Level 3 Lower GI Procedures in New Mexico
What 18 hospitals in New Mexico charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.
Average charge
$9,072
Hospital list price billed
Average allowed
$2,441
Medicare's payment + patient's share
Medicare paid
$1,975
Average per service
State rank
#15 of 49
1 = lowest average payment
Hospitals in New Mexico billed an average of $9,072 for level 3 lower gi procedures, about 3.7 times the average medicare-allowed amount of $2,441. That payment is 10% below the U.S. average 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.
Paid $2,441Billed $9,072
About 27¢ was paid for every $1 hospitals in New Mexico billed for this service.
New Mexico hospitals: level 3 lower gi procedures
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 | 80 | $8,986 | $2,435 | $1,995 |
| UNM HospitalAlbuquerque | 29 | $8,381 | $2,349 | $1,843 |
| Presbyterian Santa Fe Medical CenterSanta Fe | 15 | $10,867 | $2,655 | $2,124 |
| St Vincent HospitalSanta Fe | – | – | – | – |
| CHRISTUS Southern New MexicoAlamogordo | – | – | – | – |
| San Juan Regional Medical CenterFarmington | – | – | – | – |
| Eastern New Mexico Medical CenterRoswell | – | – | – | – |
| Lovelace Medical CenterAlbuquerque | – | – | – | – |
| Espanola HospitalEspanola | – | – | – | – |
| Memorial Medical Center INCLas Cruces | – | – | – | – |
| Plains Regional Medical CenterClovis | – | – | – | – |
| Los Alamos Medical CenterLos Alamos | – | – | – | – |
| Carlsbad Medical CenterCarlsbad | – | – | – | – |
| Lovelace Westside HospitalAlbuquerque | – | – | – | – |
| Roosevelt General HospitalPortales | – | – | – | – |
| Mountain View Regional Medical CenterLas Cruces | – | – | – | – |
| Roswell Regional HospitalRoswell | – | – | – | – |
| Three Crosses Regional Hospital LLCLas Cruces | – | – | – | – |
Lowest and highest allowed amounts in New Mexico
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
| UNM HospitalAlbuquerque, NM | $2,349 |
|---|---|
| Presbyterian HospitalAlbuquerque, NM | $2,435 |
| Presbyterian Santa Fe Medical CenterSanta Fe, NM | $2,655 |
Highest
| Presbyterian Santa Fe Medical CenterSanta Fe, NM | $2,655 |
|---|---|
| Presbyterian HospitalAlbuquerque, NM | $2,435 |
| UNM HospitalAlbuquerque, NM | $2,349 |
Level 3 Lower GI Procedures in other states
Questions
How much does level 3 lower gi procedures cost in New Mexico?
In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 18 hospitals in New Mexico was billed at $9,072 on average, while the average medicare-allowed amount was $2,441, of which Medicare paid $1,975. 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 New Mexico, average charges were 3.7 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.