facebook tracking Level 1 ICD and Similar Procedures cost in Ohio: 56 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in Ohio

What 56 hospitals in Ohio 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 $82,859 Hospital list price billed
Average allowed $20,062 Medicare's payment + patient's share
Medicare paid $18,422 Average per service
State rank #7 of 34 1 = lowest average payment

Hospitals in Ohio billed an average of $82,859 for level 1 icd and similar procedures, about 4.1 times the average medicare-allowed amount of $20,062. That payment is 11% 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 $20,062Billed $82,859

About 24¢ was paid for every $1 hospitals in Ohio billed for this service.

Ohio hospitals: level 1 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Cleveland Clinic - Main CampusCleveland 25 $61,828 $20,073 $18,441
Christ HospitalCincinnati 23 $84,522 $19,601 $17,945
Ohio State University HospitalsColumbus 22 $81,553 $20,217 $18,585
University Hospitals - Elyria Medical CenterElyria 14 $73,097 $20,073 $18,441
Hillcrest HospitalCleveland 13 $66,844 $18,655 $17,023
Toledo Hospital theToledo 12 $85,805 $19,852 $18,220
Mercy St Vincent Medical CenterToledo 12 $150,250 $20,995 $19,343
Riverside Methodist HospitalColumbus 11 $61,442 $21,026 $19,371
Miami Valley HospitalDayton 11 $105,826 $20,582 $18,950
University Hospital, INCCincinnati – – – –
Southern Ohio Medical CenterPortsmouth – – – –
Lima Memorial Health SystemLima – – – –
Marion General HospitalMarion – – – –
Mount Carmel St Ann's HospitalWesterville – – – –
Grant Medical CenterColumbus – – – –
Summa Health System - Akron CampusAkron – – – –
Firelands Community HospitalSandusky – – – –
Cleveland Clinic - Akron GeneralAkron – – – –
Mount Carmel HealthColumbus – – – –
Wooster Community HospitalWooster – – – –
Genesis Healthcare SystemZanesville – – – –
Knox Community HospitalMt Vernon – – – –
Parma Community General HospitalParma – – – –
University of Toledo Medical CenterToledo – – – –
Holzer Medical CenterGallipolis – – – –
Mercy Hospital FairfieldFairfield – – – –
Metrohealth SystemCleveland – – – –
St Elizabeth Health CenterYoungstown – – – –
St Rita's Medical CenterLima – – – –
Mercy Medical CenterCanton – – – –
Fairfield Medical CenterLancaster – – – –
Atrium Medical CenterMiddletown – – – –
Fairview HospitalCleveland – – – –
University Hospitals Portage Medical CenterRavenna – – – –
Kettering Medical CenterKettering – – – –
Aultman HospitalCanton – – – –
Springfield Regional Medical CenterSpringfield – – – –
Blanchard Valley Health AssnFindlay – – – –
Lake Hospital SystemPainesville – – – –
Ohiohealth Mansfield HospitalMansfield – – – –
St John Medical CenterWestlake – – – –
Ashtabula County Medical CenterAshtabula – – – –
Kettering Health DaytonDayton – – – –
Good Samaritan HospitalCincinnati – – – –
University Hospitals of ClevelandCleveland – – – –
Southwest General Health CenterMiddleburg Heights – – – –
Adena Regional Medical CenterChillicothe – – – –
Mercy Regional Medical CenterLorain – – – –
Upper Valley Medical CenterTroy – – – –
Bethesda North HospitalCincinnati – – – –
Mary Rutan HospitalBellefontaine – – – –
Trinity Medical Ctr East&Trinity Medical Ctr WestSteubenville – – – –
Licking Memorial HospitalNewark – – – –
West Chester Medical CenterWest Chester – – – –
Soin Medical CenterBeaver Creek – – – –
Avita OntarioOntario – – – –
Level 1 ICD and Similar Procedures: all states All Ohio hospitals Ohio hospital finances
Advertisement

Lowest and highest allowed amounts in Ohio

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

Hillcrest HospitalCleveland, OH$18,655
Christ HospitalCincinnati, OH$19,601
Toledo Hospital theToledo, OH$19,852
University Hospitals - Elyria Medical CenterElyria, OH$20,073
Cleveland Clinic - Main CampusCleveland, OH$20,073

Level 1 ICD and Similar Procedures in other states

Alabama · $19,862 Florida · $20,132 Kansas · $20,609 Kentucky · $19,787 Missouri · $19,924 Oklahoma · $19,509 South Carolina · $20,122 Tennessee · $19,646

Questions

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

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 56 hospitals in Ohio was billed at $82,859 on average, while the average medicare-allowed amount was $20,062, of which Medicare paid $18,422. 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 Ohio, average charges were 4.1 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.