facebook tracking Atherosclerosis without major complications cost in Wisconsin: 2 hospitals compared (DRG 303)

Atherosclerosis without major complications in Wisconsin

What 2 hospitals in Wisconsin charged and were paid for a Medicare hospital stay for atherosclerosis without major complications (DRG 303), from 2024 Medicare claims.

DRG 303 Inpatient 2024 Medicare data
Average charge $22,480 Hospital list price billed
Average payment $5,216 Medicare + patient + other payers
Medicare paid $3,549 Average per stay
Volume 25 Medicare hospital stays

Hospitals in Wisconsin billed an average of $22,480 for atherosclerosis without major complications, about 4.3 times the average total payment of $5,216. That payment is 26% below the U.S. average of $7,013.

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 $5,216Billed $22,480

About 23¢ was paid for every $1 hospitals in Wisconsin billed for this stay.

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

Wisconsin hospitals: atherosclerosis without major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Luther Hospital Mayo Health SystemEau Claire 14 $22,093 $5,326 $3,613
Aspirus Wausau HospitalWausau 11 $22,974 $5,076 $3,468
Advertisement

Atherosclerosis without major complications in other states

Questions

How much does atherosclerosis without major complications cost in Wisconsin?

In 2024 Medicare data, a hospital stay for atherosclerosis without major complications (DRG 303) at 2 hospitals in Wisconsin was billed at $22,480 on average, while the average total payment was $5,216, of which Medicare paid $3,549. 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 Wisconsin, average charges were 4.3 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.