facebook tracking Level 2 ICD and Similar Procedures cost in Maine: 6 hospitals compared (APC 5232)

Level 2 ICD and Similar Procedures in Maine

What 6 hospitals in Maine charged and were paid for level 2 icd and similar procedures (APC 5232), from 2024 Medicare claims.

APC 5232 Outpatient 2024 Medicare data
Average charge $134,774 Hospital list price billed
Average allowed $28,943 Medicare's payment + patient's share
Medicare paid $27,298 Average per service
State rank #15 of 47 1 = lowest average payment

Hospitals in Maine billed an average of $134,774 for level 2 icd and similar procedures, about 4.7 times the average medicare-allowed amount of $28,943. That payment is 7% below the U.S. average of $31,009.

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 $28,943Billed $134,774

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

Maine hospitals: level 2 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Maine Medical CenterPortland 27 $116,427 $29,738 $28,081
Eastern Maine Medical CenterBangor 26 $180,393 $28,578 $26,937
Northern Light a R Gould HospitalPresque Isle 15 $88,726 $28,147 $26,515
York HospitalYork – – – –
Central Maine Medical CenterLewiston – – – –
Maine General Medical CenterWaterville – – – –
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Lowest and highest allowed amounts in Maine

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

Northern Light a R Gould HospitalPresque Isle, ME$28,147
Eastern Maine Medical CenterBangor, ME$28,578
Maine Medical CenterPortland, ME$29,738

Highest

Maine Medical CenterPortland, ME$29,738
Eastern Maine Medical CenterBangor, ME$28,578
Northern Light a R Gould HospitalPresque Isle, ME$28,147

Level 2 ICD and Similar Procedures in other states

Questions

How much does level 2 icd and similar procedures cost in Maine?

In 2024 Medicare data, level 2 icd and similar procedures (APC 5232) at 6 hospitals in Maine was billed at $134,774 on average, while the average medicare-allowed amount was $28,943, of which Medicare paid $27,298. 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 Maine, average charges were 4.7 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.