Puerto Rico procedure costs
61 hospitals · 685 Medicare providers · 1,564 procedure codes with Puerto Rico locality adjustments.
The short answer
Puerto Rico has 61 hospitals and 685 Medicare-billing providers across 1,564 procedure codes. The average Medicare payment per procedure is $114.18; the average submitted (billed) charge is $326.06.
- Procedure codes
- 1,564
- Providers per hospital
- 11.2
- Billed-to-Medicare ratio
- 2.9x
- Markup rank
- #56 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.
Puerto Rico against every US state
Where the state's average Medicare payment per procedure falls, all 56 tracked jurisdictions
$114 higher than 5% of 56 states
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 Puerto Rico
Highest average Medicare payment per procedure billed in Puerto Rico. Hover any bar for the exact figure; even these top procedures are billed well above what Medicare reimburses.
Top procedures by Medicare payment - Puerto Rico
The cost spread in Puerto Rico
The highest- and lowest-paying procedures Medicare reimbursed in Puerto Rico, side by side.
Most expensive
Least expensive
Top Procedures by Volume
Puerto Rico Healthcare Cost Landscape
CMS lists 61 hospitals in Puerto Rico across 27 cities. SAN JUAN holds 14 (23%). The three densest cities together hold 38% of the state roster. Statewide that is 685 Medicare-billing providers, 11.2 per listed hospital.
8 hospitals carry a CMS overall star rating (0 five-star, 0 four-star, 3 three-star, 3 two-star, 2 one-star) ; five-star share among rated facilities is 0%. 53 hospitals in this extract have no published overall rating.
Facility-type mix: Acute Care Hospitals 55 (90%); Psychiatric 4 (7%); Acute Care - Veterans Administration 1 (2%); Childrens 1 (2%).
Among the 30 highest-volume procedure codes billed in Puerto Rico, DME (Temporary) leads with 521.7K services (29% of this top-volume slice) across 1 codes. Next is Drugs (Administered) at 19%.
Submitted charges average $326.06 against $114.18 Medicare payment (2.9x billed-to-Medicare). That ratio ranks #56 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #53 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; Iodine 1-123 Ioflupane, Diagnostic, Per Study Dose, Up To 5 Millicuries is in the high-payment set without matching volume rank.
These are CMS roster and claims aggregates for Puerto Rico, not a quote for any patient, plan, or visit. See the methodology and CMS Medicare Provider Charge Data.
Where Puerto Rico hospitals sit
City of the CMS hospital roster, not a travel or care recommendation. 27 distinct cities appear on 61 listed facilities.
| City | Hospitals | Share of state roster |
|---|---|---|
| SAN JUAN | 14 | 23% |
| BAYAMON | 5 | 8% |
| MAYAGUEZ | 4 | 7% |
| PONCE | 4 | 7% |
| HUMACAO | 3 | 5% |
| RIO PIEDRAS | 3 | 5% |
| AIBONITO | 2 | 3% |
| ARECIBO | 2 | 3% |
Nationwide states with similar hospital scale or Medicare payment
Two CMS-extract-derived peer sets for Puerto Rico: 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 (61 here).
Similar average Medicare payment
Nearest states with published averages ($114.18 here).
Hospitals in Puerto Rico
How Puerto Rico Compares Nationally
Puerto Rico's average Medicare payment is #53 of 56 in this extract. Submitted-over-Medicare markup ranks #56 of 56 (2.9x). Hospital-count peers (nearest CMS roster size to 61): South Dakota 61, Oregon 62, Montana 63, Maryland 56. Payment peers (nearest average Medicare payment to $114.18): Vermont $130.98, Maine $149.34, North Dakota $150.79, West Virginia $167.89.
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 Puerto Rico, not an out-of-pocket quote.
Related registry pages
Puerto Rico averages sit on two maps: Medicare payment and submitted-over-Medicare markup.
- Procedure codes billed in this extract, in national volume order. Browse procedures
- State payment rank versus markup rank on the rankings hub. Rankings
- How these figures are sourced. Methodology
Figures here are Puerto Rico CMS averages, not a quote for any patient, plan, or visit.
Read our methodology - how this data is sourced, computed, and verified.
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.