Level 1 ICD and Similar Procedures in Virginia
What 35 hospitals in Virginia charged and were paid for level 1 icd and similar procedures (APC 5231), from 2024 Medicare claims.
Average charge
$88,949
Hospital list price billed
Average allowed
$20,788
Medicare's payment + patient's share
Medicare paid
$19,156
Average per service
State rank
#14 of 34
1 = lowest average payment
Hospitals in Virginia billed an average of $88,949 for level 1 icd and similar procedures, about 4.3 times the average medicare-allowed amount of $20,788. That payment is 8% 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 $20,788Billed $88,949
About 23¢ was paid for every $1 hospitals in Virginia billed for this service.
Virginia hospitals: level 1 icd and similar procedures
Every Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Virginia
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
| Medical College of Virginia HospitalsRichmond, VA | $20,269 |
|---|---|
| Sentara Norfolk General HospitalNorfolk, VA | $20,459 |
| Inova Fairfax HospitalFalls Church, VA | $21,230 |
Highest
| Inova Fairfax HospitalFalls Church, VA | $21,230 |
|---|---|
| Sentara Norfolk General HospitalNorfolk, VA | $20,459 |
| Medical College of Virginia HospitalsRichmond, VA | $20,269 |
Level 1 ICD and Similar Procedures in other states
Questions
How much does level 1 icd and similar procedures cost in Virginia?
In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 35 hospitals in Virginia was billed at $88,949 on average, while the average medicare-allowed amount was $20,788, of which Medicare paid $19,156. 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 Virginia, average charges were 4.3 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.