What 19 hospitals in New Mexico charged and were paid for level 2 upper gi procedures (APC 5302), from 2024 Medicare claims.
Hospitals in New Mexico billed an average of $11,873 for level 2 upper gi procedures, about 6.9 times the average medicare-allowed amount of $1,729. That payment is 5% below the U.S. average of $1,815.
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 15¢ was paid for every $1 hospitals in New Mexico billed for this service.
Every New Mexico hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Presbyterian HospitalAlbuquerque | 209 | $7,051 | $1,654 | $1,315 |
| UNM HospitalAlbuquerque | 201 | $5,289 | $1,684 | $1,339 |
| St Vincent HospitalSanta Fe | 161 | $13,696 | $1,908 | $1,518 |
| Lovelace Medical CenterAlbuquerque | 100 | $15,625 | $1,675 | $1,335 |
| San Juan Regional Medical CenterFarmington | 66 | $12,218 | $1,847 | $1,471 |
| CHRISTUS Southern New MexicoAlamogordo | 41 | $39,126 | $1,719 | $1,364 |
| Lovelace Women's HospitalAlbuquerque | 40 | $18,415 | $1,661 | $1,329 |
| Memorial Medical Center INCLas Cruces | 24 | $18,116 | $1,657 | $1,314 |
| Presbyterian Santa Fe Medical CenterSanta Fe | 19 | $6,645 | $1,799 | $1,443 |
| Mountain View Regional Medical CenterLas Cruces | 18 | $15,608 | $1,657 | $1,319 |
| Lovelace Westside HospitalAlbuquerque | 13 | $17,513 | $1,684 | $1,342 |
| Artesia General HospitalArtesia | 11 | $13,374 | $1,775 | $1,403 |
| Roosevelt General HospitalPortales | 11 | $16,709 | $1,625 | $1,303 |
| Eastern New Mexico Medical CenterRoswell | – | – | – | – |
| Plains Regional Medical CenterClovis | – | – | – | – |
| Los Alamos Medical CenterLos Alamos | – | – | – | – |
| Carlsbad Medical CenterCarlsbad | – | – | – | – |
| Roswell Regional HospitalRoswell | – | – | – | – |
| Three Crosses Regional Hospital LLCLas Cruces | – | – | – | – |
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
| Roosevelt General HospitalPortales, NM | $1,625 |
|---|---|
| Presbyterian HospitalAlbuquerque, NM | $1,654 |
| Mountain View Regional Medical CenterLas Cruces, NM | $1,657 |
| Memorial Medical Center INCLas Cruces, NM | $1,657 |
| Lovelace Women's HospitalAlbuquerque, NM | $1,661 |
| St Vincent HospitalSanta Fe, NM | $1,908 |
|---|---|
| San Juan Regional Medical CenterFarmington, NM | $1,847 |
| Presbyterian Santa Fe Medical CenterSanta Fe, NM | $1,799 |
| Artesia General HospitalArtesia, NM | $1,775 |
| CHRISTUS Southern New MexicoAlamogordo, NM | $1,719 |
In 2024 Medicare data, level 2 upper gi procedures (APC 5302) at 19 hospitals in New Mexico was billed at $11,873 on average, while the average medicare-allowed amount was $1,729, of which Medicare paid $1,376. 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 New Mexico, average charges were 6.9 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.