IL CMS Medicare PUF 2023 Avg payment #9 of 56

Illinois procedure costs

194 hospitals · 6,426 Medicare providers · 5,193 procedure codes with Illinois locality adjustments.

The short answer

Illinois has 194 hospitals and 6,426 Medicare-billing providers across 5,193 procedure codes. The average Medicare payment per procedure is $281.39; the average submitted (billed) charge is $1,865.15.

Procedure codes
5,193
Providers per hospital
33.1
Billed-to-Medicare ratio
6.6x
Markup rank
#10 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.

194
Hospitals
6,426
Providers
$281.39
Avg Medicare Payment
$1,865.15
Avg Billed Charge

Illinois against every US state

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

$281 higher than 84% 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%). Below this entry. $225–$250: 9 states (16%). Below this entry. $250–$275: 11 states (20%). Below this entry. $275–$300: 4 states (7%). This entry sits in this band. $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 Illinois

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

Top procedures by Medicare payment - Illinois

Sipuleucel-T, Minimum Of 50 …41854Removal Of Plaque And Insert…8699Insertion Of New Or Replacem…7815Procenta, Per 200 Mg7565Insertion Of New Or Replacem…7378Insertion Of Spinal Neurosti…5977Cystourethroscopy, With Inse…5591Removal Of Plaque And Insert…5460
Top procedures by Medicare payment - Illinois-Average Medicare payment per procedure (CMS 2023)

The cost spread in Illinois

The highest- and lowest-paying procedures Medicare reimbursed in Illinois, side by side.

Top Procedures by Volume

Procedure Medicare Services
Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count $11.72 40.6M
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 $1.08 8.8M
Factor Viii (antihemophilic Factor, Human) Per I.u. $0.87 4.3M
Ground Mileage, Per Statute Mile $7.33 3.9M
Established Patient Office Or Other Outpatient Visit, 30-39 Minutes $84.68 3.8M
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) $3.89 3.4M
Injection, Ferric Carboxymaltose, 1 Mg $0.87 3.2M
Therapy Procedure Using Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes $17.68 3.1M
Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml $0.11 2.9M
Established Patient Office Or Other Outpatient Visit, 20-29 Minutes $59.49 2.6M
Injection, Denosumab, 1 Mg $18.23 2.4M
Factor Viii (antihemophilic Factor, Recombinant) Per I.u., Not Otherwise Specified $1.23 2.3M
Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-Esrd Use) $0.39 2.1M
Therapy Procedure Using Functional Activities $25.16 1.9M
Injection, Onabotulinumtoxina, 1 Unit $4.82 1.9M
Injection, Pembrolizumab, 1 Mg $42.80 1.9M
Injection, Testosterone Cypionate, 1 Mg $0.02 1.8M
Injection, Romosozumab-Aqqg, 1 Mg $7.87 1.7M
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes $63.10 1.6M
Therapy Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes $21.21 1.6M
Injection, Darbepoetin Alfa, 1 Microgram (non-Esrd Use) $2.35 1.5M
Injection, Tocilizumab, 1 Mg $4.64 1.4M
Injection, Faricimab-Svoa, 0.1 Mg $28.93 1.4M
Insertion Of Needle Into Vein For Collection Of Blood Sample $8.19 1.4M
Injection, Daptomycin, 1 Mg $0.04 1.3M
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 50 Minutes $95.75 1.2M
Injection, Fosaprepitant, 1 Mg $0.12 1.2M
Injection, Oxaliplatin, 0.5 Mg $0.06 1.2M
Injection, Nivolumab, 1 Mg $23.40 1.1M
Therapy Procedure Using Manual Technique, Each 15 Minutes $16.06 1.1M

Illinois Healthcare Cost Landscape

CMS lists 194 hospitals in Illinois across 136 cities. CHICAGO holds 34 (18%). The three densest cities together hold 21% of the state roster. Statewide that is 6,426 Medicare-billing providers, 33.1 per listed hospital.

124 hospitals carry a CMS overall star rating (12 five-star, 33 four-star, 28 three-star, 34 two-star, 17 one-star) ; five-star share among rated facilities is 10%. 70 hospitals in this extract have no published overall rating.

Facility-type mix: Acute Care Hospitals 114 (59%); Critical Access Hospitals 55 (28%); Psychiatric 17 (9%); Acute Care - Veterans Administration 5 (3%).

Among the 30 highest-volume procedure codes billed in Illinois, DME (Temporary) leads with 40.6M services (38% of this top-volume slice) across 1 codes. Next is Drugs (Administered) at 29%.

Submitted charges average $1,865.15 against $281.39 Medicare payment (6.6x billed-to-Medicare). That ratio ranks #10 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #9 of 56.

Volume leaders are not the high-payment codes. Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count is in the top volume slice but not the highest Medicare payments; Sipuleucel-T, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-Gm-Csf, Including Leukapheresis And All Other Preparatory Procedures, Per Infusion is in the high-payment set without matching volume rank.

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

Where Illinois hospitals sit

City of the CMS hospital roster, not a travel or care recommendation. 136 distinct cities appear on 194 listed facilities.

City Hospitals Share of state roster
CHICAGO 34 18%
ALTON 3 2%
ELGIN 3 2%
PEORIA 3 2%
ROCKFORD 3 2%
SPRINGFIELD 3 2%
ANNA 2 1%
AURORA 2 1%

Nationwide states with similar hospital scale or Medicare payment

Two CMS-extract-derived peer sets for Illinois: 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 (194 here).

Similar average Medicare payment

Nearest states with published averages ($281.39 here).

Hospitals in Illinois

ABRAHAM LINCOLN MEMORIAL HOSPITAL
LINCOLN · ★★☆☆☆
ADVOCATE CHRIST HOSPITAL & MEDICAL CENTER
OAK LAWN · ★★★☆☆
ADVOCATE CONDELL MEDICAL CENTER
LIBERTYVILLE · ★★★★☆
ADVOCATE GOOD SAMARITAN HOSPITAL
DOWNERS GROVE · ★★★★☆
ADVOCATE GOOD SHEPHERD HOSPITAL
BARRINGTON · ★★★★☆
ADVOCATE ILLINOIS MASONIC MEDICAL CENTER
CHICAGO · ★★★☆☆
ADVOCATE LUTHERAN GENERAL HOSPITAL
PARK RIDGE · ★★★★☆
ADVOCATE SHERMAN HOSPITAL
ELGIN · ★★★★★
ADVOCATE TRINITY HOSPITAL
CHICAGO · ★★☆☆☆
AERIES HEALTHCARE OF ILLINOIS, INC., DBA RIVEREDGE HOSPITAL
FOREST PARK · -
ALEXIAN BROTHERS BEHAVIORAL HLTH HOSP
HOFFMAN ESTATES · -
ALEXIAN BROTHERS MEDICAL CENTER 1
ELK GROVE VILLAGE · ★★★★☆
ALTON MEMORIAL HOSPITAL
ALTON · ★★★★☆
ALTON MENTAL HEALTH CENTER
ALTON · -
AMITA HEALTH RESURRECTION MEDICAL CENTER
CHICAGO · ★★★★☆
ANDERSON HOSPITAL
MARYVILLE · ★★★★☆
ANDREW MCFARLAND MENTAL HLTH CTR
SPRINGFIELD · -
ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO
CHICAGO · -
BHC STREAMWOOD HOSPITAL INC
STREAMWOOD · -
BLESSING HOSPITAL
QUINCY · ★★★★☆
CARLE BROMENN MEDICAL CENTER
NORMAL · ★★★☆☆
CARLE EUREKA HOSPITAL
EUREKA · -
CARLE FOUNDATION HOSPITAL
URBANA · ★★★☆☆
CARLE HEALTH METHODIST HOSPITAL
PEORIA · ★☆☆☆☆
CARLE HEALTH PEKIN HOSPITAL
PEKIN · ★★☆☆☆
CARLE HEALTH PROCTOR HOSPITAL
PEORIA · ★★★☆☆
CARLE HOOPESTON REGIONAL HEALTH CENTER
HOOPESTON · -
CARLE RICHLAND MEMORIAL HOSPITAL
OLNEY · -
CARLINVILLE AREA HOSPITAL
CARLINVILLE · -
CGH MEDICAL CENTER
STERLING · ★★☆☆☆

View all 194 hospitals in Illinois →

How Illinois Compares Nationally

Illinois's average Medicare payment is #9 of 56 in this extract. Submitted-over-Medicare markup ranks #10 of 56 (6.6x). Hospital-count peers (nearest CMS roster size to 194): Ohio 196, New York 190, Pennsylvania 188, Florida 222. Payment peers (nearest average Medicare payment to $281.39): New Jersey $283.16, Arizona $286.66, Colorado $268.29, Virginia $267.46.

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 Illinois, not an out-of-pocket quote.

Related registry pages

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

Figures here are Illinois 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.