Level 3 Upper GI Procedures
What 1,647 hospitals in the U.S. charged and were paid for level 3 upper gi procedures (APC 5303), from 2024 Medicare claims.
Average charge
$24,296
Hospital list price billed
Average allowed
$3,633
Medicare's payment + patient's share
Medicare paid
$2,888
Average per service
Volume
20,418
Medicare services
Hospitals in the U.S. billed an average of $24,296 for level 3 upper gi procedures, about 6.7 times the average medicare-allowed amount of $3,633.
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
| Bethesda North HospitalCincinnati, OH | $353 |
|---|---|
| Lewistown HospitalLewistown, PA | $2,405 |
| Longs Peak HospitalLongmont, CO | $2,604 |
| Enloe Medical CenterChico, CA | $2,686 |
| St John Medical CenterWestlake, OH | $2,828 |
| Grandview Medical CenterBirmingham, AL | $2,941 |
| Medical College of Ga Hospitals and ClinicsAugusta, GA | $3,034 |
| Ochsner Foundation HospitalNew Orleans, LA | $3,054 |
| University Hospitals Ahuja Medical CenterBeachwood, OH | $3,121 |
| River Oaks HospitalFlowood, MS | $3,126 |
Highest
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco, CA | $5,434 |
|---|---|
| Santa Clara Valley Medical CenterSan Jose, CA | $5,393 |
| Sequoia HospitalRedwood City, CA | $5,393 |
| El Camino HospitalMountain View, CA | $5,393 |
| Sutter General HospitalSacramento, CA | $5,364 |
| Stanford HospitalPalo Alto, CA | $5,343 |
| John Muir Medical Center - Walnut Creek CampusWalnut Creek, CA | $5,332 |
| UCSF Medical CenterSan Francisco, CA | $5,289 |
| Community Hospital of the Monterey PeninsulaMonterey, CA | $5,123 |
| University of California Davis Medical CenterSacramento, CA | $4,774 |
Level 3 Upper 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 | 28 | $38,218 | $3,113 | $2,776 – $3,328 |
| Alaska | 3 | $28,353 | $4,088 | $3,953 – $4,234 |
| Arizona | 35 | $21,487 | $3,616 | $3,336 – $4,000 |
| Arkansas | 17 | $13,492 | $3,262 | $3,153 – $3,518 |
| California | 171 | $33,051 | $4,794 | $2,686 – $5,474 |
| Colorado | 33 | $28,880 | $3,530 | $2,604 – $3,905 |
| Connecticut | 22 | $17,724 | $4,061 | $3,793 – $4,284 |
| Delaware | 5 | $18,243 | $3,845 | $3,842 – $3,852 |
| Florida | 120 | $31,940 | $3,418 | $3,162 – $3,469 |
| Georgia | 54 | $29,719 | $3,373 | $3,034 – $3,605 |
| Hawaii | 9 | $17,744 | $4,405 | $4,405 – $4,405 |
| Idaho | 11 | $15,541 | $3,485 | $3,378 – $3,640 |
| Illinois | 66 | $22,896 | $3,589 | $3,218 – $3,791 |
| Indiana | 41 | $25,488 | $3,397 | $1,975 – $3,602 |
| Iowa | 15 | $21,531 | $3,319 | $3,082 – $3,492 |
| Kansas | 18 | $20,934 | $3,287 | $3,224 – $3,502 |
| Kentucky | 31 | $22,760 | $3,305 | $3,140 – $3,543 |
| Louisiana | 23 | $24,353 | $3,238 | $3,054 – $3,319 |
| Maine | 8 | $13,684 | $3,557 | $3,336 – $3,760 |
| Massachusetts | 41 | $18,374 | $4,090 | $3,895 – $4,320 |
| Michigan | 47 | $17,743 | $3,408 | $3,258 – $3,598 |
| Minnesota | 22 | $15,997 | $3,496 | $3,400 – $3,736 |
| Mississippi | 16 | $33,500 | $3,242 | $3,126 – $3,434 |
| Missouri | 38 | $17,451 | $3,304 | $3,120 – $3,603 |
| Montana | 9 | $18,288 | $3,662 | $3,591 – $3,845 |
| Nebraska | 15 | $21,055 | $3,348 | $3,210 – $3,534 |
| Nevada | 15 | $45,417 | $4,144 | $3,976 – $4,650 |
| New Hampshire | 9 | $19,162 | $3,802 | $3,653 – $3,912 |
| New Jersey | 47 | $26,846 | $4,080 | $3,827 – $4,358 |
| New Mexico | 9 | $21,265 | $3,469 | $3,261 – $3,878 |
| New York | 80 | $23,418 | $4,191 | $3,583 – $4,358 |
| North Carolina | 40 | $20,327 | $3,388 | $3,111 – $3,527 |
| North Dakota | 6 | $18,059 | $3,599 | $3,591 – $3,654 |
| Ohio | 67 | $14,214 | $2,441 | $353 – $3,437 |
| Oklahoma | 21 | $29,791 | $3,273 | $3,241 – $3,300 |
| Oregon | 17 | $18,383 | $3,966 | $3,751 – $4,650 |
| Pennsylvania | 77 | $32,096 | $3,478 | $2,405 – $4,036 |
| Rhode Island | 7 | $15,495 | $3,827 | $3,665 – $3,887 |
| South Carolina | 29 | $26,358 | $3,270 | $3,142 – $3,513 |
| South Dakota | 8 | $18,426 | $3,626 | $3,521 – $3,780 |
| Tennessee | 32 | $19,128 | $3,195 | $3,155 – $3,434 |
| Texas | 138 | $31,446 | $3,403 | $3,046 – $3,551 |
| Utah | 17 | $14,275 | $3,431 | $3,430 – $3,431 |
| Vermont | 2 | $25,194 | $3,092 | $3,092 – $3,092 |
| Virginia | 39 | $24,968 | $3,381 | $3,178 – $3,766 |
| Washington | 32 | $20,412 | $3,895 | $3,781 – $4,130 |
| West Virginia | 14 | $15,398 | $3,241 | $3,146 – $3,658 |
| Wisconsin | 35 | $21,648 | $3,542 | $3,427 – $3,608 |
| Wyoming | 4 | $12,838 | $3,846 | $3,846 – $3,846 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Bethesda North HospitalCincinnati, OH | 302 | $1,481 | $353 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 253 | $16,596 | $3,400 |
| Stanford HospitalPalo Alto, CA | 195 | $59,974 | $5,343 |
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco, CA | 192 | $20,122 | $5,434 |
| Clarian Health PartnersIndianapolis, IN | 167 | $29,652 | $3,473 |
| Cleveland Clinic - Main CampusCleveland, OH | 160 | $18,493 | $3,187 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 144 | $55,185 | $4,414 |
| Boca Raton Regional HospitalBoca Raton, FL | 141 | $35,169 | $3,437 |
| New York-Presbyterian HospitalNew York, NY | 141 | $20,793 | $4,309 |
| NYU Hospitals CenterNew York, NY | 139 | $51,191 | $4,232 |
| Mayo Clinic HospitalPhoenix, AZ | 135 | $27,028 | $3,336 |
| Enloe Medical CenterChico, CA | 135 | $12,537 | $2,686 |
| Missouri Baptist Medical CenterTown and Country, MO | 133 | $10,684 | $3,328 |
| Sarasota Memorial HospitalSarasota, FL | 126 | $25,971 | $3,469 |
| MUSC Medical CenterCharleston, SC | 123 | $30,344 | $3,283 |
Questions
How much does level 3 upper gi procedures cost in the U.S.?
In 2024 Medicare data, level 3 upper gi procedures (APC 5303) at 1,647 hospitals in the U.S. was billed at $24,296 on average, while the average medicare-allowed amount was $3,633, of which Medicare paid $2,888. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 3 upper gi procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($4,794), Hawaii ($4,405), New York ($4,191) and lowest in Ohio ($2,441), Alabama ($3,113), Tennessee ($3,195).
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 6.7 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.