facebook tracking Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit cost in Illinois: 4 hospitals compared (DRG 216)

Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit in Illinois

What 4 hospitals in Illinois charged and were paid for a Medicare hospital stay for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit (DRG 216), from 2024 Medicare claims.

DRG 216 Inpatient 2024 Medicare data
Average charge $438,597 Hospital list price billed
Average payment $110,602 Medicare + patient + other payers
Medicare paid $88,366 Average per stay
State rank #12 of 20 1 = lowest average payment

Hospitals in Illinois billed an average of $438,597 for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit, about 4.0 times the average total payment of $110,602. That payment is 3% above the U.S. average of $107,634.

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 $110,602Billed $438,597

About 25¢ was paid for every $1 hospitals in Illinois billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Illinois:

Illinois hospitals: cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit

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

Hospital Stays Avg charge Avg payment Medicare paid
Advocate Christ Hospital & Medical CenterOak Lawn 15 $325,457 $114,246 $76,136
Northwestern Memorial HospitalChicago 15 $564,610 $115,159 $89,980
Evanston HospitalEvanston 13 $439,741 $94,271 $91,301
Loyola University Medical CenterMaywood 11 $419,692 $118,719 $99,376
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Lowest and highest payments in Illinois

Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

Highest

Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit in other states

Questions

How much does cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit cost in Illinois?

In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit (DRG 216) at 4 hospitals in Illinois was billed at $438,597 on average, while the average total payment was $110,602, of which Medicare paid $88,366. 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 Illinois, average charges were 4.0 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.