Cardiac valve and other major cardiothoracic procedures without cardiac catheterization in Montana
What 2 hospitals in Montana 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
$165,839
Hospital list price billed
Average payment
$63,563
Medicare + patient + other payers
Medicare paid
$60,176
Average per stay
Volume
76
Medicare hospital stays
Hospitals in Montana billed an average of $165,839 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 2.6 times the average total payment of $63,563. That payment is 24% 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 $63,563Billed $165,839
About 38¢ was paid for every $1 hospitals in Montana billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Montana:
Montana hospitals: cardiac valve and other major cardiothoracic procedures without cardiac catheterization
Every Montana hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| St Patrick Hospital and Health Sciences CenterMissoula | 47 | $146,369 | $62,178 | $57,839 |
| Billings Clinic HospitalBillings | 29 | $197,393 | $65,809 | $63,965 |
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 Montana?
In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 219) at 2 hospitals in Montana was billed at $165,839 on average, while the average total payment was $63,563, of which Medicare paid $60,176. 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 Montana, average charges were 2.6 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.