facebook tracking Cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in Wisconsin: 7 hospitals compared (DRG 219)

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

What 7 hospitals in Wisconsin 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 $267,987 Hospital list price billed
Average payment $75,431 Medicare + patient + other payers
Medicare paid $59,368 Average per stay
State rank #19 of 37 1 = lowest average payment

Hospitals in Wisconsin billed an average of $267,987 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 3.6 times the average total payment of $75,431. That payment is 10% 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 $75,431Billed $267,987

About 28¢ was paid for every $1 hospitals in Wisconsin billed for this stay.

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

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

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 62 $275,004 $81,428 $49,130
Froedtert Mem Lutheran HsptlMilwaukee 55 $285,058 $76,590 $59,791
University of Wi Hospitals & Clinics AuthorityMadison 42 $333,800 $88,014 $73,695
St Mary's HospitalMadison 35 $257,392 $61,720 $59,748
Marshfield Medical CenterMarshfield 15 $172,057 $71,248 $68,782
Aspirus Wausau HospitalWausau 14 $177,530 $58,311 $49,927
Luther Hospital Mayo Health SystemEau Claire 12 $179,492 $60,285 $58,329
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Lowest and highest payments in Wisconsin

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

Aspirus Wausau HospitalWausau, WI$58,311
Luther Hospital Mayo Health SystemEau Claire, WI$60,285
St Mary's HospitalMadison, WI$61,720
Marshfield Medical CenterMarshfield, WI$71,248
Froedtert Mem Lutheran HsptlMilwaukee, WI$76,590

Highest

University of Wi Hospitals & Clinics AuthorityMadison, WI$88,014
Aurora St Lukes Medical CenterMilwaukee, WI$81,428
Froedtert Mem Lutheran HsptlMilwaukee, WI$76,590
Marshfield Medical CenterMarshfield, WI$71,248
St Mary's HospitalMadison, WI$61,720

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 Wisconsin?

In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 219) at 7 hospitals in Wisconsin was billed at $267,987 on average, while the average total payment was $75,431, of which Medicare paid $59,368. 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 3.6 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.