facebook tracking Aortic and heart assist procedures except pulsation balloon with major complications cost in Kentucky: 2 hospitals compared (DRG 268)

Aortic and heart assist procedures except pulsation balloon with major complications in Kentucky

What 2 hospitals in Kentucky charged and were paid for a Medicare hospital stay for aortic and heart assist procedures except pulsation balloon with major complications (DRG 268), from 2024 Medicare claims.

DRG 268 Inpatient 2024 Medicare data
Average charge $226,730 Hospital list price billed
Average payment $63,719 Medicare + patient + other payers
Medicare paid $55,683 Average per stay
Volume 24 Medicare hospital stays

Hospitals in Kentucky billed an average of $226,730 for aortic and heart assist procedures except pulsation balloon with major complications, about 3.6 times the average total payment of $63,719. That payment is 25% below the U.S. average of $85,314.

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 $63,719Billed $226,730

About 28¢ was paid for every $1 hospitals in Kentucky billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Kentucky:

Kentucky hospitals: aortic and heart assist procedures except pulsation balloon with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
University of Kentucky HospLexington 13 $297,690 $71,884 $65,627
Saint Joseph HospitalLexington 11 $142,868 $54,069 $43,932
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Aortic and heart assist procedures except pulsation balloon with major complications in other states

Questions

How much does aortic and heart assist procedures except pulsation balloon with major complications cost in Kentucky?

In 2024 Medicare data, a hospital stay for aortic and heart assist procedures except pulsation balloon with major complications (DRG 268) at 2 hospitals in Kentucky was billed at $226,730 on average, while the average total payment was $63,719, of which Medicare paid $55,683. 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 Kentucky, average charges were 3.6 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.