What 6 hospitals in South Dakota charged and were paid for level 2 intraocular procedures (APC 5492), from 2024 Medicare claims.
Hospitals in South Dakota billed an average of $12,733 for level 2 intraocular procedures, about 3.3 times the average medicare-allowed amount of $3,869. That payment is 1% below the U.S. average of $3,924.
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.
About 30¢ was paid for every $1 hospitals in South Dakota billed for this service.
Every South Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Sioux Falls Surgical Hospital LLPSioux Falls | 122 | $11,923 | $3,812 | $3,037 |
| Prairie Lakes Hosp & Care CtrWatertown | 40 | $12,208 | $4,083 | $3,251 |
| Sanford Usd Medical CenterSioux Falls | 12 | $22,712 | $3,738 | $2,978 |
| Avera McKennan Hospital & University Health CenterSioux Falls | – | – | – | – |
| Dunes Surgical HospitalNorth Sioux City | – | – | – | – |
| Black Hills Surgical Hospital LLPRapid City | – | – | – | – |
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
| Sanford Usd Medical CenterSioux Falls, SD | $3,738 |
|---|---|
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | $3,812 |
| Prairie Lakes Hosp & Care CtrWatertown, SD | $4,083 |
| Prairie Lakes Hosp & Care CtrWatertown, SD | $4,083 |
|---|---|
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | $3,812 |
| Sanford Usd Medical CenterSioux Falls, SD | $3,738 |
In 2024 Medicare data, level 2 intraocular procedures (APC 5492) at 6 hospitals in South Dakota was billed at $12,733 on average, while the average medicare-allowed amount was $3,869, of which Medicare paid $3,082. Your own cost depends on your insurance, deductible and the hospital.
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 South Dakota, average charges were 3.3 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.