Complex GI Procedures — what U.S. hospitals charge
APC 5331 · Hospital outpatient visit · 512 U.S. hospitals publish a price
Cheapest quarter
under $22,625
Typical charge
$29,990
Dearest quarter
over $40,647
Actually paid
$5,369
The middle U.S. hospital bills $29,990 for Complex GI Procedures. The dearest hospitals charge about 3.3x what the cheapest do for the same coded work. Medicare actually paid about $5,369 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Complex GI Procedures cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| New Mexico | 3 | $14,434 | $13,920 – $59,316 |
| District of Columbia | 3 | $18,420 | $17,621 – $21,521 |
| Utah | 4 | $19,312 | $16,965 – $23,087 |
| Montana | 5 | $19,588 | $14,931 – $39,486 |
| Idaho | 4 | $19,701 | $14,648 – $24,522 |
| Minnesota | 11 | $20,756 | $14,497 – $28,341 |
| Michigan | 10 | $20,812 | $14,144 – $42,843 |
| Massachusetts | 10 | $21,773 | $19,677 – $49,323 |
| Oregon | 7 | $22,354 | $14,160 – $40,572 |
| Arkansas | 4 | $22,674 | $14,896 – $29,264 |
| Missouri | 13 | $22,836 | $12,313 – $62,263 |
| Virginia | 14 | $22,858 | $10,027 – $147,071 |
| Ohio | 21 | $23,553 | $14,533 – $47,640 |
| Maine | 3 | $24,357 | $21,303 – $31,764 |
| West Virginia | 6 | $24,976 | $19,506 – $40,349 |
| Hawaii | 3 | $26,898 | $17,745 – $27,216 |
| North Carolina | 15 | $26,947 | $17,434 – $43,398 |
| New York | 30 | $27,005 | $15,588 – $82,963 |
| Tennessee | 11 | $27,498 | $16,465 – $49,160 |
| Wisconsin | 12 | $27,663 | $18,981 – $34,298 |
| New Hampshire | 3 | $27,775 | $25,440 – $37,152 |
| Connecticut | 6 | $27,835 | $15,250 – $39,339 |
| South Dakota | 3 | $27,998 | $26,651 – $29,247 |
| Nebraska | 4 | $28,087 | $24,675 – $37,417 |
| Kansas | 6 | $28,270 | $7,712 – $54,178 |
| Arizona | 12 | $29,416 | $19,234 – $54,054 |
| Washington | 15 | $29,719 | $13,904 – $42,604 |
| Kentucky | 8 | $30,247 | $16,424 – $53,331 |
| New Jersey | 18 | $30,579 | $17,253 – $91,990 |
| Louisiana | 7 | $32,698 | $17,878 – $52,423 |
| South Carolina | 11 | $32,842 | $17,648 – $65,041 |
| Alabama | 8 | $32,882 | $25,547 – $110,240 |
| Iowa | 3 | $33,747 | $16,295 – $35,666 |
| Illinois | 25 | $33,866 | $11,060 – $61,364 |
| Georgia | 17 | $34,456 | $18,405 – $67,427 |
| Indiana | 14 | $34,923 | $16,383 – $65,343 |
| Colorado | 7 | $36,904 | $27,936 – $89,064 |
| Pennsylvania | 25 | $37,424 | $21,620 – $73,781 |
| Florida | 26 | $38,024 | $18,832 – $81,413 |
| Oklahoma | 7 | $38,045 | $15,283 – $91,195 |
| Texas | 37 | $40,872 | $14,261 – $112,542 |
| California | 47 | $41,033 | $21,924 – $177,195 |
| Mississippi | 4 | $49,423 | $19,581 – $78,117 |
Where Complex GI Procedures is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Kansas Medical Center Llc
Andover, KS |
$7,712 | $4,866 |
|
Inova Fair Oaks Hospital
Fairfax, VA |
$10,027 | $4,401 |
|
Silver Cross Hospital And Medical Centers
New Lenox, IL |
$11,060 | $5,221 |
|
Advocate Christ Hospital & Medical Center
Oak Lawn, IL |
$11,663 | $4,717 |
|
Inova Alexandria Hospital
Alexandria, VA |
$11,992 | $4,941 |
|
Mercy Hospital South
Saint Louis, MO |
$12,313 | $4,831 |
|
Inova Fairfax Hospital
Falls Church, VA |
$13,676 | $4,821 |
|
Winchester Medical Center
Winchester, VA |
$13,784 | $5,605 |
|
Confluence Health Hospital
Wenatchee, WA |
$13,904 | $5,349 |
|
Presbyterian Hospital
Albuquerque, NM |
$13,920 | $5,044 |
|
Bronson Methodist Hospital
Kalamazoo, MI |
$14,144 | $4,985 |
|
Asante Rogue Regional Medical Center
Medford, OR |
$14,160 | $6,920 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Good Samaritan Hospital
San Jose, CA |
$177,195 | $8,025 |
|
Cjw Medical Center
Richmond, VA |
$147,071 | $4,906 |
|
Lewisgale Medical Center
Salem, VA |
$140,698 | $4,906 |
|
Los Robles Hospital & Medical Center
Thousand Oaks, CA |
$128,490 | $7,007 |
|
Medical City Plano
Plano, TX |
$112,542 | $4,934 |
|
Grandview Medical Center
Birmingham, AL |
$110,240 | $4,573 |
|
North Austin Medical Center
Austin, TX |
$100,710 | $5,016 |
|
Englewood Hospital And Medical Center
Englewood, NJ |
$91,990 | $5,601 |
|
O U Medical Center
Oklahoma City, OK |
$91,195 | $4,850 |
|
Hca Healthone Presbyterian St. Lukes
Denver, CO |
$89,064 | $5,425 |
|
Princeton Baptist Medical Center
Birmingham, AL |
$87,178 | $4,413 |
|
Adventist Health Lodi Memorial
Lodi, CA |
$86,491 | $7,157 |
Questions people ask
What do U.S. hospitals charge for Complex GI Procedures?
Across 512 U.S. hospitals, the middle charge for Complex GI Procedures is $29,990. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $22,625 and the dearest quarter over $40,647.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Complex GI Procedures, the hospitals in the dearest tenth charge about 3.3x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $5,369 is roughly what Medicare actually paid per case, against an average charge of $34,865. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as APC 5331: “Complex GI Procedures”. An APC covers one outpatient visit for that level of service — you go home the same day.