Cardiac congenital and valvular disorders with major complications in California
What 2 hospitals in California charged and were paid for a Medicare hospital stay for cardiac congenital and valvular disorders with major complications (DRG 306), from 2024 Medicare claims.
Average charge
$221,111
Hospital list price billed
Average payment
$24,857
Medicare + patient + other payers
Medicare paid
$18,475
Average per stay
Volume
34
Medicare hospital stays
Hospitals in California billed an average of $221,111 for cardiac congenital and valvular disorders with major complications, about 8.9 times the average total payment of $24,857. That payment is 30% above the U.S. average of $19,049.
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 $24,857Billed $221,111
About 11¢ was paid for every $1 hospitals in California billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in California:
California hospitals: cardiac congenital and valvular disorders with major complications
Every California hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Cedars-Sinai Medical CenterLos Angeles | 22 | $218,580 | $20,039 | $16,024 |
| Stanford HospitalPalo Alto | 12 | $225,753 | $33,689 | $22,968 |
Cardiac congenital and valvular disorders with major complications in other states
Questions
How much does cardiac congenital and valvular disorders with major complications cost in California?
In 2024 Medicare data, a hospital stay for cardiac congenital and valvular disorders with major complications (DRG 306) at 2 hospitals in California was billed at $221,111 on average, while the average total payment was $24,857, of which Medicare paid $18,475. 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 California, average charges were 8.9 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.