Level 1 Abdominal/Peritoneal/Biliary and Related Procedures in Kentucky
What 55 hospitals in Kentucky charged and were paid for level 1 abdominal/peritoneal/biliary and related procedures (APC 5341), from 2024 Medicare claims.
APC 5341Outpatient2024 Medicare data
Average charge$25,325Hospital list price billed
Average allowed$2,971Medicare's payment + patient's share
Medicare paid$2,356Average per service
State rank#11 of 491 = lowest average payment
Hospitals in Kentucky billed an average of $25,325 for level 1 abdominal/peritoneal/biliary and related procedures, about 8.5 times the average medicare-allowed amount of $2,971. That payment is 11% below the U.S. average of $3,323.
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 $2,971Billed $25,325
About 12¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: level 1 abdominal/peritoneal/biliary and related procedures
Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
How much does level 1 abdominal/peritoneal/biliary and related procedures cost in Kentucky?
In 2024 Medicare data, level 1 abdominal/peritoneal/biliary and related procedures (APC 5341) at 55 hospitals in Kentucky was billed at $25,325 on average, while the average medicare-allowed amount was $2,971, of which Medicare paid $2,356. 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 Kentucky, average charges were 8.5 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.
