facebook tracking Digestive malignancy with complications cost in Pennsylvania: 10 hospitals compared (DRG 375)

Digestive malignancy with complications in Pennsylvania

What 10 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for digestive malignancy with complications (DRG 375), from 2024 Medicare claims.

DRG 375 Inpatient 2024 Medicare data
Average charge $71,241 Hospital list price billed
Average payment $11,299 Medicare + patient + other payers
Medicare paid $8,340 Average per stay
State rank #7 of 20 1 = lowest average payment

Hospitals in Pennsylvania billed an average of $71,241 for digestive malignancy with complications, about 6.3 times the average total payment of $11,299. That payment is 14% below the U.S. average of $13,131.

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 $11,299Billed $71,241

About 16¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Pennsylvania:

Pennsylvania hospitals: digestive malignancy with complications

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
Thomas Jefferson University HospitalPhiladelphia 23 $62,744 $14,904 $11,301
Lehigh Valley HospitalAllentown 18 $85,580 $10,846 $8,807
Main Line Hospital PaoliPaoli 16 $74,327 $8,315 $7,286
UPMC Presbyterian ShadysidePittsburgh 16 $116,356 $13,912 $8,540
Chester County HospitalWest Chester 16 $56,138 $9,611 $6,451
Abington Memorial HospitalAbington 15 $40,060 $11,188 $6,807
UPMC Pinnacle HospitalsHarrisburg 13 $51,221 $10,313 $8,097
Milton S Hershey Medical CenterHershey 12 $50,749 $13,092 $10,798
UPMC PassavantPittsburgh 11 $103,926 $9,598 $5,887
Riddle Memorial HospitalMedia 11 $73,251 $8,559 $7,521
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Lowest and highest payments in Pennsylvania

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

Main Line Hospital PaoliPaoli, PA$8,315
Riddle Memorial HospitalMedia, PA$8,559
UPMC PassavantPittsburgh, PA$9,598
Chester County HospitalWest Chester, PA$9,611
UPMC Pinnacle HospitalsHarrisburg, PA$10,313

Highest

Thomas Jefferson University HospitalPhiladelphia, PA$14,904
UPMC Presbyterian ShadysidePittsburgh, PA$13,912
Milton S Hershey Medical CenterHershey, PA$13,092
Abington Memorial HospitalAbington, PA$11,188
Lehigh Valley HospitalAllentown, PA$10,846

Digestive malignancy with complications in other states

Questions

How much does digestive malignancy with complications cost in Pennsylvania?

In 2024 Medicare data, a hospital stay for digestive malignancy with complications (DRG 375) at 10 hospitals in Pennsylvania was billed at $71,241 on average, while the average total payment was $11,299, of which Medicare paid $8,340. 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 6.3 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.