Level 3 Lower GI Procedures
What 2,331 hospitals in the U.S. charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.
Average charge
$18,904
Hospital list price billed
Average allowed
$2,703
Medicare's payment + patient's share
Medicare paid
$2,176
Average per service
Volume
32,745
Medicare services
Hospitals in the U.S. billed an average of $18,904 for level 3 lower gi procedures, about 7.0 times the average medicare-allowed amount of $2,703.
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.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Metrohealth SystemCleveland, OH | $1,035 |
|---|---|
| Fletcher Allen Hospital of VermontBurlington, VT | $1,458 |
| UPMC MemorialYork, PA | $1,498 |
| Memorial Hospital at GulfportGulfport, MS | $1,752 |
| Wellstar Cobb HospitalAustell, GA | $1,926 |
| Gundersen Luth Med CtrLa Crosse, WI | $2,018 |
| St Francis HospitalMemphis, TN | $2,057 |
| Conway Medical CenterConway, SC | $2,090 |
| University of Kentucky HospLexington, KY | $2,109 |
| University Medical CenterLubbock, TX | $2,144 |
Highest
| Peninsula Medical CenterBurlingame, CA | $4,013 |
|---|---|
| San Francisco General HospitalSan Francisco, CA | $4,013 |
| UCSF Medical CenterSan Francisco, CA | $3,954 |
| El Camino HospitalMountain View, CA | $3,954 |
| Santa Clara Valley Medical CenterSan Jose, CA | $3,953 |
| Community Hospital of the Monterey PeninsulaMonterey, CA | $3,952 |
| Sutter General HospitalSacramento, CA | $3,931 |
| Santa Rosa Memorial HospitalSanta Rosa, CA | $3,930 |
| Sequoia HospitalRedwood City, CA | $3,885 |
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco, CA | $3,881 |
Level 3 Lower GI Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 51 | $25,335 | $2,259 | $2,155 – $2,368 |
| Alaska | 5 | $38,056 | $2,898 | $2,898 – $2,898 |
| Arizona | 39 | $22,033 | $2,726 | $2,602 – $2,932 |
| Arkansas | 31 | $15,246 | $2,455 | $2,319 – $2,579 |
| California | 208 | $23,122 | $3,550 | $2,991 – $4,013 |
| Colorado | 40 | $15,953 | $2,651 | $2,398 – $2,863 |
| Connecticut | 23 | $14,619 | $3,097 | $2,871 – $3,163 |
| Delaware | 6 | $16,400 | $2,796 | $2,725 – $2,824 |
| Florida | 143 | $30,272 | $2,502 | $1,657 – $2,544 |
| Georgia | 75 | $21,385 | $2,442 | $1,926 – $2,643 |
| Hawaii | 10 | $16,533 | $3,137 | $3,137 – $3,137 |
| Idaho | 13 | $12,065 | $2,530 | $2,490 – $2,572 |
| Illinois | 97 | $18,538 | $2,639 | $2,279 – $2,779 |
| Indiana | 60 | $15,793 | $2,536 | $2,357 – $2,654 |
| Iowa | 26 | $11,548 | $2,410 | $2,308 – $2,560 |
| Kansas | 33 | $18,148 | $2,402 | $2,202 – $2,571 |
| Kentucky | 48 | $17,186 | $2,374 | $2,109 – $2,598 |
| Louisiana | 53 | $17,111 | $2,316 | $2,155 – $2,431 |
| Maine | 16 | $11,247 | $2,586 | $2,433 – $2,729 |
| Massachusetts | 49 | $10,302 | $2,977 | $2,857 – $3,056 |
| Michigan | 71 | $12,684 | $2,461 | $2,168 – $2,639 |
| Minnesota | 38 | $11,461 | $2,709 | $2,610 – $2,783 |
| Mississippi | 36 | $19,051 | $2,262 | $1,752 – $2,518 |
| Missouri | 55 | $13,988 | $2,443 | $2,222 – $2,569 |
| Montana | 9 | $11,189 | $2,662 | $2,528 – $2,819 |
| Nebraska | 16 | $15,233 | $2,441 | $2,362 – $2,530 |
| Nevada | 17 | $24,885 | $2,984 | $2,807 – $3,015 |
| New Hampshire | 13 | $17,328 | $2,752 | $2,583 – $2,868 |
| New Jersey | 52 | $20,634 | $2,980 | $2,762 – $3,195 |
| New Mexico | 18 | $9,072 | $2,441 | $2,349 – $2,655 |
| New York | 110 | $20,649 | $3,067 | $2,550 – $3,249 |
| North Carolina | 72 | $14,515 | $2,490 | $2,225 – $2,617 |
| North Dakota | 5 | $12,423 | $2,631 | $2,501 – $2,691 |
| Ohio | 98 | $15,458 | $2,361 | $1,035 – $2,520 |
| Oklahoma | 43 | $17,774 | $2,364 | $2,165 – $2,555 |
| Oregon | 26 | $13,361 | $2,857 | $2,685 – $2,967 |
| Pennsylvania | 104 | $21,656 | $2,595 | $1,464 – $2,959 |
| Rhode Island | 8 | $7,557 | $2,820 | $2,812 – $2,847 |
| South Carolina | 43 | $19,423 | $2,346 | $2,090 – $2,617 |
| South Dakota | 13 | $12,911 | $2,629 | $2,558 – $2,765 |
| Tennessee | 54 | $16,192 | $2,318 | $2,057 – $2,574 |
| Texas | 181 | $22,955 | $2,481 | $2,141 – $2,609 |
| Utah | 23 | $12,221 | $2,391 | $2,168 – $2,694 |
| Vermont | 6 | $12,520 | $1,458 | $1,458 – $1,458 |
| Virginia | 61 | $22,084 | $2,501 | $2,305 – $2,760 |
| Washington | 44 | $14,165 | $2,859 | $2,653 – $3,120 |
| West Virginia | 19 | $12,906 | $2,348 | $2,274 – $2,620 |
| Wisconsin | 56 | $15,764 | $2,488 | $2,018 – $2,663 |
| Wyoming | 9 | $21,514 | $2,819 | $2,819 – $2,819 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 347 | $39,908 | $3,135 |
| New York-Presbyterian HospitalNew York, NY | 243 | $19,767 | $3,188 |
| University of California San Diego Medical CenterSan Diego, CA | 219 | $18,709 | $3,450 |
| Sanford Medical Center FargoFargo, ND | 204 | $12,721 | $2,631 |
| University of Virginia Medical CenterCharlottesville, VA | 202 | $10,121 | $2,559 |
| UCSF Medical CenterSan Francisco, CA | 201 | $27,043 | $3,954 |
| Mercy Medical Center - Cedar RapidsCedar Rapids, IA | 200 | $9,093 | $2,419 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 195 | $14,920 | $2,783 |
| Waccamaw Community HospitalMurrells Inlet, SC | 190 | $16,779 | $2,370 |
| Adventhealth OrlandoOrlando, FL | 173 | $29,949 | $2,512 |
| MUSC Medical CenterCharleston, SC | 173 | $20,260 | $2,286 |
| UCLA Medical CenterLos Angeles, CA | 168 | $12,604 | $3,419 |
| Stanford HospitalPalo Alto, CA | 164 | $46,114 | $3,857 |
| Eisenhower Memorial HospitalRancho Mirage, CA | 159 | $16,799 | $2,991 |
| Hospital of the Univ of PaPhiladelphia, PA | 151 | $23,318 | $2,711 |
Questions
How much does level 3 lower gi procedures cost in the U.S.?
In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 2,331 hospitals in the U.S. was billed at $18,904 on average, while the average medicare-allowed amount was $2,703, of which Medicare paid $2,176. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 3 lower gi procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($3,550), Hawaii ($3,137), Connecticut ($3,097) and lowest in Vermont ($1,458), Alabama ($2,259), Mississippi ($2,262).
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 the U.S., average charges were 7.0 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.