Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit in Wisconsin
What 2 hospitals in Wisconsin 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.
Average charge
$403,730
Hospital list price billed
Average payment
$116,476
Medicare + patient + other payers
Medicare paid
$77,808
Average per stay
Volume
41
Medicare hospital stays
Hospitals in Wisconsin billed an average of $403,730 for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit, about 3.5 times the average total payment of $116,476. That payment is 8% 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 $116,476Billed $403,730
About 29¢ was paid for every $1 hospitals in Wisconsin billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Wisconsin:
Wisconsin hospitals: cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit
Every Wisconsin hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Aurora St Lukes Medical CenterMilwaukee | 30 | $386,693 | $115,852 | $67,687 |
| University of Wi Hospitals & Clinics AuthorityMadison | 11 | $450,195 | $118,175 | $105,410 |
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 Wisconsin?
In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit (DRG 216) at 2 hospitals in Wisconsin was billed at $403,730 on average, while the average total payment was $116,476, of which Medicare paid $77,808. 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 Wisconsin, average charges were 3.5 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.