Level 4 Pacemaker and Similar Procedures — what U.S. hospitals charge
APC 5224 · Hospital outpatient visit · 550 U.S. hospitals publish a price
Cheapest quarter
under $72,423
Typical charge
$95,511
Dearest quarter
over $127,850
Actually paid
$18,610
The middle U.S. hospital bills $95,511 for Level 4 Pacemaker and Similar Procedures. The dearest hospitals charge about 2.9x what the cheapest do for the same coded work. Medicare actually paid about $18,610 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.
Level 4 Pacemaker and Similar 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 |
|---|---|---|---|
| Massachusetts | 10 | $59,670 | $41,321 – $100,254 |
| Arkansas | 10 | $63,523 | $42,597 – $89,392 |
| Iowa | 7 | $66,475 | $48,628 – $84,104 |
| Ohio | 13 | $69,289 | $51,654 – $96,063 |
| North Dakota | 3 | $70,943 | $69,034 – $112,193 |
| Missouri | 19 | $71,094 | $46,196 – $172,233 |
| Kansas | 9 | $74,140 | $44,875 – $169,576 |
| Idaho | 6 | $76,396 | $45,872 – $212,632 |
| Wisconsin | 12 | $77,133 | $47,626 – $123,388 |
| Nebraska | 6 | $78,171 | $52,232 – $104,984 |
| Michigan | 14 | $78,250 | $44,181 – $162,106 |
| Connecticut | 6 | $78,648 | $50,717 – $97,867 |
| Oklahoma | 7 | $79,782 | $67,267 – $134,072 |
| Utah | 5 | $79,859 | $50,469 – $301,476 |
| Delaware | 3 | $80,203 | $70,581 – $105,813 |
| Virginia | 18 | $81,220 | $52,770 – $337,330 |
| Mississippi | 8 | $81,608 | $56,838 – $107,777 |
| Minnesota | 8 | $82,465 | $57,730 – $119,737 |
| Georgia | 20 | $84,962 | $34,452 – $199,683 |
| Oregon | 7 | $85,300 | $67,266 – $105,898 |
| Washington | 15 | $87,000 | $40,626 – $136,750 |
| West Virginia | 5 | $89,008 | $53,340 – $186,640 |
| Alabama | 8 | $89,093 | $59,156 – $366,747 |
| New York | 21 | $89,360 | $23,683 – $246,816 |
| Illinois | 26 | $90,816 | $37,926 – $157,205 |
| Louisiana | 8 | $94,637 | $41,755 – $178,694 |
| Indiana | 13 | $97,243 | $50,129 – $253,809 |
| New Jersey | 10 | $98,190 | $54,850 – $278,760 |
| Tennessee | 13 | $98,294 | $46,175 – $280,333 |
| Pennsylvania | 20 | $100,747 | $35,655 – $274,822 |
| New Hampshire | 3 | $104,695 | $66,701 – $114,634 |
| North Carolina | 18 | $106,903 | $48,370 – $150,185 |
| New Mexico | 3 | $108,626 | $97,130 – $162,115 |
| Kentucky | 11 | $109,293 | $54,646 – $260,337 |
| South Carolina | 12 | $113,333 | $82,003 – $351,431 |
| California | 48 | $115,568 | $74,095 – $420,815 |
| Colorado | 12 | $118,350 | $94,456 – $201,331 |
| Arizona | 14 | $128,222 | $89,185 – $178,387 |
| Texas | 38 | $128,892 | $40,451 – $306,007 |
| Florida | 44 | $131,174 | $60,200 – $292,771 |
| Nevada | 5 | $159,921 | $105,897 – $280,246 |
Where Level 4 Pacemaker and Similar Procedures is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Crouse Hospital
Syracuse, NY |
$23,683 | $20,608 |
|
Emory University Hospital
Atlanta, GA |
$34,452 | $18,042 |
|
Saint Joseph's Hospital Of Atlanta, Inc
Atlanta, GA |
$34,697 | $17,470 |
|
Robert Packer Hospital
Sayre, PA |
$35,655 | $17,485 |
|
Kaleida Health
Buffalo, NY |
$35,744 | $20,608 |
|
Silver Cross Hospital And Medical Centers
New Lenox, IL |
$37,926 | $18,457 |
|
St Francis Hospital- Emory Healthcare
Columbus, GA |
$39,691 | $16,435 |
|
Memorial Hermann Memorial City Hospital
Houston, TX |
$40,451 | $18,027 |
|
Prov Sacred Hrt Med Ctr & Childs Hosp.
Spokane, WA |
$40,626 | $19,509 |
|
South Shore Hospital
South Weymouth, MA |
$41,321 | $20,874 |
|
Terrebonne General Medical Center - Parish
Houma, LA |
$41,755 | $16,314 |
|
Mercy Hospital Northwest Arkansas
Rogers, AR |
$42,597 | $16,401 |
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 |
$420,815 | $27,359 |
|
Grandview Medical Center
Birmingham, AL |
$366,747 | $16,167 |
|
Grand Strand Regional Medical Center
Myrtle Beach, SC |
$351,431 | $16,654 |
|
Cjw Medical Center
Richmond, VA |
$337,330 | $16,739 |
|
Trident Medical Center
Charleston, SC |
$308,842 | $16,776 |
|
Hca Houston Healthcare Kingwood
Kingwood, TX |
$306,007 | $18,027 |
|
St Mark's Hospital
Salt Lake City, UT |
$301,476 | $17,417 |
|
St David's Medical Center
Austin, TX |
$299,937 | $17,113 |
|
Cedars-Sinai Medical Center
Los Angeles, CA |
$298,422 | $23,891 |
|
Delray Medical Center
Delray Beach, FL |
$292,771 | $14,116 |
|
Medical City Dallas Hospital
Dallas, TX |
$283,742 | $17,496 |
|
Physicians Regional Medical Center
Powell, TN |
$280,333 | $15,351 |
Questions people ask
What do U.S. hospitals charge for Level 4 Pacemaker and Similar Procedures?
Across 550 U.S. hospitals, the middle charge for Level 4 Pacemaker and Similar Procedures is $95,511. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $72,423 and the dearest quarter over $127,850.
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 Level 4 Pacemaker and Similar Procedures, the hospitals in the dearest tenth charge about 2.9x 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. $18,610 is roughly what Medicare actually paid per case, against an average charge of $108,814. 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 5224: “Level 4 Pacemaker and Similar Procedures”. An APC covers one outpatient visit for that level of service — you go home the same day.