Biopsies of musculoskeletal system and connective tissue with major complications
What 21 hospitals in the U.S. charged and were paid for a Medicare hospital stay for biopsies of musculoskeletal system and connective tissue with major complications (DRG 477), from 2024 Medicare claims.
Average charge
$218,260
Hospital list price billed
Average payment
$38,036
Medicare + patient + other payers
Medicare paid
$29,231
Average per stay
Volume
319
Medicare hospital stays
Hospitals in the U.S. billed an average of $218,260 for biopsies of musculoskeletal system and connective tissue with major complications, about 5.7 times the average total payment of $38,036.
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 $38,036Billed $218,260
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
| Adventhealth OrlandoOrlando, FL | $25,917 |
|---|---|
| Barnes Jewish HospitalSt Louis, MO | $39,072 |
| New York-Presbyterian HospitalNew York, NY | $44,292 |
| NYU Hospitals CenterNew York, NY | $46,387 |
Highest
| NYU Hospitals CenterNew York, NY | $46,387 |
|---|---|
| New York-Presbyterian HospitalNew York, NY | $44,292 |
| Barnes Jewish HospitalSt Louis, MO | $39,072 |
| Adventhealth OrlandoOrlando, FL | $25,917 |
Biopsies of musculoskeletal system and connective tissue with major 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 |
|---|---|---|---|---|
| Arizona | 1 | $95,856 | $39,480 | – |
| California | 2 | $393,573 | $53,456 | $37,781 – $68,011 |
| Connecticut | 1 | $158,913 | $42,840 | – |
| Florida | 3 | $213,466 | $25,809 | $22,908 – $27,941 |
| Illinois | 1 | $245,172 | $43,520 | – |
| Kansas | 1 | $256,374 | $36,918 | – |
| Massachusetts | 1 | $213,289 | $43,400 | – |
| Minnesota | 1 | $169,104 | $89,282 | – |
| Missouri | 1 | $137,511 | $39,072 | – |
| New Jersey | 1 | $244,777 | $44,943 | – |
| New York | 2 | $295,763 | $45,339 | $44,292 – $46,387 |
| North Carolina | 1 | $132,784 | $22,972 | – |
| Oklahoma | 1 | $98,460 | $24,847 | – |
| Pennsylvania | 1 | $207,685 | $29,589 | – |
| Texas | 1 | $326,712 | $20,177 | – |
| Virginia | 2 | $77,648 | $26,274 | $20,984 – $31,564 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 39 | $243,013 | $25,917 |
| New York-Presbyterian HospitalNew York, NY | 22 | $261,163 | $44,292 |
| NYU Hospitals CenterNew York, NY | 22 | $330,362 | $46,387 |
| Barnes Jewish HospitalSt Louis, MO | 21 | $137,511 | $39,072 |
| University of Kansas HospitalKansas City, KS | 17 | $256,374 | $36,918 |
| Lehigh Valley HospitalAllentown, PA | 17 | $207,685 | $29,589 |
| Massachusetts General HospitalBoston, MA | 15 | $213,289 | $43,400 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 14 | $629,449 | $68,011 |
| Mayo Clinic HospitalPhoenix, AZ | 13 | $95,856 | $39,480 |
| Sutter Roseville Medical CenterRoseville, CA | 13 | $139,554 | $37,781 |
| Baptist Hospital of Miami INCMiami, FL | 13 | $196,388 | $27,941 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 13 | $169,104 | $89,282 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | 12 | $132,784 | $22,972 |
| Yale-New Haven HospitalNew Haven, CT | 11 | $158,913 | $42,840 |
| Holmes Regional Medical CenterMelbourne, FL | 11 | $128,893 | $22,908 |
Questions
How much does biopsies of musculoskeletal system and connective tissue with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for biopsies of musculoskeletal system and connective tissue with major complications (DRG 477) at 21 hospitals in the U.S. was billed at $218,260 on average, while the average total payment was $38,036, of which Medicare paid $29,231. 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 major complications?
Among states with at least three hospitals reporting, the average total payment was highest in Florida ($25,809) and lowest in Florida ($25,809).
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 5.7 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.