DE CMS Medicare PUF 2023 Avg payment #37 of 56

Delaware procedure costs

13 hospitals · 820 Medicare providers · 2,493 procedure codes with Delaware locality adjustments.

The short answer

Delaware has 13 hospitals and 820 Medicare-billing providers across 2,493 procedure codes. The average Medicare payment per procedure is $208.28; the average submitted (billed) charge is $1,072.22.

Procedure codes
2,493
Providers per hospital
63.1
Billed-to-Medicare ratio
5.1x
Markup rank
#40 of 56

Source: CMS Medicare Physician & Other Practitioners, 2023.

About this dataset, nationwide

According to the Centers for Medicare & Medicaid Services (CMS), the 2023 Medicare Physician & Other Practitioners dataset records payments for 9,297 procedure codes billed across 5,426 hospitals in 56 states and territories; see our methodology for how each figure is sourced and computed.

13
Hospitals
820
Providers
$208.28
Avg Medicare Payment
$1,072.22
Avg Billed Charge

Delaware against every US state

Where the state's average Medicare payment per procedure falls, all 56 tracked jurisdictions

$208 higher than 34% of 56 states

$75–$100: 3 states (5%). Below this entry. $100–$125: 1 states (2%). Below this entry. $125–$150: 2 states (4%). Below this entry. $150–$175: 5 states (9%). Below this entry. $175–$200: 7 states (13%). Below this entry. $200–$225: 9 states (16%). This entry sits in this band. $225–$250: 9 states (16%). Above this entry. $250–$275: 11 states (20%). Above this entry. $275–$300: 4 states (7%). Above this entry. $300–$325: 4 states (7%). Above this entry. $325–$350: 1 states (2%). Above this entry. This state $75 $350 every US state, bucketed by value

Each bar is a $25-wide band; taller bars hold more states. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners, 2023

The priciest procedures in Delaware

Highest average Medicare payment per procedure billed in Delaware. Hover any bar for the exact figure; even these top procedures are billed well above what Medicare reimburses.

Top procedures by Medicare payment - Delaware

Removal Of Plaque And Insert…7324Cystourethroscopy, With Inse…5769Removal Of Plaque In Artery …4654Removal And/or Dissolving Of…4370Heat Destruction Of Intraoss…4326Insertion Of Peripheral Or G…3396Insertion Of Needle And/or T…3364Insertion Of Spinal Neurosti…3305
Top procedures by Medicare payment - Delaware-Average Medicare payment per procedure (CMS 2023)

Top Procedures by Volume

Procedure Medicare Services
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $3.88 1.1M
Established Patient Office Or Other Outpatient Visit, 30-39 Minutes $83.61 558.9K
Therapy Procedure Using Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes $17.59 486.3K
Injection, Denosumab, 1 Mg $18.24 452.1K
Established Patient Office Or Other Outpatient Visit, 20-29 Minutes $58.71 420.5K
Therapy Procedure Using Functional Activities $25.35 359.2K
Travel Allowance One Way In Connection With Medically Necessary Laboratory Specimen Collection Drawn From Home Bound Or Nursing Home Bound Patient; Prorated Miles Actually Travelled $1.09 345.2K
Injection, Gadoterate Meglumine, 0.1 Ml $0.11 337.6K
Ground Mileage, Per Statute Mile $7.94 299.9K
Injection, Onabotulinumtoxina, 1 Unit $4.92 285.8K
Injection, Tocilizumab, 1 Mg $4.61 282.7K
Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml $0.11 274.3K
Therapy Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes $21.08 263.0K
Injection, Pembrolizumab, 1 Mg $43.14 233.2K
Injection, Romosozumab-Aqqg, 1 Mg $7.75 228.8K
Therapy Procedure Using Manual Technique, Each 15 Minutes $15.91 202.2K
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes $60.98 171.3K
Injection, Golimumab, 1 Mg, For Intravenous Use $10.31 157.6K
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $33.32 138.9K
Injection, Azacitidine, 1 Mg $0.34 124.8K
Injection, Darbepoetin Alfa, 1 Microgram (non-Esrd Use) $2.34 110.1K
Injection, Vedolizumab, 1 Mg $17.22 105.9K
Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count $10.84 101.4K
Injection, Faricimab-Svoa, 0.1 Mg $28.77 100.1K
Aminolevulinic Acid Hcl For Topical Administration, 10% Gel, 10 Mg $1.29 97.2K
Injection, Inclisiran, 1 Mg $9.27 95.8K
Injection, Nivolumab, 1 Mg $23.60 95.7K
Injection, Ferric Carboxymaltose, 1 Mg $0.87 90.8K
Injection, Daratumumab, 10 Mg And Hyaluronidase-Fihj $37.81 86.2K
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 50 Minutes $92.56 84.6K

Delaware Healthcare Cost Landscape

CMS lists 13 hospitals in Delaware across 8 cities. WILMINGTON holds 3 (23%). The three densest cities together hold 54% of the state roster. Statewide that is 820 Medicare-billing providers, 63.1 per listed hospital.

7 hospitals carry a CMS overall star rating (1 five-star, 2 four-star, 3 three-star, 1 two-star, 0 one-star) ; five-star share among rated facilities is 14%. 6 hospitals in this extract have no published overall rating.

Facility-type mix: Acute Care Hospitals 6 (46%); Psychiatric 5 (38%); Acute Care - Veterans Administration 1 (8%); Childrens 1 (8%).

Among the 30 highest-volume procedure codes billed in Delaware, Drugs (Administered) leads with 3.8M services (49% of this top-volume slice) across 17 codes. Next is Medicine at 17%.

Submitted charges average $1,072.22 against $208.28 Medicare payment (5.1x billed-to-Medicare). That ratio ranks #40 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #37 of 56.

Volume leaders are not the high-payment codes. Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) is in the top volume slice but not the highest Medicare payments; Removal Of Plaque And Insertion Of Stents In Arteries Of Leg is in the high-payment set without matching volume rank.

These are CMS roster and claims aggregates for Delaware, not a quote for any patient, plan, or visit. See the methodology and CMS Medicare Provider Charge Data.

Where Delaware hospitals sit

City of the CMS hospital roster, not a travel or care recommendation. 8 distinct cities appear on 13 listed facilities.

City Hospitals Share of state roster
WILMINGTON 3 23%
DOVER 2 15%
NEW CASTLE 2 15%
NEWARK 2 15%
GEORGETOWN 1 8%
LEWES 1 8%
MILFORD 1 8%
SEAFORD 1 8%

Nationwide states with similar hospital scale or Medicare payment

Two CMS-extract-derived peer sets for Delaware: nearest hospital inventory and nearest statewide average Medicare payment. Not clinical substitutes: registry-scale and payment neighborhoods only.

Similar CMS hospital count

Nearest states with ≥5 hospitals (13 here).

Similar average Medicare payment

Nearest states with published averages ($208.28 here).

How Delaware Compares Nationally

Delaware's average Medicare payment is #37 of 56 in this extract. Submitted-over-Medicare markup ranks #40 of 56 (5.1x). Hospital-count peers (nearest CMS roster size to 13): Rhode Island 13, District of Columbia 10, Vermont 17, Hawaii 24. Payment peers (nearest average Medicare payment to $208.28): Alabama $211.12, Kentucky $211.69, Oklahoma $212.27, Wisconsin $201.63.

Those peer sets are registry neighborhoods, not clinical substitutes. Markup rank and payment rank can diverge: a jurisdiction can sit high on billed-to-Medicare while sitting mid-pack on payment, or the reverse. Figures remain CMS averages for Delaware, not an out-of-pocket quote.

Related registry pages

Delaware averages sit on two maps: Medicare payment and submitted-over-Medicare markup.

Figures here are Delaware CMS averages, not a quote for any patient, plan, or visit.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure  · Verify with CMS →

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, the data changelog, or report a data error.