facebook tracking Level 1 ICD and Similar Procedures cost in Georgia: 38 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in Georgia

What 38 hospitals in Georgia 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 $96,060 Hospital list price billed
Average allowed $21,553 Medicare's payment + patient's share
Medicare paid $19,909 Average per service
State rank #20 of 34 1 = lowest average payment

Hospitals in Georgia billed an average of $96,060 for level 1 icd and similar procedures, about 4.5 times the average medicare-allowed amount of $21,553. That payment is 5% below 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 $21,553Billed $96,060

About 22¢ was paid for every $1 hospitals in Georgia billed for this service.

Georgia hospitals: level 1 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Piedmont HospitalAtlanta 13 $91,556 $21,819 $20,167
Atrium Health Navicent the Medical CenterMacon 12 $71,643 $21,021 $19,385
Wellstar Kennestone HospitalMarietta 11 $128,021 $21,819 $20,175
Hamilton Medical CenterDalton – – – –
Northside Hospital ForsythCumming – – – –
St Mary's HospitalAthens – – – –
Phoebe Putney Memorial HospitalAlbany – – – –
Northside Hospital CherokeeCanton – – – –
Emory University HospitalAtlanta – – – –
Tanner Medical Center - CarrolltonCarrollton – – – –
West Georgia Medical CenterLagrange – – – –
Piedmont Augusta HospitalAugusta – – – –
Northeast Georgia Medical Center, INCGainesville – – – –
Spalding Regional Medical CenterGriffin – – – –
Medical College of Ga Hospitals and ClinicsAugusta – – – –
Memorial Health Univ Med Cen, INCSavannah – – – –
Wellstar Paulding HospitalDallas – – – –
St Joseph's Hospital - SavannahSavannah – – – –
Piedmont Columbus Regional MidtownColumbus – – – –
Athens Regional Medical CenterAthens – – – –
East Georgia Regional Medical CenterStatesboro – – – –
Emory Decatur HospitalDecatur – – – –
Emory University Hospital MidtownAtlanta – – – –
Saint Joseph's Hosp of AtlantaAtlanta – – – –
Gwinnett Medical CenterLawrenceville – – – –
Colquitt Reg Medical CenterMoultrie – – – –
Sgmc HealthValdosta – – – –
Fairview Park HospitalDublin – – – –
Wellstar Cobb HospitalAustell – – – –
Northside HospitalAtlanta – – – –
Coliseum Medical CenterMacon – – – –
Southern Regional Medical CenterRiverdale – – – –
Redmond Regional Medical CenterRome – – – –
Henry Medical Center, INCStockbridge – – – –
Emory Eastside Medical CenterSnellville – – – –
Piedmont Fayette HospitalFayetteville – – – –
Piedmont Newnan Hospital, INCNewnan – – – –
Emory Johns Creek HospitalJohns Creek – – – –
Level 1 ICD and Similar Procedures: all states All Georgia hospitals Georgia hospital finances
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Lowest and highest allowed amounts in Georgia

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

Atrium Health Navicent the Medical CenterMacon, GA$21,021
Wellstar Kennestone HospitalMarietta, GA$21,819
Piedmont HospitalAtlanta, GA$21,819

Highest

Piedmont HospitalAtlanta, GA$21,819
Wellstar Kennestone HospitalMarietta, GA$21,819
Atrium Health Navicent the Medical CenterMacon, GA$21,021

Level 1 ICD and Similar Procedures in other states

Illinois · $21,639 Indiana · $21,143 Iowa · $21,044 Mississippi · $21,084 Nebraska · $21,186 Pennsylvania · $21,882 Utah · $21,062 Wisconsin · $22,123

Questions

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

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 38 hospitals in Georgia was billed at $96,060 on average, while the average medicare-allowed amount was $21,553, of which Medicare paid $19,909. 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 Georgia, average charges were 4.5 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.