Cardiac valve and other major cardiothoracic procedures without cardiac catheterization
What 350 hospitals in the U.S. charged and were paid for a Medicare hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 219), from 2024 Medicare claims.
Average charge
$393,302
Hospital list price billed
Average payment
$83,705
Medicare + patient + other payers
Medicare paid
$69,387
Average per stay
Volume
12,333
Medicare hospital stays
Hospitals in the U.S. billed an average of $393,302 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 4.7 times the average total payment of $83,705.
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 $83,705Billed $393,302
About 21¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Arkansas Heart HospitalLittle Rock, AR | $48,208 |
|---|---|
| Oklahoma Heart HospitalOklahoma City, OK | $49,528 |
| Nebraska Heart Hospital, LLCLincoln, NE | $51,123 |
| Martin Memorial Health SystemsStuart, FL | $51,156 |
| Morton Plant HospitalClearwater, FL | $52,417 |
| Avera Heart Hospital of South Dakota LLCSioux Falls, SD | $52,430 |
| Sarasota Memorial HospitalSarasota, FL | $52,694 |
| St Vincent Infirmary Medical CenterLittle Rock, AR | $53,710 |
| St Vincent Heart Center of Indiana LLCIndianapolis, IN | $53,762 |
| The Heart Hospital Baylor DentonDenton, TX | $54,005 |
Highest
| University of Maryland Medical CenterBaltimore, MD | $184,101 |
|---|---|
| Stanford HospitalPalo Alto, CA | $165,642 |
| USC University HospitalLos Angeles, CA | $136,689 |
| University of Virginia Medical CenterCharlottesville, VA | $129,400 |
| UCSF Medical CenterSan Francisco, CA | $128,696 |
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco, CA | $126,569 |
| UCLA Medical CenterLos Angeles, CA | $126,137 |
| New York-Presbyterian HospitalNew York, NY | $115,987 |
| Advocate Christ Hospital & Medical CenterOak Lawn, IL | $115,692 |
| Mount Sinai HospitalNew York, NY | $114,361 |
Cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 3 | $398,663 | $82,014 | $58,903 – $95,770 |
| Arizona | 10 | $441,915 | $78,607 | $56,180 – $93,639 |
| Arkansas | 4 | $255,197 | $58,815 | $48,208 – $81,960 |
| California | 30 | $722,532 | $110,926 | $71,961 – $165,642 |
| Colorado | 8 | $462,112 | $68,504 | $54,309 – $79,829 |
| Connecticut | 5 | $222,391 | $89,971 | $68,214 – $102,402 |
| Delaware | 1 | $341,224 | $100,476 | – |
| Florida | 24 | $448,384 | $67,295 | $42,093 – $93,207 |
| Georgia | 9 | $383,795 | $84,279 | $63,682 – $139,505 |
| Hawaii | 2 | $314,573 | $93,452 | $91,274 – $96,251 |
| Idaho | 3 | $282,726 | $71,624 | $65,778 – $77,253 |
| Illinois | 15 | $379,508 | $89,234 | $52,604 – $132,178 |
| Indiana | 5 | $338,074 | $60,785 | $53,762 – $91,180 |
| Iowa | 3 | $281,139 | $64,460 | $58,097 – $71,981 |
| Kansas | 3 | $405,316 | $65,336 | $56,555 – $71,176 |
| Kentucky | 6 | $318,759 | $70,818 | $50,610 – $91,439 |
| Louisiana | 2 | $228,380 | $62,171 | $50,008 – $75,440 |
| Maine | 2 | $256,974 | $75,317 | $57,496 – $83,023 |
| Maryland | 4 | $148,700 | $133,090 | $64,278 – $184,101 |
| Massachusetts | 10 | $279,272 | $92,925 | $67,711 – $107,202 |
| Michigan | 8 | $260,841 | $85,570 | $58,182 – $102,071 |
| Minnesota | 10 | $269,961 | $86,335 | $58,889 – $107,592 |
| Mississippi | 4 | $230,062 | $61,300 | $55,197 – $69,618 |
| Missouri | 9 | $323,097 | $74,855 | $53,808 – $90,395 |
| Montana | 2 | $165,839 | $63,563 | $62,178 – $65,809 |
| Nebraska | 4 | $239,885 | $66,212 | $51,123 – $77,337 |
| Nevada | 5 | $657,234 | $72,105 | $64,577 – $86,392 |
| New Hampshire | 3 | $391,844 | $75,136 | $66,288 – $84,232 |
| New Jersey | 10 | $438,135 | $85,322 | $65,377 – $96,046 |
| New Mexico | 2 | $199,853 | $81,592 | $62,009 – $98,162 |
| New York | 18 | $421,826 | $99,995 | $63,165 – $120,285 |
| North Carolina | 12 | $285,620 | $74,303 | $55,502 – $105,264 |
| North Dakota | 3 | $212,575 | $68,919 | $62,518 – $74,309 |
| Ohio | 12 | $291,743 | $80,295 | $53,175 – $107,422 |
| Oklahoma | 4 | $325,929 | $59,290 | $49,528 – $76,091 |
| Oregon | 5 | $294,139 | $88,045 | $82,371 – $99,150 |
| Pennsylvania | 20 | $486,264 | $79,198 | $48,367 – $112,921 |
| Rhode Island | 1 | $196,990 | $84,305 | – |
| South Carolina | 5 | $368,749 | $78,445 | $55,961 – $87,744 |
| South Dakota | 2 | $257,070 | $54,288 | $52,430 – $56,942 |
| Tennessee | 9 | $390,216 | $68,492 | $52,002 – $88,913 |
| Texas | 25 | $435,899 | $74,398 | $51,262 – $99,671 |
| Utah | 2 | $299,777 | $86,920 | $82,132 – $91,259 |
| Vermont | 1 | $217,039 | $82,034 | – |
| Virginia | 8 | $424,430 | $90,582 | $64,435 – $129,400 |
| Washington | 7 | $396,501 | $88,089 | $65,564 – $110,979 |
| West Virginia | 2 | $338,877 | $87,710 | $84,206 – $88,666 |
| Wisconsin | 7 | $267,987 | $75,431 | $58,311 – $88,014 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Cleveland Clinic - Main CampusCleveland, OH | 405 | $289,834 | $85,389 |
| Massachusetts General HospitalBoston, MA | 263 | $337,937 | $95,850 |
| New York-Presbyterian HospitalNew York, NY | 213 | $492,117 | $115,987 |
| Northwestern Memorial HospitalChicago, IL | 201 | $431,072 | $87,941 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 199 | $239,476 | $99,611 |
| The Heart Hospital Baylor PlanoPlano, TX | 183 | $215,029 | $66,417 |
| Brigham and Women's HosptialBoston, MA | 158 | $327,057 | $93,788 |
| NYU Hospitals CenterNew York, NY | 152 | $518,841 | $110,246 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 139 | $898,892 | $91,466 |
| St Vincent Heart Center of Indiana LLCIndianapolis, IN | 135 | $257,230 | $53,762 |
| Inova Fairfax HospitalFalls Church, VA | 134 | $281,707 | $94,075 |
| Stanford HospitalPalo Alto, CA | 131 | $1,337,746 | $165,642 |
| Medstar Washington Hospital CenterWashington, DC | 131 | $308,597 | $94,091 |
| Mount Sinai HospitalNew York, NY | 121 | $381,852 | $114,361 |
| Univ of Michigan HospitalsAnn Arbor, MI | 117 | $281,127 | $97,884 |
Questions
How much does cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in the U.S.?
In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 219) at 350 hospitals in the U.S. was billed at $393,302 on average, while the average total payment was $83,705, of which Medicare paid $69,387. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for cardiac valve and other major cardiothoracic procedures without cardiac catheterization?
Among states with at least three hospitals reporting, the average total payment was highest in Maryland ($133,090), California ($110,926), New York ($99,995) and lowest in Arkansas ($58,815), Oklahoma ($59,290), Indiana ($60,785).
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 the U.S., average charges were 4.7 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.