Biopsies of musculoskeletal system and connective tissue with complications
What 93 hospitals in the U.S. charged and were paid for a Medicare hospital stay for biopsies of musculoskeletal system and connective tissue with complications (DRG 478), from 2024 Medicare claims.
Average charge
$137,262
Hospital list price billed
Average payment
$23,170
Medicare + patient + other payers
Medicare paid
$18,928
Average per stay
Volume
1,480
Medicare hospital stays
Hospitals in the U.S. billed an average of $137,262 for biopsies of musculoskeletal system and connective tissue with complications, about 5.9 times the average total payment of $23,170.
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 $23,170Billed $137,262
About 17¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Baptist Hospital EastLouisville, KY | $15,842 |
|---|---|
| Gulf Coast Medical Center Lee HealthFort Myers, FL | $16,442 |
| Morton Plant HospitalClearwater, FL | $16,896 |
| Central Dupage HospitalWinfield, IL | $18,174 |
| Riverside Regional Medical CenterNewport News, VA | $19,748 |
| Baptist Hospital of Miami INCMiami, FL | $20,413 |
| Riverside Methodist HospitalColumbus, OH | $20,992 |
| Medical Center of PlanoPlano, TX | $21,006 |
| Carilion Medical CenterRoanoke, VA | $21,150 |
| Adventhealth OrlandoOrlando, FL | $22,671 |
Highest
| New York-Presbyterian HospitalNew York, NY | $32,724 |
|---|---|
| NYU Hospitals CenterNew York, NY | $32,324 |
| Cedars-Sinai Medical CenterLos Angeles, CA | $31,277 |
| Barnes Jewish HospitalSt Louis, MO | $28,140 |
| Cooper University HospitalCamden, NJ | $26,285 |
| Eisenhower Memorial HospitalRancho Mirage, CA | $25,319 |
| Christiana Care Health Services, INC.Newark, DE | $22,896 |
| Adventhealth OrlandoOrlando, FL | $22,671 |
| Carilion Medical CenterRoanoke, VA | $21,150 |
| Medical Center of PlanoPlano, TX | $21,006 |
Biopsies of musculoskeletal system and connective tissue with complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 1 | $129,639 | $23,886 | – |
| Arizona | 1 | $102,456 | $18,373 | – |
| California | 12 | $221,605 | $28,021 | $21,420 – $42,282 |
| Colorado | 2 | $168,768 | $24,800 | $22,150 – $26,742 |
| Connecticut | 1 | $114,714 | $36,624 | – |
| Delaware | 1 | $89,735 | $22,896 | – |
| Florida | 14 | $132,148 | $19,616 | $15,517 – $23,938 |
| Georgia | 4 | $139,842 | $21,050 | $17,498 – $30,553 |
| Illinois | 4 | $128,057 | $21,223 | $18,174 – $29,538 |
| Kansas | 1 | $143,684 | $22,810 | – |
| Kentucky | 3 | $126,442 | $17,214 | $15,842 – $19,131 |
| Louisiana | 3 | $82,662 | $17,838 | $14,842 – $22,329 |
| Massachusetts | 4 | $75,275 | $26,992 | $18,301 – $32,162 |
| Michigan | 3 | $89,544 | $22,762 | $20,326 – $25,393 |
| Minnesota | 1 | $70,294 | $27,134 | – |
| Mississippi | 1 | $84,777 | $23,918 | – |
| Missouri | 3 | $86,179 | $23,233 | $16,585 – $28,140 |
| Nebraska | 1 | $58,520 | $23,357 | – |
| New Jersey | 5 | $144,797 | $26,398 | $20,229 – $35,536 |
| New York | 5 | $178,202 | $29,906 | $20,451 – $32,978 |
| North Carolina | 1 | $46,747 | $22,047 | – |
| Ohio | 3 | $78,586 | $18,884 | $15,072 – $20,992 |
| Pennsylvania | 3 | $106,550 | $20,672 | $20,023 – $21,327 |
| South Carolina | 1 | $88,125 | $26,395 | – |
| Tennessee | 2 | $104,508 | $22,784 | $18,718 – $26,850 |
| Texas | 8 | $181,955 | $20,442 | $16,767 – $25,412 |
| Virginia | 3 | $81,634 | $22,714 | $19,748 – $31,526 |
| Washington | 1 | $109,795 | $20,024 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 62 | $157,684 | $22,671 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 37 | $399,516 | $31,277 |
| Morton Plant HospitalClearwater, FL | 32 | $83,571 | $16,896 |
| Baptist Hospital of Miami INCMiami, FL | 29 | $141,885 | $20,413 |
| NYU Hospitals CenterNew York, NY | 28 | $224,293 | $32,324 |
| Central Dupage HospitalWinfield, IL | 27 | $156,448 | $18,174 |
| Barnes Jewish HospitalSt Louis, MO | 27 | $91,117 | $28,140 |
| Eisenhower Memorial HospitalRancho Mirage, CA | 25 | $119,290 | $25,319 |
| New York-Presbyterian HospitalNew York, NY | 25 | $216,902 | $32,724 |
| Riverside Methodist HospitalColumbus, OH | 24 | $81,625 | $20,992 |
| Carilion Medical CenterRoanoke, VA | 24 | $84,597 | $21,150 |
| Riverside Regional Medical CenterNewport News, VA | 23 | $69,233 | $19,748 |
| Baptist Hospital EastLouisville, KY | 22 | $153,376 | $15,842 |
| Cooper University HospitalCamden, NJ | 22 | $112,189 | $26,285 |
| Christiana Care Health Services, INC.Newark, DE | 21 | $89,735 | $22,896 |
Questions
How much does biopsies of musculoskeletal system and connective tissue with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for biopsies of musculoskeletal system and connective tissue with complications (DRG 478) at 93 hospitals in the U.S. was billed at $137,262 on average, while the average total payment was $23,170, of which Medicare paid $18,928. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for biopsies of musculoskeletal system and connective tissue with complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($29,906), California ($28,021), Massachusetts ($26,992) and lowest in Kentucky ($17,214), Louisiana ($17,838), Ohio ($18,884).
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 the U.S., average charges were 5.9 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.