facebook tracking Cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in Massachusetts: 7 hospitals compared (DRG 220)

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

What 7 hospitals in Massachusetts charged and were paid for a Medicare hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 220), from 2024 Medicare claims.

DRG 220 Inpatient 2024 Medicare data
Average charge $168,995 Hospital list price billed
Average payment $62,437 Medicare + patient + other payers
Medicare paid $50,467 Average per stay
State rank #29 of 33 1 = lowest average payment

Hospitals in Massachusetts billed an average of $168,995 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 2.7 times the average total payment of $62,437. That payment is 12% above the U.S. average of $55,508.

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 $62,437Billed $168,995

About 37¢ was paid for every $1 hospitals in Massachusetts billed for this stay.

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

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Massachusetts General HospitalBoston 47 $242,992 $66,724 $53,228
Baystate Medical CenterSpringfield 45 $129,774 $57,827 $47,454
Umass Memorial Medical Center INCWorcester 27 $207,225 $64,020 $54,303
Beth Israel Deaconess Medical CenterBoston 26 $91,573 $65,507 $47,385
Tufts Medical CenterBoston 18 $154,847 $69,309 $51,171
Boston Medical Center-BrightonBrighton 12 $113,030 $59,612 $55,537
Southcoast Hospital Group, INCFall River 11 $186,635 $43,670 $42,187
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Lowest and highest payments in Massachusetts

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

Highest

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 Massachusetts?

In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 220) at 7 hospitals in Massachusetts was billed at $168,995 on average, while the average total payment was $62,437, of which Medicare paid $50,467. 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 Massachusetts, average charges were 2.7 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.