Amounts Generally Billed (AGB) Percentage
A hospital's amounts generally billed percentage.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Total allowed amounts for the 12-month period
- 4200000 USD
- Total gross charges for those claims
- 10000000 USD
- A patient's gross charges
- 12000 USD
Result: AGB percentage 42%: a financial-assistance-eligible patient may be charged at most 42% of gross charges for emergency or medically necessary care. On gross charges of $12,000.00, that is $5,040.00.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Total allowed amounts for the 12-month period
- Total gross charges for those claims
- Payers included
- End of the 12-month period (YYYY-MM-DD)
- A patient's gross charges
How this is calculated
Citation
26 CFR 1.501(r)-5(b)(3): AGB percentage = claims allowed by Medicare fee-for-service (alone or with private insurers) or Medicaid over the associated gross charges for a prior 12-month period, applied by the 120th day after the period ends. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.