facebook tracking Digestive malignancy with major complications cost in Kentucky: 2 hospitals compared (DRG 374)

Digestive malignancy with major complications in Kentucky

What 2 hospitals in Kentucky charged and were paid for a Medicare hospital stay for digestive malignancy with major complications (DRG 374), from 2024 Medicare claims.

DRG 374 Inpatient 2024 Medicare data
Average charge $63,787 Hospital list price billed
Average payment $17,575 Medicare + patient + other payers
Medicare paid $13,582 Average per stay
Volume 46 Medicare hospital stays

Hospitals in Kentucky billed an average of $63,787 for digestive malignancy with major complications, about 3.6 times the average total payment of $17,575. That payment is 24% below the U.S. average of $23,203.

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 $17,575Billed $63,787

About 28¢ was paid for every $1 hospitals in Kentucky billed for this stay.

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

Kentucky hospitals: digestive malignancy 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 25 $53,743 $14,227 $12,541
University of Kentucky HospLexington 21 $75,744 $21,560 $14,821
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Digestive malignancy with major complications in other states

Questions

How much does digestive malignancy with major complications cost in Kentucky?

In 2024 Medicare data, a hospital stay for digestive malignancy with major complications (DRG 374) at 2 hospitals in Kentucky was billed at $63,787 on average, while the average total payment was $17,575, of which Medicare paid $13,582. 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 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.