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Biopsies of musculoskeletal system and connective tissue with major complications in Texas

What 1 hospital in Texas 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.

DRG 477 Inpatient 2024 Medicare data
Average charge $326,712 Hospital list price billed
Average payment $20,177 Medicare + patient + other payers
Medicare paid $19,531 Average per stay
Volume 11 Medicare hospital stays

Hospitals in Texas billed an average of $326,712 for biopsies of musculoskeletal system and connective tissue with major complications, about 16.2 times the average total payment of $20,177. That payment is 47% below the U.S. average 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 $20,177Billed $326,712

About 6¢ was paid for every $1 hospitals in Texas billed for this stay.

Texas hospitals: biopsies of musculoskeletal system and connective tissue with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Medical Center of PlanoPlano 11 $326,712 $20,177 $19,531
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Biopsies of musculoskeletal system and connective tissue with major complications in other states

Questions

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

In 2024 Medicare data, a hospital stay for biopsies of musculoskeletal system and connective tissue with major complications (DRG 477) at 1 hospital in Texas was billed at $326,712 on average, while the average total payment was $20,177, of which Medicare paid $19,531. 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 Texas, average charges were 16.2 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.