Back and neck procedures except spinal fusion with complications in Pennsylvania
What 10 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for back and neck procedures except spinal fusion with complications (DRG 519), from 2024 Medicare claims.
Average charge
$119,246
Hospital list price billed
Average payment
$19,592
Medicare + patient + other payers
Medicare paid
$15,905
Average per stay
State rank
#14 of 26
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $119,246 for back and neck procedures except spinal fusion with complications, about 6.1 times the average total payment of $19,592. That payment is 5% below the U.S. average of $20,542.
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 $19,592Billed $119,246
About 16¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: back and neck procedures except spinal fusion with complications
Every Pennsylvania hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Penn Presbyterian Medical CenterPhiladelphia | 27 | $176,357 | $22,286 | $17,274 |
| Hospital of the Univ of PaPhiladelphia | 24 | $138,847 | $23,593 | $19,327 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia | 20 | $122,025 | $18,959 | $16,676 |
| Hamot Medical CenterErie | 18 | $95,370 | $17,568 | $14,653 |
| Thomas Jefferson University HospitalPhiladelphia | 17 | $108,052 | $22,611 | $16,689 |
| Lancaster General HospitalLancaster | 16 | $55,836 | $14,962 | $13,495 |
| Lehigh Valley HospitalAllentown | 15 | $84,151 | $17,885 | $13,208 |
| Geisinger Medical CenterDanville | 12 | $190,928 | $19,733 | $17,008 |
| Reading Hospital and Med CtrWest Reading | 12 | $84,403 | $18,655 | $14,080 |
| Main Line Hospital PaoliPaoli | 11 | $87,522 | $13,979 | $12,487 |
Lowest and highest payments in Pennsylvania
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Main Line Hospital PaoliPaoli, PA | $13,979 |
|---|---|
| Lancaster General HospitalLancaster, PA | $14,962 |
| Hamot Medical CenterErie, PA | $17,568 |
| Lehigh Valley HospitalAllentown, PA | $17,885 |
| Reading Hospital and Med CtrWest Reading, PA | $18,655 |
Highest
| Hospital of the Univ of PaPhiladelphia, PA | $23,593 |
|---|---|
| Thomas Jefferson University HospitalPhiladelphia, PA | $22,611 |
| Penn Presbyterian Medical CenterPhiladelphia, PA | $22,286 |
| Geisinger Medical CenterDanville, PA | $19,733 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia, PA | $18,959 |
Back and neck procedures except spinal fusion with complications in other states
Questions
How much does back and neck procedures except spinal fusion with complications cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for back and neck procedures except spinal fusion with complications (DRG 519) at 10 hospitals in Pennsylvania was billed at $119,246 on average, while the average total payment was $19,592, of which Medicare paid $15,905. 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 Pennsylvania, average charges were 6.1 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.