facebook tracking Level 3 Upper GI Procedures cost in Wisconsin: 35 hospitals compared (APC 5303)

Level 3 Upper GI Procedures in Wisconsin

What 35 hospitals in Wisconsin charged and were paid for level 3 upper gi procedures (APC 5303), from 2024 Medicare claims.

APC 5303 Outpatient 2024 Medicare data
Average charge $21,648 Hospital list price billed
Average allowed $3,542 Medicare's payment + patient's share
Medicare paid $2,820 Average per service
State rank #28 of 48 1 = lowest average payment

Hospitals in Wisconsin billed an average of $21,648 for level 3 upper gi procedures, about 6.1 times the average medicare-allowed amount of $3,542. That payment is 2% below the U.S. average 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.

Paid $3,542Billed $21,648

About 16¢ was paid for every $1 hospitals in Wisconsin billed for this service.

Wisconsin hospitals: level 3 upper gi procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
University of Wi Hospitals & Clinics AuthorityMadison 74 $21,855 $3,575 $2,848
Aurora St Lukes Medical CenterMilwaukee 57 $24,255 $3,533 $2,810
St Mary's HospitalMadison 40 $17,999 $3,575 $2,848
Gundersen Luth Med CtrLa Crosse 33 $17,275 $3,608 $2,869
St Marys Hsptl Med CtrGreen Bay 31 $22,604 $3,444 $2,744
Froedtert Mem Lutheran HsptlMilwaukee 30 $25,193 $3,604 $2,870
Aspirus Wausau HospitalWausau 25 $15,715 $3,427 $2,728
Aurora Med Ctr KenoshaKenosha 17 $35,891 $3,593 $2,872
Aurora Medical CenterGrafton 14 $18,420 $3,489 $2,766
Mayo Clinic Health System-Franciscan Medical CenterLa Crosse 13 $22,874 $3,608 $2,875
Aurora Baycare Med CtrGreen Bay 13 $17,349 $3,448 $2,747
Appleton Med CtrAppleton 11 $19,974 $3,452 $2,745
Waukesha Memorial HospitalWaukesha – – – –
St Elizabeth HsptlAppleton – – – –
Froedtert SouthKenosha – – – –
Marshfield Medical CenterMarshfield – – – –
Aurora Med Center-Washington CountyHartford – – – –
Thedacare Regional Med Ctr - NeenahNeenah – – – –
Bellin Memorial HsptlGreen Bay – – – –
Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee – – – –
Aurora Memorial Hsptl BurlingtonBurlington – – – –
Luther Hospital Mayo Health SystemEau Claire – – – –
St Vincent HsptlGreen Bay – – – –
Wheaton Franciscan Healthcare- St FrancisMilwaukee – – – –
St Agnes HsptlFond du Lac – – – –
Meriter HsptlMadison – – – –
Wheaton Franciscan Healthcare- All SaintsRacine – – – –
Aurora Lakeland Med CtrElkhorn – – – –
Community Mem HsptlMenomonee Falls – – – –
Holy Family Memorial INCManitowoc – – – –
Ascension SE Wisconsin HospitalMilwaukee – – – –
Aurora Med Ctr OshkoshOshkosh – – – –
St Clare's Hospital of Weston INCWeston – – – –
Aurora Medical CenterSummit – – – –
Marshfield Medical Center - Eau ClaireEau Claire – – – –
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Lowest and highest allowed amounts in Wisconsin

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

Aspirus Wausau HospitalWausau, WI$3,427
St Marys Hsptl Med CtrGreen Bay, WI$3,444
Aurora Baycare Med CtrGreen Bay, WI$3,448
Appleton Med CtrAppleton, WI$3,452
Aurora Medical CenterGrafton, WI$3,489

Level 3 Upper GI Procedures in other states

Questions

How much does level 3 upper gi procedures cost in Wisconsin?

In 2024 Medicare data, level 3 upper gi procedures (APC 5303) at 35 hospitals in Wisconsin was billed at $21,648 on average, while the average medicare-allowed amount was $3,542, of which Medicare paid $2,820. 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 Wisconsin, average charges were 6.1 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.