facebook tracking Level 3 Pacemaker and Similar Procedures cost in Rhode Island: 5 hospitals compared (APC 5223)

Level 3 Pacemaker and Similar Procedures in Rhode Island

What 5 hospitals in Rhode Island charged and were paid for level 3 pacemaker and similar procedures (APC 5223), from 2024 Medicare claims.

APC 5223 Outpatient 2024 Medicare data
Average charge $31,360 Hospital list price billed
Average allowed $10,745 Medicare's payment + patient's share
Medicare paid $9,107 Average per service
State rank #39 of 49 1 = lowest average payment

Hospitals in Rhode Island billed an average of $31,360 for level 3 pacemaker and similar procedures, about 2.9 times the average medicare-allowed amount of $10,745. That payment is 5% above the U.S. average of $10,202.

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 $10,745Billed $31,360

About 34¢ was paid for every $1 hospitals in Rhode Island billed for this service.

Rhode Island hospitals: level 3 pacemaker and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Miriam HospitalProvidence 52 $31,365 $10,825 $9,189
Kent County Memorial HospitalWarwick 28 $19,308 $10,825 $9,190
Rhode Island HospitalProvidence 17 $30,949 $10,825 $9,193
South County Hospital INCWakefield 14 $55,949 $10,186 $8,537
Landmark Medical Center, INCWoonsocket – – – –
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Lowest and highest allowed amounts in Rhode Island

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

South County Hospital INCWakefield, RI$10,186
Rhode Island HospitalProvidence, RI$10,825
Kent County Memorial HospitalWarwick, RI$10,825
Miriam HospitalProvidence, RI$10,825

Highest

Miriam HospitalProvidence, RI$10,825
Kent County Memorial HospitalWarwick, RI$10,825
Rhode Island HospitalProvidence, RI$10,825
South County Hospital INCWakefield, RI$10,186

Level 3 Pacemaker and Similar Procedures in other states

Questions

How much does level 3 pacemaker and similar procedures cost in Rhode Island?

In 2024 Medicare data, level 3 pacemaker and similar procedures (APC 5223) at 5 hospitals in Rhode Island was billed at $31,360 on average, while the average medicare-allowed amount was $10,745, of which Medicare paid $9,107. 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 Rhode Island, average charges were 2.9 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.