facebook tracking Level 1 ICD and Similar Procedures cost in California: 128 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in California

What 128 hospitals in California charged and were paid for level 1 icd and similar procedures (APC 5231), from 2024 Medicare claims.

APC 5231 Outpatient 2024 Medicare data
Average charge $204,698 Hospital list price billed
Average allowed $30,072 Medicare's payment + patient's share
Medicare paid $28,437 Average per service
State rank #34 of 34 1 = lowest average payment

Hospitals in California billed an average of $204,698 for level 1 icd and similar procedures, about 6.8 times the average medicare-allowed amount of $30,072. That payment is 33% above the U.S. average of $22,647.

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 $30,072Billed $204,698

About 15¢ was paid for every $1 hospitals in California billed for this service.

California hospitals: level 1 icd and similar procedures

Every California hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
Cedars-Sinai Medical CenterLos Angeles 23 $528,404 $28,895 $27,263
Scripps Memorial Hospital la JollaLa Jolla 18 $127,604 $28,895 $27,263
Stanford HospitalPalo Alto 17 $273,510 $33,090 $31,458
University of California San Diego Medical CenterSan Diego 13 $75,308 $28,895 $27,263
UCLA Medical CenterLos Angeles 13 $73,936 $28,895 $27,263
John Muir Medical Center - Concord CampusConcord 13 $184,297 $32,719 $31,087
Adventist Health BakersfieldBakersfield 12 $163,090 $28,895 $27,263
Grossmont HospitalLa Mesa 11 $109,857 $28,895 $27,263
El Camino HospitalMountain View 11 $163,083 $33,090 $31,437
Eisenhower Memorial HospitalRancho Mirage 11 $61,072 $28,895 $27,249
St Joseph HospitalEureka – – – –
Queen of the Valley Medical CenterNapa – – – –
St Helena HospitalDeer Park – – – –
Mercy General HospitalSacramento – – – –
Riverside Community HospitalRiverside – – – –
Oroville HospitalOroville – – – –
Bakersfield Memorial HospitalBakersfield – – – –
Santa Clara Valley Medical CenterSan Jose – – – –
Enloe Medical CenterChico – – – –
Alta Bates Summit Medical CenterOakland – – – –
California Pacific Medical Ctr-Pacific Campus HospSan Francisco – – – –
Antelope Valley Hospital Med CenterLancaster – – – –
Kaweah Delta Medical CenterVisalia – – – –
Glendale Mem Hospital & Hlth CenterGlendale – – – –
Community Regional Medical CenterFresno – – – –
Scripps Mercy HospitalSan Diego – – – –
St Johns Regional Medical CenterOxnard – – – –
St Josephs Med Center of StocktonStockton – – – –
Saint Agnes Medical CenterFresno – – – –
San Antonio Community HospitalUpland – – – –
Sharp Memorial HospitalSan Diego – – – –
Sutter Solano Medical CenterVallejo – – – –
White Memorial Medical CenterLos Angeles – – – –
Marian Medical CenterSanta Maria – – – –
Sutter General HospitalSacramento – – – –
Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica – – – –
Palomar Medical CenterEscondido – – – –
Northridge Hospital Medical CenterNorthridge – – – –
Doctors Hospital of MantecaManteca – – – –
Hanford Community Medical CenterHanford – – – –
Dameron HospitalStockton – – – –
Verdugo Hills HospitalGlendale – – – –
Regional Medical Center of San JoseSan Jose – – – –
Valley Presbyterian HospitalVan Nuys – – – –
Woodland Memorial HospitalWoodland – – – –
Tri-City Medical CenterOceanside – – – –
Rideout Memorial HospitalMarysville – – – –
Kaiser Foundation Hospital - los AngelesLos Angeles – – – –
California Hospital Medical Center laLos Angeles – – – –
St Jude Medical CenterFullerton – – – –
Santa Rosa Memorial HospitalSanta Rosa – – – –
Emanuel Medical Center INCTurlock – – – –
John Muir Medical Center - Walnut Creek CampusWalnut Creek – – – –
Washington HospitalFremont – – – –
Sequoia HospitalRedwood City – – – –
Palmdale Regional Medical CenterLancaster – – – –
Sharp Chula Vista Medical CenterChula Vista – – – –
Hoag Memorial Hospital PresbyterianNewport Beach – – – –
Ahmc Anaheim Regional Medical CenterAnaheim – – – –
Pomona Valley Hospital Medical CenterPomona – – – –
French Hospital Medical CenterSan Luis Obispo – – – –
Providence Saint Joseph Medical CtrBurbank – – – –
USC Arcadia HospitalArcadia – – – –
Glendale Adventist Medical CtrGlendale – – – –
Dominican HospitalSanta Cruz – – – –
Natividad Medical CenterSalinas – – – –
Marshall Medical Center (1-Rh)Placerville – – – –
Providence Holy Cross Medical CenterMission Hills – – – –
Stanford Health Care Tri-ValleyPleasanton – – – –
Seton Medical CenterDaly City – – – –
Saint John's Health CenterSanta Monica – – – –
Sutter Medical Center of Santa RosaSanta Rosa – – – –
St Mary Medical CenterApple Valley – – – –
Ukiah Valley Medical Center/Hospital DUkiah – – – –
Sutter Roseville Medical CenterRoseville – – – –
Highland HospitalOakland – – – –
Loma Linda University Medical CenterLoma Linda – – – –
Corona Regional Medical CenterCorona – – – –
Salinas Valley Memorial HospitalSalinas – – – –
UCI Health-OrangeOrange – – – –
Torrance Memorial Medical CenterTorrance – – – –
Providence Little Company of Mary Med Ctr TorranceTorrance – – – –
Marinhealth Medical CenterGreenbrae – – – –
Northbay Medical CenterFairfield – – – –
Lac/Harbor-UCLA Med CenterTorrance – – – –
Good Samaritan HospitalSan Jose – – – –
Emanate Health Inter-Community HospitalCovina – – – –
Hemet Valley Medical CenterHemet – – – –
Downey Regional Medical CenterDowney – – – –
Community Memorial Hospital - VenturaVentura – – – –
Santa Barbara Cottage HospitalSanta Barbara – – – –
Huntington Memorial HospitalPasadena – – – –
Mercy Medical Ctr MercedMerced – – – –
UCSF Medical CenterSan Francisco – – – –
Doctors Medical CenterModesto – – – –
Good Samaritan HospitalLos Angeles – – – –
West Hills Hospital & Medical CenterWest Hills – – – –
Long Beach Memorial Medical CenterLong Beach – – – –
Clovis Community Medical CenterClovis – – – –
Sutter Auburn Faith HospitalAuburn – – – –
Scripps Memorial Hospital - EncinitasEncinitas – – – –
Mercy San Juan Medical CenterCarmichael – – – –
Victor Valley Community HospitalVictorville – – – –
Sutter Delta Medical CenterAntioch – – – –
Los Robles Hospital & Medical CenterThousand Oaks – – – –
Los Alamitos Medical CenterLos Alamitos – – – –
Memorial Medical CenterModesto – – – –
Mission Hospital Regional Med CenterMission Viejo – – – –
Fountain Valley Regional Hospital & Medical CenterFountain Valley – – – –
Lakewood Regional Medical CenterLakewood – – – –
Chino Valley Medical CenterChino – – – –
UCI Health-Placentia LindaPlacentia – – – –
University of California Davis Medical CenterSacramento – – – –
Saddleback Memorial Medical CenterLaguna Hills – – – –
Henry Mayo Newhall Memorial HospitalValencia – – – –
Palomar Medical Center PowayPoway – – – –
Orange Coast Memorial Medical CenterFountain Valley – – – –
San Ramon Regional Medical CtrSan Ramon – – – –
USC University HospitalLos Angeles – – – –
Southwest Healthcare SystemMurrieta – – – –
Desert Valley HospitalVictorville – – – –
Garfield Medical CenterMonterey Park – – – –
Providence Tarzana Medical CenterTarzana – – – –
Shasta Regional Medical CenterRedding – – – –
Sutter Surgical Hospital - North ValleyYuba City – – – –
Loma Linda University Medical Center-MurrietaMurrieta – – – –
Temecula Valley HospitalTemecula – – – –
Adventist Health TulareTulare – – – –
Level 1 ICD and Similar Procedures: all states All California hospitals California hospital finances
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Lowest and highest allowed amounts in California

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

University of California San Diego Medical CenterSan Diego, CA$28,895
Grossmont HospitalLa Mesa, CA$28,895
UCLA Medical CenterLos Angeles, CA$28,895
Scripps Memorial Hospital la JollaLa Jolla, CA$28,895
Adventist Health BakersfieldBakersfield, CA$28,895

Highest

El Camino HospitalMountain View, CA$33,090
Stanford HospitalPalo Alto, CA$33,090
John Muir Medical Center - Concord CampusConcord, CA$32,719
Eisenhower Memorial HospitalRancho Mirage, CA$28,895
University of California San Diego Medical CenterSan Diego, CA$28,895

Level 1 ICD and Similar Procedures in other states

Connecticut · $26,452 Delaware · $23,586 Massachusetts · $24,790 New Jersey · $25,172 New York · $26,006 Oregon · $24,665 Rhode Island · $23,857 Washington · $24,220

Questions

How much does level 1 icd and similar procedures cost in California?

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 128 hospitals in California was billed at $204,698 on average, while the average medicare-allowed amount was $30,072, of which Medicare paid $28,437. 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 California, average charges were 6.8 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.