facebook tracking Aftercare, musculoskeletal system and connective tissue with major complications cost in California: 2 hospitals compared (DRG 559)

Aftercare, musculoskeletal system and connective tissue with major complications in California

What 2 hospitals in California charged and were paid for a Medicare hospital stay for aftercare, musculoskeletal system and connective tissue with major complications (DRG 559), from 2024 Medicare claims.

DRG 559 Inpatient 2024 Medicare data
Average charge $180,948 Hospital list price billed
Average payment $21,806 Medicare + patient + other payers
Medicare paid $19,811 Average per stay
Volume 26 Medicare hospital stays

Hospitals in California billed an average of $180,948 for aftercare, musculoskeletal system and connective tissue with major complications, about 8.3 times the average total payment of $21,806. That payment is 26% below the U.S. average of $29,305.

These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.

Paid $21,806Billed $180,948

About 12¢ was paid for every $1 hospitals in California billed for this stay.

California hospitals: aftercare, musculoskeletal system and connective tissue with major complications

Every California hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
Hollywood Community Hospital of HollywoodLos Angeles 15 $108,619 $20,790 $19,838
Cedars-Sinai Medical CenterLos Angeles 11 $279,579 $23,191 $19,774
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Aftercare, musculoskeletal system and connective tissue with major complications in other states

Questions

How much does aftercare, musculoskeletal system and connective tissue with major complications cost in California?

In 2024 Medicare data, a hospital stay for aftercare, musculoskeletal system and connective tissue with major complications (DRG 559) at 2 hospitals in California was billed at $180,948 on average, while the average total payment was $21,806, of which Medicare paid $19,811. Your own cost depends on your insurance, deductible and the hospital.

Why are hospital charges so much higher than payments?

Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in California, average charges were 8.3 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.

Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.