Thomas Memorial HospitalSouth Charleston | 17 | $20,129 | $4,605 | $3,623 |
| Mon Health Medical CenterMorgantown | 14 | $33,233 | $4,552 | $3,571 |
| Greenbrier Valley Medical CenterRonceverte | – | – | – | – |
| St Mary's Medical CenterHuntington | – | – | – | – |
| Berkeley Medical CenterMartinsburg | – | – | – | – |
| Weirton Medical CenterWeirton | – | – | – | – |
| Logan Regional Medical CenterLogan | – | – | – | – |
| Wheeling HospitalWheeling | – | – | – | – |
| Camden Clark Memorial HospitalParkersburg | – | – | – | – |
Lowest and highest allowed amounts in West Virginia
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
| West Virginia University HospitalsMorgantown, WV | $4,431 |
|---|---|
| Cabell-Huntington Hospital INCHuntington, WV | $4,518 |
| Mon Health Medical CenterMorgantown, WV | $4,552 |
| Thomas Memorial HospitalSouth Charleston, WV | $4,605 |
| Charleston Area Medical CenterCharleston, WV | $4,831 |
Highest
| United Hospital CenterBridgeport, WV | $5,444 |
|---|---|
| Charleston Area Medical CenterCharleston, WV | $4,831 |
| Thomas Memorial HospitalSouth Charleston, WV | $4,605 |
| Mon Health Medical CenterMorgantown, WV | $4,552 |
| Cabell-Huntington Hospital INCHuntington, WV | $4,518 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in West Virginia?
In 2024 Medicare data, complex gi procedures (APC 5331) at 13 hospitals in West Virginia was billed at $25,685 on average, while the average medicare-allowed amount was $4,661, of which Medicare paid $3,680. 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 West Virginia, 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.