Combined anterior and posterior spinal fusion without complications in Wisconsin
What 2 hospitals in Wisconsin charged and were paid for a Medicare hospital stay for combined anterior and posterior spinal fusion without complications (DRG 455), from 2024 Medicare claims.
Average charge
$143,202
Hospital list price billed
Average payment
$39,412
Medicare + patient + other payers
Medicare paid
$37,312
Average per stay
Volume
25
Medicare hospital stays
Hospitals in Wisconsin billed an average of $143,202 for combined anterior and posterior spinal fusion without complications, about 3.6 times the average total payment of $39,412. That payment is 3% below the U.S. average of $40,610.
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 $39,412Billed $143,202
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: combined anterior and posterior spinal fusion without complications
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 |
|---|---|---|---|---|
| University of Wi Hospitals & Clinics AuthorityMadison | 14 | $103,897 | $43,285 | $40,753 |
| Waukesha Memorial HospitalWaukesha | 11 | $193,227 | $34,483 | $32,933 |
Combined anterior and posterior spinal fusion without complications in other states
Questions
How much does combined anterior and posterior spinal fusion without complications cost in Wisconsin?
In 2024 Medicare data, a hospital stay for combined anterior and posterior spinal fusion without complications (DRG 455) at 2 hospitals in Wisconsin was billed at $143,202 on average, while the average total payment was $39,412, of which Medicare paid $37,312. 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.