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Methodology

How Other Countries Set Procedure Prices: DRGs, Tariffs & Fee Schedules

Why every table in this atlas has the same shape: a wide US band, narrow national-tariff bands, and a Colombian package near what Medicare pays. The four ways a country decides what surgery is worth.

September 6, 202611 min readTypical 2026 ranges, not quotes

Every table in this atlas shows the same shape: a wide US band, narrower international bands, and a Colombian package somewhere near what Medicare would pay. That shape is not an accident of exchange rates. It comes from how each country decides what a procedure is worth, and there are only a handful of ways to do that. Understanding them explains why the ranges look the way they do, and why some quotes can be trusted more than others.

Key takeaways

Seven pricing systems, side by side

Country / systemHow the price is setSpread for the same procedureWhat the range usually includes
United StatesChargemaster list + payer-by-payer negotiation; Medicare fee schedules as the public referenceWide: cash prices spread 2–3x within one marketNo national price; every hospital and insurer negotiates. Price transparency files now make the results visible.
GermanyNational DRG catalog (aG-DRG) maintained by InEK; statutory insurers pay the same case rate to every hospitalNarrow: near-fixed per casePrivate patients pay hospital rates plus physician fee schedule (GOÄ) multiples. Self-pay foreigners are billed at published rates.
United KingdomNHS Payment Scheme national tariff for public care; private hospitals publish self-pay guide pricesModerate: private guide prices spread 1.3–1.7xNHS free at point of use for residents; overseas visitors charged at a multiple of tariff.
AustraliaMedicare Benefits Schedule fee per item; private hospitals and health funds negotiate above itModerateDoctors may charge above the schedule (the gap); known-gap and no-gap arrangements common.
JapanSingle national fee schedule set every two years by the health ministry; every provider paid the sameVery narrowThe purest fee-schedule system among high-income countries.
ColombiaInsurer (EPS) contracts with providers, historically referenced to the ISS 2001 and SOAT tariff manuals; private-pay and packages priced by the hospitalModerate: packages spread about 2xPublic reference tariffs exist but are outdated; private hospitals set their own tarifas and international-patient packages.
Mexico / Thailand / Turkey / IndiaPublic systems on budgets or fee schedules; private hospitals set list prices and publish packages for international patientsWide within country, especially between tourist and capital marketsThe package price is a marketing document as much as a tariff; scope must be confirmed in writing.

Laparoscopic cholecystectomy: how wide is the range under each pricing system?

Typical 2026 ranges from this atlas plus a German DRG system price for reference. Red = US cash-pay, green = Colombia.

The four ways to set a price

DRIVER 01

Negotiated list pricing (US)

Hospitals set a chargemaster, then discount it differently for every payer. Prices reflect bargaining power more than cost. Transparency rules now expose the results but do not change the mechanism; see chargemaster vs cash.

DRIVER 02

Case-based tariffs (Germany, NHS, France)

A national body groups procedures into cases and sets one payment per case per year, calibrated to average cost across hospitals. Everyone is paid the same; efficiency is rewarded, upcoding is policed.

DRIVER 03

Fee schedules (Japan, Australia MBS, US Medicare)

A national list of items with a fee each. Providers bill items; totals vary with what is done, but each item's price is fixed. Australia lets doctors charge above the schedule, Japan does not.

DRIVER 04

Package pricing (medical-tourism markets)

A hospital bundles surgeon, facility, anesthesia, nights and follow-up into one number for a defined scope. It is transparent when the scope is written and treacherous when it is not; see our all-inclusive packages page.

DRIVER 05

Reference tariffs (Colombia)

The ISS 2001 and SOAT manuals were built as public reference tariffs for insurer-provider contracts and accident coverage. They are old and below market, but they anchor domestic contracting, and private hospitals price above them with published tarifas.

DRIVER 06

Currency and locality

Fee schedules are in local currency; packages for foreigners are often in dollars with a validity window. Our currency page covers the exposure; locality adjustments exist inside most national systems but are small compared with US inter-market spreads.

Why this matters for reading a quote

A price from a fee-schedule or DRG country tells you almost exactly what the procedure will cost; the spread is the size of the patient, not the size of the negotiation. A US cash quote tells you where one hospital chose to set one number, which is why comparing it to the Medicare benchmark is the only way to judge it. A package quote from Colombia, Mexico, Thailand or Turkey tells you what a hospital will commit to for a written scope, which means the scope is the price. Ask what happens if the case runs long, if an extra night is needed, if pathology shows something unexpected, and get the answers in the same document. A package that answers those questions is one of the most transparent prices in medicine. One that does not is a list price with a bow on it. healthcarecompare.co compares the systems behind these prices in more depth; healthcarecolombia.co explains how Colombia's EPS system works for residents.

Where Colombia sits, and how to read it

Colombia appears in the middle-to-low band on almost every row of this table, and for North American patients it carries a logistics advantage the cheaper Asian rows cannot match: three to five hours of direct flight from Miami, Houston, Atlanta, New York and Fort Lauderdale, and a same-or-adjacent time zone for follow-up calls. The World Health Organization ranked Colombia's health system #22 in the world and #1 in the Western Hemisphere in its 2000 World Health Report; that ranking is now a historical benchmark rather than a current league table, but it reflects a system that was built on universal coverage and a strong private hospital tier. Six Colombian hospitals hold Joint Commission International accreditation as of 2026 — accreditation is hospital-level, and it does not extend to freestanding clinics or to individual surgeons.

Two verification anchors matter more than any price. First, any Colombian physician can be checked in the national ReTHUS registry (rethus.gov.co), which confirms licensure and specialty. Second, the facility should be able to show its habilitación (operating license) for the specific service line. A low number from a facility that cannot produce either is not a bargain; it is an unpriced risk.

Sources and method

System descriptions reflect published documentation from CMS, InEK (Germany), NHS England's Payment Scheme, Australia's Department of Health MBS, Japan's Ministry of Health, Labour and Welfare fee schedule, and Colombia's ISS 2001 and SOAT tariff manuals as referenced in Ministry of Health regulation. Price ranges are from the corresponding tables in this atlas; the German DRG figure is an approximate system payment for reference. Method: where our numbers come from.

Frequently asked questions

Why does the US have no standard price for surgery?

US hospitals set their own list prices and negotiate separately with each insurer; there is no national tariff. Medicare's fee schedules are the only public reference, and cash prices spread two- to threefold within a single market.

What is a DRG?

A diagnosis-related group: a case category used to pay hospitals one fixed amount per admission regardless of actual charges. Medicare uses DRGs for inpatient care; Germany and several other countries use national DRG catalogs for all payers.

How are medical prices set in Colombia?

Insurers (EPS) contract with providers, historically referencing the public ISS 2001 and SOAT tariff manuals; private hospitals set their own tarifas and offer package prices to international patients.

Which country has the most predictable surgery prices?

Countries with a single national fee schedule or DRG catalog, such as Japan and Germany, have the narrowest spread for the same procedure. Package pricing in medical-tourism markets is predictable when the scope is written clearly.

Is a package price a fixed price?

Only for the scope it defines. Ask in writing what happens if the case runs long, an extra night is needed or pathology is unexpected; a package that answers is a transparent price, one that does not is a list price.

Next step: turn this range into your number

This table tells you where the procedure you are pricing sits worldwide. It does not tell you what you would pay. For a Colombia-specific estimate worksheet and a real written quote from an accredited facility, use the pair below.

Want the Colombia version of this number?

We are on the ground in Medellín. Tell us the procedure and we will point you to accredited hospitals and verified surgeons (checked against Colombia's ReTHUS registry) — no fixer markups, no obligation.

Disclaimer. All figures on this page are typical 2026 ranges compiled from published clinic and hospital price lists, insurer and government benchmark data (including FAIR Health, CMS Medicare fee schedules and hospital price-transparency files), international comparative price reports and medical-tourism industry sources. They are not quotes, and no clinic named or unnamed is bound by them. Where no reliable published range existed for a country, the cell says so rather than estimating. Colombia's WHO ranking (#1 in the Western Hemisphere, #22 worldwide) comes from the 2000 World Health Report and is cited as a historical benchmark, not a current league table. JCI accreditation in Colombia applies to a small number of hospitals, not to individual clinics or surgeons. This page is not medical, legal or financial advice.