Combined anterior and posterior spinal fusion with major complications in Kentucky
What 2 hospitals in Kentucky charged and were paid for a Medicare hospital stay for combined anterior and posterior spinal fusion with major complications (DRG 453), from 2024 Medicare claims.
Average charge
$295,750
Hospital list price billed
Average payment
$71,107
Medicare + patient + other payers
Medicare paid
$69,349
Average per stay
Volume
26
Medicare hospital stays
Hospitals in Kentucky billed an average of $295,750 for combined anterior and posterior spinal fusion with major complications, about 4.2 times the average total payment of $71,107. That payment is 32% below the U.S. average of $105,253.
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 $71,107Billed $295,750
About 24¢ 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: combined anterior and posterior spinal fusion with major complications
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 |
|---|---|---|---|---|
| Norton Healthcare PavilionLouisville | 14 | $443,649 | $81,201 | $79,262 |
| Saint Joseph HospitalLexington | 12 | $123,202 | $59,331 | $57,784 |
Combined anterior and posterior spinal fusion with major complications in other states
Questions
How much does combined anterior and posterior spinal fusion with major complications cost in Kentucky?
In 2024 Medicare data, a hospital stay for combined anterior and posterior spinal fusion with major complications (DRG 453) at 2 hospitals in Kentucky was billed at $295,750 on average, while the average total payment was $71,107, of which Medicare paid $69,349. 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 4.2 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.