facebook tracking Cardiac congenital and valvular disorders without major complications cost in California: 2 hospitals compared (DRG 307)

Cardiac congenital and valvular disorders without major complications in California

What 2 hospitals in California charged and were paid for a Medicare hospital stay for cardiac congenital and valvular disorders without major complications (DRG 307), from 2024 Medicare claims.

DRG 307 Inpatient 2024 Medicare data
Average charge $134,542 Hospital list price billed
Average payment $12,839 Medicare + patient + other payers
Medicare paid $10,785 Average per stay
Volume 38 Medicare hospital stays

Hospitals in California billed an average of $134,542 for cardiac congenital and valvular disorders without major complications, about 10.5 times the average total payment of $12,839. That payment is 3% above the U.S. average of $12,474.

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 $12,839Billed $134,542

About 10¢ 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 without 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 27 $123,930 $11,870 $9,887
Stanford HospitalPalo Alto 11 $160,592 $15,218 $12,989
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Cardiac congenital and valvular disorders without major complications in other states

Questions

How much does cardiac congenital and valvular disorders without major complications cost in California?

In 2024 Medicare data, a hospital stay for cardiac congenital and valvular disorders without major complications (DRG 307) at 2 hospitals in California was billed at $134,542 on average, while the average total payment was $12,839, of which Medicare paid $10,785. 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 10.5 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.