facebook tracking Level 1 ICD and Similar Procedures cost in Tennessee: 29 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in Tennessee

What 29 hospitals in Tennessee 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 $94,175 Hospital list price billed
Average allowed $19,646 Medicare's payment + patient's share
Medicare paid $18,014 Average per service
State rank #3 of 34 1 = lowest average payment

Hospitals in Tennessee billed an average of $94,175 for level 1 icd and similar procedures, about 4.8 times the average medicare-allowed amount of $19,646. That payment is 13% 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 $19,646Billed $94,175

About 21¢ was paid for every $1 hospitals in Tennessee billed for this service.

Tennessee hospitals: level 1 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Baptist Memorial HospitalMemphis 27 $96,802 $19,242 $17,610
Methodist Healthcare-MemphisMemphis 19 $166,710 $19,741 $18,109
Vanderbilt University HospitalNashville 17 $89,253 $19,652 $18,020
Memorial Healthcare System, INCChattanooga 14 $49,599 $20,039 $18,407
Jackson-Madison Cnty Gen HospJackson 12 $60,777 $21,084 $19,452
Univ of Tn Mem HospitalKnoxville 11 $71,621 $17,778 $16,146
Centennial Medical CenterNashville 11 $85,769 $20,258 $18,626
Skyline Medical CenterNashville – – – –
Wellmont Bristol Regional Medical CenterBristol – – – –
Baptist Memorial Hospital HuntingdonHuntingdon – – – –
Wellmont Holston Vly Med CtrKingsport – – – –
Roane Medical CenterHarriman – – – –
Methodist Med Ctr of Oak RidgeOak Ridge – – – –
Horizon Medical CenterDickson – – – –
Saint Thomas Rutherford HospitalMurfreesboro – – – –
Southern Tennessee Medical CenterWinchester – – – –
Cookeville Regional Med CenterCookeville – – – –
Johnson City Medical CenterJohnson City – – – –
Maury Regional HospitalColumbia – – – –
St Thomas HospitalNashville – – – –
Erlanger Medical CenterChattanooga – – – –
Physicians Regional Medical CenterKnoxville – – – –
Vanderbilt Bedford HospitalShelbyville – – – –
Harton Regional Medical CenterTullahoma – – – –
Parkridge Medical CenterChattanooga – – – –
St Francis HospitalMemphis – – – –
Vanderbilt Wilson County HospitalLebanon – – – –
Hendersonville Medical CenterHendersonville – – – –
Saint Francis Bartlett Medical CenterBartlett – – – –
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Lowest and highest allowed amounts in Tennessee

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

Univ of Tn Mem HospitalKnoxville, TN$17,778
Baptist Memorial HospitalMemphis, TN$19,242
Vanderbilt University HospitalNashville, TN$19,652
Methodist Healthcare-MemphisMemphis, TN$19,741
Memorial Healthcare System, INCChattanooga, TN$20,039

Highest

Jackson-Madison Cnty Gen HospJackson, TN$21,084
Centennial Medical CenterNashville, TN$20,258
Memorial Healthcare System, INCChattanooga, TN$20,039
Methodist Healthcare-MemphisMemphis, TN$19,741
Vanderbilt University HospitalNashville, TN$19,652

Level 1 ICD and Similar Procedures in other states

Questions

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

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 29 hospitals in Tennessee was billed at $94,175 on average, while the average medicare-allowed amount was $19,646, of which Medicare paid $18,014. 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 Tennessee, average charges were 4.8 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.