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Outpatient procedure · APC 5331 · Surgery or procedure

Complex GI Procedures

In 2024, Medicare and patients paid an average of $5,364 per procedure at 512 hospitals. Half of hospitals averaged between $4,867 and $5,721.

National figures, 2024

Average payment per case
$5,364
Typical range (middle half of hospitals)
$4,867–$5,721
Medicare’s share
$4,26379% of the payment
Average billed charge
$34,865
Hospitals reporting
51220,597 procedures

Hospitals in Pennsylvania

Narrow by a state, city or ZIP code (optionally a distance around it), and/or pick specific hospitals. With both, your picks are added to the area’s hospitals.

Location
Pennsylvania
Specific hospitals up to 10
Average payment across these 24 hospitals
$5,157National $5,364 · Pennsylvania $5,177
Median hospital
$5,091
Lowest to highest
$4,074–$5,537
Medicare procedures
849

24 hospitals reported at least 11 Medicare procedures for this in 2024. Download as CSV

Medicare payments per case for Complex GI Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Wilkes-Barre General HospitalWilkes-Barre, PA · CCN 39013732$4,07424% below the national average$3,169$56,545
UPMC WilliamsportWilliamsport, PA · CCN 39004511$4,62814% below the national average$3,687$41,662
Lehigh Valley HospitalAllentown, PA · CCN 39013342$4,65913% below the national average$3,691$70,839
Geisinger Wyoming Valley Medical CenterWilkes Barre, PA · CCN 39027019$4,66313% below the national average$3,629$58,768
Geisinger-Lewistown HospitalLewistown, PA · CCN 39004835$4,67113% below the national average$3,722$31,297
St Lukes HospitalBethlehem, PA · CCN 39004965$4,82710% below the national average$3,816$50,399
Lancaster General HospitalLancaster, PA · CCN 39010024$5,080About average$4,048$26,051
Allegheny General HospitalPittsburgh, PA · CCN 39005038$5,090About average$4,056$37,813
UPMC Presbyterian ShadysidePittsburgh, PA · CCN 39016435$5,090About average$4,056$51,704
Geisinger Medical CenterDanville, PA · CCN 39000642$5,090About average$4,051$67,999
West Penn HospitalPittsburgh, PA · CCN 39009022$5,090About average$4,050$31,970
Geisinger-Community Medical CenterScranton, PA · CCN 39000114$5,091About average$4,042$63,713
UPMC PassavantPittsburgh, PA · CCN 39010712$5,091About average$4,040$37,061
UPMC Pinnacle HospitalsHarrisburg, PA · CCN 39006715$5,107About average$4,063$23,839
Reading HospitalWest Reading, PA · CCN 39004411$5,207About average$4,149$22,511
Robert Packer HospitalSayre, PA · CCN 39007923$5,235About average$4,171$23,538
Jefferson Abington HospitalAbington, PA · CCN 39023115$5,347About average$4,260$37,424
Wellspan York HospitalYork, PA · CCN 39004617$5,364About average$4,274$30,066
Milton S Hershey Medical CenterHershey, PA · CCN 390256 · +$3,160 outlier payments per case67$5,364About average$4,273$59,243
Thomas Jefferson University HospitalPhiladelphia, PA · CCN 390174 · +$1,670 outlier payments per case135$5,435About average$4,331$51,680
Doylestown HospitalDoylestown, PA · CCN 39020318$5,498About average$4,381$30,501
Main Line Hospital LankenauWynnewood, PA · CCN 39019539$5,498About average$4,381$30,941
Hospital Of University Of PennsylvaniaPhiladelphia, PA · CCN 390111102$5,517About average$4,395$35,667
Jefferson Einstein Philadelphia HospitalPhiladelphia, PA · CCN 39014216$5,537About average$4,412$21,620

National trend

Average payment and billed charge per procedure, and how many Medicare procedures were reported each year.

  • Average payment
  • Average billed charge
2020: 20,796 procedures at 559 hospitals · 2021: 21,704 procedures at 553 hospitals · 2022: 21,496 procedures at 548 hospitals · 2023: 20,937 procedures at 533 hospitals · 2024: 20,597 procedures at 512 hospitals
View data as a table
National average payment and billed charge for Complex GI Procedures
Year of careAverage paymentAverage billed charge
2020$4,700$27K
2021$4,970$29K
2022$5,056$30K
2023$5,110$32K
2024$5,364$35K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 49 states
Average payment by state for Complex GI Procedures, 2024
StateHospitalsCasesAverage paymentTypical range
Vermont123$3,074$3,074–$3,074
Kentucky8389$4,113$4,455–$4,936
Utah4198$4,182$4,535–$5,105
Missouri13680$4,447$4,539–$4,977
Alabama8220$4,593$4,412–$4,712
South Carolina11539$4,632$4,628–$4,897
West Virginia6189$4,661$4,527–$4,775
Mississippi484$4,740$4,654–$4,771
Ohio21624$4,759$4,541–$4,956
Tennessee11279$4,762$4,669–$4,891
Iowa3223$4,769$4,607–$4,741
Oklahoma7282$4,772$4,665–$4,880
Kansas6274$4,777$4,835–$4,866
Arkansas4160$4,783$4,758–$5,170
Louisiana7188$4,788$4,779–$4,827
Michigan10539$4,809$4,802–$5,072
North Carolina15650$4,900$4,957–$5,126
Virginia14574$4,903$4,838–$4,936
Georgia17437$4,927$4,631–$5,121
Arizona12848$4,962$5,163–$5,557
Texas371,293$4,995$4,934–$5,129
Indiana14500$5,027$4,837–$5,164
Nebraska4173$5,060$4,989–$5,136
Maine390$5,066$4,985–$5,062
Illinois251,019$5,069$4,846–$5,384
Florida261,074$5,073$5,133–$5,162
New Mexico336$5,146$4,850–$5,408
Idaho4112$5,177$5,091–$5,226
Pennsylvania25897$5,177$5,080–$5,364
Wisconsin12292$5,248$5,134–$5,364
Delaware244$5,253$5,149–$5,528
South Dakota3152$5,258$5,201–$5,291
Montana597$5,342$5,343–$5,723
Colorado7411$5,379$5,385–$5,425
North Dakota2115$5,383$5,438–$5,628
Minnesota11791$5,385$5,392–$5,448
New Hampshire379$5,639$5,450–$5,613
District of Columbia3236$5,710$5,578–$5,716
Washington15588$5,713$5,602–$5,846
Rhode Island234$5,784$5,784–$5,784
Oregon7192$5,805$5,680–$6,001
Alaska117$5,883$5,883–$5,883
New Jersey18574$5,910$5,618–$6,291
Massachusetts10706$5,938$5,857–$6,121
Nevada240$6,104$6,104–$6,104
New York301,137$6,189$6,042–$6,401
Connecticut6273$6,266$6,093–$6,323
Hawaii373$6,293$6,181–$6,327
California472,152$7,178$6,934–$7,660

About these numbers

Average payment is what Medicare paid plus the patient’s deductible and coinsurance (and any other insurer), averaged over the hospital’s Medicare cases. It covers the hospital’s part of the care; doctors bill separately. For outpatient procedures it is Medicare’s allowed amount, which leaves out extra “outlier” payments for unusually costly cases; those are shown under the hospital name where CMS reported any, and included in the CSV. Billed charges are the hospital’s list prices, which few patients pay.

Medicare sets its payments by formula, adjusting for local wages, teaching programs, the share of low-income patients and unusually costly cases. Those adjustments drive most differences between hospitals, so a lower payment doesn’t mean better or worse care, and Medicare patients’ own costs usually vary much less than the totals. Private insurance pays different, usually higher, prices.

Source: CMS Medicare Outpatient Hospitals by Provider and Service (Medicare fee-for-service claims). CMS omits hospitals with fewer than 11 procedures. More in the glossary.