facebook tracking Level 1 ICD and Similar Procedures cost in Michigan: 42 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in Michigan

What 42 hospitals in Michigan 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 $141,698 Hospital list price billed
Average allowed $20,647 Medicare's payment + patient's share
Medicare paid $19,011 Average per service
State rank #11 of 34 1 = lowest average payment

Hospitals in Michigan billed an average of $141,698 for level 1 icd and similar procedures, about 6.9 times the average medicare-allowed amount of $20,647. That payment is 9% 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 $20,647Billed $141,698

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

Michigan hospitals: level 1 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Edward W Sparrow HospitalLansing 17 $149,924 $20,484 $18,852
Beaumont Hospital - DearbornDearborn 14 $142,941 $20,995 $19,355
William Beaumont HospitalRoyal Oak 13 $128,774 $19,469 $17,829
Univ of Michigan HospitalsAnn Arbor 12 $142,595 $21,749 $20,117
Bronson Methodist HospitalKalamazoo – – – –
Providence Hospital and Medical CentersSouthfield – – – –
Lakeland Hospital, St JosephSt Joseph – – – –
St Joseph Mercy OaklandPontiac – – – –
Mymichigan Medical Center AlmaAlma – – – –
Spectrum Health - Butterworth CampusGrand Rapids – – – –
Bay Regional Medical CenterBay City – – – –
Henry Ford Macomb HospitalClinton Twp – – – –
Henry Ford HospitalDetroit – – – –
Marquette General Hlth SystemMarquette – – – –
Dickinson County Memorial HospitalIron Mountain – – – –
Trinity Health Muskegon HospitalMuskegon – – – –
Covenant Medical Center, INCSaginaw – – – –
Mymichigan Medical Center SaginawSaginaw – – – –
Central Michigan Community HospitalMt Pleasant – – – –
Beaumont Hospital, Grosse PointeGrosse Pointe – – – –
Allegiance HealthJackson – – – –
West Branch Regional Medical CenterWest Branch – – – –
Munson Medical CenterTraverse City – – – –
Harper University HospitalDetroit – – – –
Northern Michigan Regional HospitalPetoskey – – – –
Borgess Medical CenterKalamazoo – – – –
Hurley Medical CenterFlint – – – –
McLaren Regional Medical CenterFlint – – – –
Henry Ford Wyandotte HospitalWyandotte – – – –
Beaumont Hospital - Farmington HillsFarmington Hls – – – –
Trinity Health Ann Arbor HospitalAnn Arbor – – – –
St John Hospital and Medical CenterDetroit – – – –
McLaren Greater LansingLansing – – – –
Henry Ford Health Warren HospitalWarren – – – –
Genesys Regional Medical Center - Health ParkGrand Blanc – – – –
McLaren OaklandPontiac – – – –
Port Huron HospitalPort Huron – – – –
Midmichigan Medical Center-MidlandMidland – – – –
McLaren MacombMt Clemens – – – –
University of Michigan Health - WestWyoming – – – –
William Beaumont Hospital-TroyTroy – – – –
Huron Valley-Sinai HospitalCommerce Twp – – – –
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Lowest and highest allowed amounts in Michigan

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

William Beaumont HospitalRoyal Oak, MI$19,469
Edward W Sparrow HospitalLansing, MI$20,484
Beaumont Hospital - DearbornDearborn, MI$20,995
Univ of Michigan HospitalsAnn Arbor, MI$21,749

Highest

Univ of Michigan HospitalsAnn Arbor, MI$21,749
Beaumont Hospital - DearbornDearborn, MI$20,995
Edward W Sparrow HospitalLansing, MI$20,484
William Beaumont HospitalRoyal Oak, MI$19,469

Level 1 ICD and Similar Procedures in other states

Questions

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

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 42 hospitals in Michigan was billed at $141,698 on average, while the average medicare-allowed amount was $20,647, of which Medicare paid $19,011. 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 Michigan, average charges were 6.9 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.