facebook tracking Level 1 ICD and Similar Procedures cost in New York: 49 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in New York

What 49 hospitals in New York 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 $130,876 Hospital list price billed
Average allowed $26,006 Medicare's payment + patient's share
Medicare paid $24,372 Average per service
State rank #32 of 34 1 = lowest average payment

Hospitals in New York billed an average of $130,876 for level 1 icd and similar procedures, about 5.0 times the average medicare-allowed amount of $26,006. That payment is 15% 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 $26,006Billed $130,876

About 20¢ was paid for every $1 hospitals in New York billed for this service.

New York hospitals: level 1 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
New York-Presbyterian HospitalNew York 56 $93,848 $26,746 $25,113
NYU Hospitals CenterNew York 50 $259,231 $26,461 $24,829
St Francis Hospital, RoslynRoslyn 49 $135,886 $25,977 $24,342
University HospitalStony Brook 19 $167,656 $26,252 $24,612
St Peter's HospitalAlbany 17 $48,038 $24,922 $23,290
Montefiore Medical CenterBronx 17 $99,027 $26,475 $24,843
Buffalo General HospitalBuffalo 15 $44,532 $24,922 $23,290
Mount Sinai HospitalNew York 15 $62,426 $26,746 $25,114
Wynn HospitalUtica 14 $98,648 $24,922 $23,290
Strong Memorial HospitalRochester 14 $68,037 $24,922 $23,290
Good Samaritan Hospital Medical CenterWest Islip 12 $157,048 $24,200 $22,568
Albany Medical Center HospitalAlbany – – – –
Jamaica Hospital Med CenterJamaica – – – –
Vassar Brothers Medical CenterPoughkeepsie – – – –
Richmond University Medical CenterStaten Island – – – –
Southside HospitalBay Shore – – – –
Huntington HospitalHuntington – – – –
Mount Sinai WestNew York – – – –
New York Hospital Medical Center of QueensNew York – – – –
Arnot Ogden Medical CenterElmira – – – –
North Shore University HospitalManhasset – – – –
Peconic Bay Medical CenterRiverhead – – – –
Lenox Hill HospitalNew York – – – –
Rochester General HospitalRochester – – – –
Garnet Health Medical CenterGoshen – – – –
Jacobi Medical CenterBronx – – – –
Mary Imogene Bassett HospitalCooperstown – – – –
St Joseph's Hospital Health CenterSyracuse – – – –
Ellis HospitalSchenectady – – – –
Good Samaritan Hospital of SuffernSuffern – – – –
Staten Island University HospitalStaten Island – – – –
Northern Westchester HospitalMt Kisco – – – –
Glens Falls HospitalGlens Falls – – – –
Maimonides Medical CenterBrooklyn – – – –
Long Island Jewish Medical CenterNew Hyde Park – – – –
South Nassau Communities HospitalOceanside – – – –
Crouse HospitalSyracuse – – – –
Bellevue Hospital CenterNew York – – – –
Unity Hospital of RochesterRochester – – – –
Westchester Medical CenterValhalla – – – –
UPMC Chautauqua at WcaJamestown – – – –
University Hospital S U N Y Health Science CenterSyracuse – – – –
Champlain Valley Physicians Hospital Medical CtrPlattsburgh – – – –
Cornwall HospitalCornwall – – – –
Mercy HospitalBuffalo – – – –
White Plains Hospital CtrWhite Plains – – – –
Cayuga Medical Center at IthacaIthaca – – – –
United Health Services HospsBinghamton – – – –
St Catherine of Siena HospitalSmithtown – – – –
Level 1 ICD and Similar Procedures: all states All New York hospitals New York hospital finances
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Lowest and highest allowed amounts in New York

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

Good Samaritan Hospital Medical CenterWest Islip, NY$24,200
Buffalo General HospitalBuffalo, NY$24,922
Wynn HospitalUtica, NY$24,922
St Peter's HospitalAlbany, NY$24,922
Strong Memorial HospitalRochester, NY$24,922

Highest

New York-Presbyterian HospitalNew York, NY$26,746
Mount Sinai HospitalNew York, NY$26,746
Montefiore Medical CenterBronx, NY$26,475
NYU Hospitals CenterNew York, NY$26,461
University HospitalStony Brook, NY$26,252

Level 1 ICD and Similar Procedures in other states

Connecticut · $26,452 Delaware · $23,586 Massachusetts · $24,790 Minnesota · $23,386 New Jersey · $25,172 Oregon · $24,665 Rhode Island · $23,857 Washington · $24,220

Questions

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

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 49 hospitals in New York was billed at $130,876 on average, while the average medicare-allowed amount was $26,006, of which Medicare paid $24,372. 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 New York, average charges were 5.0 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.