Level 1 ICD and Similar Procedures in Massachusetts
What 31 hospitals in Massachusetts charged and were paid for level 1 icd and similar procedures (APC 5231), from 2024 Medicare claims.
Average charge
$61,341
Hospital list price billed
Average allowed
$24,790
Medicare's payment + patient's share
Medicare paid
$23,158
Average per service
State rank
#30 of 34
1 = lowest average payment
Hospitals in Massachusetts billed an average of $61,341 for level 1 icd and similar procedures, about 2.5 times the average medicare-allowed amount of $24,790. That payment is 9% 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 $24,790Billed $61,341
About 40¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 1 icd and similar procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Massachusetts
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
| South Shore HospitalSouth Weymouth, MA | $23,277 |
|---|---|
| Lahey Clinic HospitalBurlington, MA | $23,428 |
| Massachusetts General HospitalBoston, MA | $25,244 |
| Beth Israel Deaconess Medical CenterBoston, MA | $25,244 |
| Brigham and Women's HosptialBoston, MA | $25,244 |
Highest
| Massachusetts General HospitalBoston, MA | $25,244 |
|---|---|
| Beth Israel Deaconess Medical CenterBoston, MA | $25,244 |
| Brigham and Women's HosptialBoston, MA | $25,244 |
| Umass Memorial Medical Center INCWorcester, MA | $25,244 |
| Lahey Clinic HospitalBurlington, MA | $23,428 |
Level 1 ICD and Similar Procedures in other states
Questions
How much does level 1 icd and similar procedures cost in Massachusetts?
In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 31 hospitals in Massachusetts was billed at $61,341 on average, while the average medicare-allowed amount was $24,790, of which Medicare paid $23,158. 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 Massachusetts, average charges were 2.5 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.