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

What 2 hospitals in Virginia 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 $77,648 Hospital list price billed
Average payment $26,274 Medicare + patient + other payers
Medicare paid $19,603 Average per stay
Volume 22 Medicare hospital stays

Hospitals in Virginia billed an average of $77,648 for biopsies of musculoskeletal system and connective tissue with major complications, about 3.0 times the average total payment of $26,274. That payment is 31% 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 $26,274Billed $77,648

About 34¢ was paid for every $1 hospitals in Virginia billed for this stay.

Virginia hospitals: biopsies of musculoskeletal system and connective tissue with major 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 11 $93,887 $31,564 $20,003
Riverside Regional Medical CenterNewport News 11 $61,409 $20,984 $19,202
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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 Virginia?

In 2024 Medicare data, a hospital stay for biopsies of musculoskeletal system and connective tissue with major complications (DRG 477) at 2 hospitals in Virginia was billed at $77,648 on average, while the average total payment was $26,274, of which Medicare paid $19,603. 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 3.0 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.