What 6 hospitals in South Dakota charged and were paid for level 3 pacemaker and similar procedures (APC 5223), from 2024 Medicare claims.
Hospitals in South Dakota billed an average of $55,255 for level 3 pacemaker and similar procedures, about 5.5 times the average medicare-allowed amount of $10,035. That payment is 2% below 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.
About 18¢ 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 |
|---|---|---|---|---|
| Avera Heart Hospital of South Dakota LLCSioux Falls | 237 | $71,916 | $9,897 | $8,264 |
| Sanford Usd Medical CenterSioux Falls | 200 | $46,733 | $9,810 | $8,176 |
| Rapid City Regional HospitalRapid City | 96 | $41,232 | $10,711 | $9,078 |
| Avera St LukesAberdeen | 26 | $29,989 | $10,004 | $8,359 |
| Prairie Lakes Hosp & Care CtrWatertown | 20 | $43,212 | $10,711 | $9,074 |
| Avera Sacred Heart HospitalYankton | – | – | – | – |
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 | $9,810 |
|---|---|
| Avera Heart Hospital of South Dakota LLCSioux Falls, SD | $9,897 |
| Avera St LukesAberdeen, SD | $10,004 |
| Rapid City Regional HospitalRapid City, SD | $10,711 |
| Prairie Lakes Hosp & Care CtrWatertown, SD | $10,711 |
| Prairie Lakes Hosp & Care CtrWatertown, SD | $10,711 |
|---|---|
| Rapid City Regional HospitalRapid City, SD | $10,711 |
| Avera St LukesAberdeen, SD | $10,004 |
| Avera Heart Hospital of South Dakota LLCSioux Falls, SD | $9,897 |
| Sanford Usd Medical CenterSioux Falls, SD | $9,810 |
In 2024 Medicare data, level 3 pacemaker and similar procedures (APC 5223) at 6 hospitals in South Dakota was billed at $55,255 on average, while the average medicare-allowed amount was $10,035, of which Medicare paid $8,401. 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 5.5 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.