facebook tracking Cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in Kentucky: 6 hospitals compared (DRG 219)

Cardiac valve and other major cardiothoracic procedures without cardiac catheterization in Kentucky

What 6 hospitals in Kentucky 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.

DRG 219 Inpatient 2024 Medicare data
Average charge $318,759 Hospital list price billed
Average payment $70,818 Medicare + patient + other payers
Medicare paid $56,359 Average per stay
State rank #12 of 37 1 = lowest average payment

Hospitals in Kentucky billed an average of $318,759 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 4.5 times the average total payment of $70,818. That payment is 15% below the U.S. average 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 $70,818Billed $318,759

About 22¢ was paid for every $1 hospitals in Kentucky billed for this stay.

Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Kentucky:

Kentucky hospitals: cardiac valve and other major cardiothoracic procedures without cardiac catheterization

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

Hospital Stays Avg charge Avg payment Medicare paid
Jewish HospitalLouisville 30 $312,855 $69,062 $58,696
Norton Healthcare PavilionLouisville 27 $390,600 $69,262 $67,821
University of Kentucky HospLexington 25 $378,981 $91,439 $63,813
St Elizabeth Med Center-SouthEdgewood 19 $214,936 $63,907 $52,568
Baptist Hospital EastLouisville 18 $307,582 $50,610 $39,717
Saint Joseph HospitalLexington 11 $219,270 $77,565 $38,688
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Lowest and highest payments in Kentucky

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

Baptist Hospital EastLouisville, KY$50,610
St Elizabeth Med Center-SouthEdgewood, KY$63,907
Jewish HospitalLouisville, KY$69,062
Norton Healthcare PavilionLouisville, KY$69,262
Saint Joseph HospitalLexington, KY$77,565

Highest

University of Kentucky HospLexington, KY$91,439
Saint Joseph HospitalLexington, KY$77,565
Norton Healthcare PavilionLouisville, KY$69,262
Jewish HospitalLouisville, KY$69,062
St Elizabeth Med Center-SouthEdgewood, KY$63,907

Cardiac valve and other major cardiothoracic procedures without cardiac catheterization in other states

Questions

How much does cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in Kentucky?

In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 219) at 6 hospitals in Kentucky was billed at $318,759 on average, while the average total payment was $70,818, of which Medicare paid $56,359. 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 Kentucky, average charges were 4.5 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.