facebook tracking Hospital procedure costs: what Medicare pays for 612 procedures, by state and hospital

Hospital procedure costs

What hospitals charge and what Medicare actually pays for 540 types of hospital stay and 72 outpatient services, for every state and hospital, from 2024 Medicare claims.

Most common hospital stays

Ranked by the number of Medicare stays. "Payment" is the average total paid by Medicare, the patient and any other insurer.

StayHospitalsAvg chargeAvg payment
Septicemia or severe sepsis without ventilator >96 hours with major complicationsDRG 8712,661$90,381$18,230
Heart failure and shock with major complicationsDRG 2912,587$56,495$12,050
Respiratory infections and inflammations with major complicationsDRG 1772,332$71,065$14,949
Simple pneumonia and pleurisy with major complicationsDRG 1932,442$60,101$12,020
Septicemia or severe sepsis without ventilator >96 hours without major complicationsDRG 8722,216$49,416$10,085
Kidney and urinary tract infections without major complicationsDRG 6902,133$38,134$7,824
Pulmonary edema and respiratory failureDRG 1892,098$57,943$12,197
Esophagitis, gastroenteritis and miscellaneous digestive disorders without major complicationsDRG 3921,962$40,642$7,791
Acute myocardial infarction, discharged alive with major complicationsDRG 2801,825$76,887$14,805
Kidney and urinary tract infections with major complicationsDRG 6891,945$52,052$10,698
Infectious and parasitic diseases with o.r. procedures with major complicationsDRG 8531,779$232,698$46,667
Renal failure with complicationsDRG 6832,018$41,156$8,610
Gastrointestinal hemorrhage with complicationsDRG 3781,789$48,832$9,353
Other kidney and urinary tract diagnoses with major complicationsDRG 6981,795$74,649$15,452
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with major complicationsDRG 6401,869$61,341$12,830
Renal failure with major complicationsDRG 6821,906$67,156$13,701
Intracranial hemorrhage or cerebral infarction with complications or TPA in 24 hoursDRG 0651,727$56,315$9,911
Hip and femur procedures except major joint with complicationsDRG 4811,700$101,431$18,473
Intracranial hemorrhage or cerebral infarction with major complicationsDRG 0641,480$102,229$18,937
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without major complicationsDRG 6411,940$37,589$7,740
Cardiac arrhythmia and conduction disorders with complicationsDRG 3091,656$36,238$7,238
Major hip and knee joint replacement or reattachment of lower extremity without major complicationsDRG 4701,212$92,976$17,318
Percutaneous and other intracardiac procedures without major complicationsDRG 274780$156,826$27,497
Cellulitis without major complicationsDRG 6031,685$37,743$8,642
Syncope and collapseDRG 3121,487$46,199$8,552
Gastrointestinal hemorrhage with major complicationsDRG 3771,554$86,993$16,745
Chronic obstructive pulmonary disease with major complicationsDRG 1901,595$50,958$10,575
Percutaneous cardiovascular procedures with intraluminal device without major complicationsDRG 3221,339$114,054$17,158
Medical back problems without major complicationsDRG 5521,284$50,120$9,373
Cardiac arrhythmia and conduction disorders with major complicationsDRG 3081,502$57,178$11,347
Simple pneumonia and pleurisy with complicationsDRG 1941,522$38,636$7,941
Endovascular cardiac valve replacement and supplement procedures without major complicationsDRG 267690$220,616$44,077
PsychosesDRG 885562$42,664$14,304
Hip replacement with principal diagnosis of hip fracture without major complicationsDRG 5221,414$102,629$18,301
Circulatory disorders except AMI, with cardiac catheterization with major complicationsDRG 2861,085$113,650$21,968
Major small and large bowel procedures with complicationsDRG 3301,074$118,796$22,927
Gastrointestinal obstruction with complicationsDRG 3891,356$39,323$7,859
Other kidney and urinary tract diagnoses with complicationsDRG 6991,102$49,314$10,600
Percutaneous cardiovascular procedures with intraluminal device with major complications or 4+ arteries/DRG 3211,136$164,137$26,768
Acute myocardial infarction, discharged alive with complicationsDRG 2811,239$51,411$8,829
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Most common outpatient services

Hospital outpatient departments: scans, procedures, ER and clinic visits. "Allowed" is Medicare's payment plus the patient's share.

ServiceHospitalsAvg chargeAvg allowed
Comprehensive Observation ServicesAPC 80112,914$24,060$2,634
Level 5 Musculoskeletal ProceduresAPC 51152,645$72,739$12,402
Level 2 Excision/Biopsy/Incision and DrainageAPC 50722,895$11,310$1,539
Level 1 Endovascular ProceduresAPC 51911,924$28,716$3,094
Level 1 Intraocular ProceduresAPC 54911,382$13,330$2,208
Level 2 Upper GI ProceduresAPC 53022,698$13,589$1,815
Level 2 Urology and Related ServicesAPC 53721,980$3,156$638
Level 3 Urology and Related ServicesAPC 53732,464$13,270$1,912
Level 3 Vascular ProceduresAPC 51832,804$21,311$3,030
Level 1 Laparoscopy and Related ServicesAPC 53612,753$42,492$5,495
Level 4 Musculoskeletal ProceduresAPC 51142,738$46,846$6,708
Level 4 Urology and Related ServicesAPC 53742,411$23,596$3,312
Level 5 Urology and Related ServicesAPC 53752,317$32,752$4,934
Level 3 Excision/Biopsy/Incision and DrainageAPC 50732,787$21,053$2,697
Level 1 Nerve ProceduresAPC 54312,558$12,341$1,774
Level 3 Endovascular ProceduresAPC 51931,994$78,383$10,507
Level 3 Electrophysiologic ProceduresAPC 52131,110$163,748$22,751
Level 3 Musculoskeletal ProceduresAPC 51132,760$23,966$2,995
Level 2 Musculoskeletal ProceduresAPC 51122,801$12,397$1,511
Level 6 Musculoskeletal ProceduresAPC 51162,342$97,523$17,392
Level 2 Laparoscopy and Related ServicesAPC 53622,263$72,672$9,797
Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 53412,693$26,986$3,323
Level 3 Pacemaker and Similar ProceduresAPC 52231,843$60,973$10,202
Level 2 Endovascular ProceduresAPC 51921,964$38,060$5,463

Every procedure A–Z

About these prices

Every figure comes from Medicare claims that hospitals submitted for patients with original (fee-for-service) Medicare. Charges are hospitals' list prices; payments are what was actually paid. Private insurance and Medicare Advantage plans negotiate their own prices, so use these figures to compare hospitals and places, not as a quote for your own bill.

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