facebook tracking Level 1 ICD and Similar Procedures cost in Wisconsin: 24 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in Wisconsin

What 24 hospitals in Wisconsin 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 $117,325 Hospital list price billed
Average allowed $22,123 Medicare's payment + patient's share
Medicare paid $20,491 Average per service
State rank #23 of 34 1 = lowest average payment

Hospitals in Wisconsin billed an average of $117,325 for level 1 icd and similar procedures, about 5.3 times the average medicare-allowed amount of $22,123. That payment is 2% 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 $22,123Billed $117,325

About 19¢ was paid for every $1 hospitals in Wisconsin billed for this service.

Wisconsin hospitals: level 1 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Aurora St Lukes Medical CenterMilwaukee 12 $117,325 $22,123 $20,491
Ministry St Michaels Hospital of Stevens PointStevens Point – – – –
Mayo Clinic Health System-Franciscan Medical CenterLa Crosse – – – –
Waukesha Memorial HospitalWaukesha – – – –
St Elizabeth HsptlAppleton – – – –
Monroe ClinicMonroe – – – –
Aspirus Wausau HospitalWausau – – – –
Marshfield Medical CenterMarshfield – – – –
Bellin Memorial HsptlGreen Bay – – – –
Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee – – – –
Aurora Memorial Hsptl BurlingtonBurlington – – – –
Luther Hospital Mayo Health SystemEau Claire – – – –
St Mary's HospitalMadison – – – –
Gundersen Luth Med CtrLa Crosse – – – –
St Agnes HsptlFond du Lac – – – –
Meriter HsptlMadison – – – –
St Marys Hsptl Med CtrGreen Bay – – – –
University of Wi Hospitals & Clinics AuthorityMadison – – – –
Beloit Mem HsptlBeloit – – – –
Community Mem HsptlMenomonee Falls – – – –
Froedtert Mem Lutheran HsptlMilwaukee – – – –
St Clare's Hospital of Weston INCWeston – – – –
Aurora Medical CenterSummit – – – –
Aurora Medical CenterGrafton – – – –
Level 1 ICD and Similar Procedures: all states All Wisconsin hospitals Wisconsin hospital finances
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Level 1 ICD and Similar Procedures in other states

Arizona · $22,924 Georgia · $21,553 Illinois · $21,639 Indiana · $21,143 Mississippi · $21,084 Nebraska · $21,186 Pennsylvania · $21,882 Utah · $21,062

Questions

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

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 24 hospitals in Wisconsin was billed at $117,325 on average, while the average medicare-allowed amount was $22,123, of which Medicare paid $20,491. 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 Wisconsin, average charges were 5.3 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.