facebook tracking Biopsies of musculoskeletal system and connective tissue with complications cost in Georgia: 4 hospitals compared (DRG 478)

Biopsies of musculoskeletal system and connective tissue with complications in Georgia

What 4 hospitals in Georgia 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.

DRG 478 Inpatient 2024 Medicare data
Average charge $139,842 Hospital list price billed
Average payment $21,050 Medicare + patient + other payers
Medicare paid $17,005 Average per stay
State rank #7 of 15 1 = lowest average payment

Hospitals in Georgia billed an average of $139,842 for biopsies of musculoskeletal system and connective tissue with complications, about 6.6 times the average total payment of $21,050. That payment is 9% below the U.S. average 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 $21,050Billed $139,842

About 15¢ was paid for every $1 hospitals in Georgia billed for this stay.

Georgia hospitals: biopsies of musculoskeletal system and connective tissue with complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Northside Hospital ForsythCumming 17 $133,473 $18,400 $17,152
Northeast Georgia Medical Center, INCGainesville 13 $139,038 $19,022 $16,685
Northside Hospital CherokeeCanton 12 $129,561 $17,498 $16,005
Northside HospitalAtlanta 12 $160,015 $30,553 $18,143
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Lowest and highest payments in Georgia

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

Northside Hospital CherokeeCanton, GA$17,498
Northside Hospital ForsythCumming, GA$18,400
Northeast Georgia Medical Center, INCGainesville, GA$19,022
Northside HospitalAtlanta, GA$30,553

Highest

Northside HospitalAtlanta, GA$30,553
Northeast Georgia Medical Center, INCGainesville, GA$19,022
Northside Hospital ForsythCumming, GA$18,400
Northside Hospital CherokeeCanton, GA$17,498

Biopsies of musculoskeletal system and connective tissue with complications in other states

Questions

How much does biopsies of musculoskeletal system and connective tissue with complications cost in Georgia?

In 2024 Medicare data, a hospital stay for biopsies of musculoskeletal system and connective tissue with complications (DRG 478) at 4 hospitals in Georgia was billed at $139,842 on average, while the average total payment was $21,050, of which Medicare paid $17,005. 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 Georgia, average charges were 6.6 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.