facebook tracking Biopsies of musculoskeletal system and connective tissue with complications cost in Virginia: 3 hospitals compared (DRG 478)

Biopsies of musculoskeletal system and connective tissue with complications in Virginia

What 3 hospitals in Virginia 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 $81,634 Hospital list price billed
Average payment $22,714 Medicare + patient + other payers
Medicare paid $17,522 Average per stay
State rank #9 of 15 1 = lowest average payment

Hospitals in Virginia billed an average of $81,634 for biopsies of musculoskeletal system and connective tissue with complications, about 3.6 times the average total payment of $22,714. That payment is 2% 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 $22,714Billed $81,634

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

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Carilion Medical CenterRoanoke 24 $84,597 $21,150 $15,794
Riverside Regional Medical CenterNewport News 23 $69,233 $19,748 $17,289
University of Virginia Medical CenterCharlottesville 12 $99,477 $31,526 $21,423
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Lowest and highest payments in Virginia

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

Riverside Regional Medical CenterNewport News, VA$19,748
Carilion Medical CenterRoanoke, VA$21,150
University of Virginia Medical CenterCharlottesville, VA$31,526

Highest

University of Virginia Medical CenterCharlottesville, VA$31,526
Carilion Medical CenterRoanoke, VA$21,150
Riverside Regional Medical CenterNewport News, VA$19,748

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 Virginia?

In 2024 Medicare data, a hospital stay for biopsies of musculoskeletal system and connective tissue with complications (DRG 478) at 3 hospitals in Virginia was billed at $81,634 on average, while the average total payment was $22,714, of which Medicare paid $17,522. 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 Virginia, 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.