Cardiac valve and other major cardiothoracic procedures without cardiac catheterization in Pennsylvania
What 2 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 221), from 2024 Medicare claims.
Average charge
$277,709
Hospital list price billed
Average payment
$47,938
Medicare + patient + other payers
Medicare paid
$40,099
Average per stay
Volume
49
Medicare hospital stays
Hospitals in Pennsylvania billed an average of $277,709 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 5.8 times the average total payment of $47,938. That payment is 12% above the U.S. average of $42,892.
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 $47,938Billed $277,709
About 17¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: cardiac valve and other major cardiothoracic procedures without cardiac catheterization
Every Pennsylvania hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Hospital of the Univ of PaPhiladelphia | 30 | $358,563 | $54,905 | $43,544 |
| UPMC Pinnacle HospitalsHarrisburg | 19 | $150,046 | $36,936 | $34,660 |
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 Pennsylvania?
In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 221) at 2 hospitals in Pennsylvania was billed at $277,709 on average, while the average total payment was $47,938, of which Medicare paid $40,099. 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 Pennsylvania, average charges were 5.8 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.