Extensive operating room procedures unrelated to principal diagnosis with major complications
What 680 hospitals in the U.S. charged and were paid for a Medicare hospital stay for extensive operating room procedures unrelated to principal diagnosis with major complications (DRG 981), from 2024 Medicare claims.
Average charge
$226,646
Hospital list price billed
Average payment
$47,051
Medicare + patient + other payers
Medicare paid
$40,277
Average per stay
Volume
14,959
Medicare hospital stays
Hospitals in the U.S. billed an average of $226,646 for extensive operating room procedures unrelated to principal diagnosis with major complications, about 4.8 times the average total payment of $47,051.
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 $47,051Billed $226,646
About 21¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Mercy Health Center, INCOklahoma City, OK | $25,126 |
|---|---|
| Roper HospitalCharleston, SC | $25,927 |
| Baylor Scott and White Medical Center McKinneyMc Kinney, TX | $26,249 |
| Forrest General HospitalHattiesburg, MS | $26,406 |
| Piedmont Augusta HospitalAugusta, GA | $26,959 |
| Mississippi Baptist Medical CenterJackson, MS | $27,670 |
| Delray Medical CenterDelray Beach, FL | $28,841 |
| Palm Beach Gardens Medical CenterPalm Beach Gardens, FL | $29,150 |
| St Joseph's HospitalTampa, FL | $29,303 |
| Texas Health Harris Methodist Fort WorthFort Worth, TX | $29,461 |
Highest
| UCLA Medical CenterLos Angeles, CA | $158,720 |
|---|---|
| University of Maryland Medical CenterBaltimore, MD | $143,780 |
| The Johns Hopkins HospitalBaltimore, MD | $133,037 |
| Stanford HospitalPalo Alto, CA | $102,982 |
| UCSF Medical CenterSan Francisco, CA | $101,660 |
| University of California Davis Medical CenterSacramento, CA | $101,477 |
| John Muir Medical Center - Walnut Creek CampusWalnut Creek, CA | $97,864 |
| Hospital of the Univ of PaPhiladelphia, PA | $96,365 |
| Westchester Medical CenterValhalla, NY | $91,753 |
| Brookdale Hospital Medical CenterBrooklyn, NY | $88,256 |
Extensive operating room procedures unrelated to principal diagnosis with major complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 11 | $190,642 | $38,247 | $26,735 – $71,629 |
| Alaska | 2 | $282,642 | $57,637 | $56,125 – $61,212 |
| Arizona | 16 | $234,727 | $47,277 | $30,219 – $67,791 |
| Arkansas | 11 | $141,888 | $32,494 | $26,274 – $39,147 |
| California | 65 | $390,779 | $62,446 | $37,111 – $158,720 |
| Colorado | 6 | $275,434 | $40,903 | $28,286 – $66,871 |
| Connecticut | 6 | $181,870 | $54,430 | $40,760 – $63,659 |
| Delaware | 3 | $169,913 | $48,939 | $36,026 – $53,936 |
| Florida | 47 | $258,138 | $38,790 | $28,750 – $69,804 |
| Georgia | 16 | $225,926 | $44,053 | $26,581 – $61,472 |
| Hawaii | 1 | $226,723 | $47,191 | – |
| Idaho | 4 | $163,099 | $37,486 | $30,708 – $43,566 |
| Illinois | 33 | $193,912 | $47,326 | $31,098 – $95,169 |
| Indiana | 17 | $175,537 | $36,641 | $31,019 – $48,302 |
| Iowa | 7 | $165,460 | $39,562 | $27,471 – $48,284 |
| Kansas | 4 | $246,108 | $43,021 | $30,404 – $50,499 |
| Kentucky | 13 | $176,398 | $36,347 | $28,430 – $46,145 |
| Louisiana | 7 | $217,714 | $39,834 | $34,220 – $58,113 |
| Maine | 2 | $161,886 | $42,712 | $37,882 – $44,237 |
| Maryland | 19 | $76,891 | $69,594 | $30,130 – $143,780 |
| Massachusetts | 19 | $160,918 | $57,989 | $31,904 – $80,778 |
| Michigan | 25 | $141,628 | $42,161 | $30,832 – $55,842 |
| Minnesota | 12 | $165,095 | $49,742 | $33,919 – $76,197 |
| Mississippi | 10 | $154,005 | $30,485 | $26,406 – $43,799 |
| Missouri | 15 | $184,942 | $42,510 | $26,429 – $72,134 |
| Montana | 2 | $90,329 | $35,895 | $33,852 – $37,159 |
| Nebraska | 5 | $177,728 | $45,351 | $29,478 – $64,946 |
| Nevada | 8 | $300,741 | $41,352 | $36,238 – $51,893 |
| New Hampshire | 2 | $170,558 | $57,765 | $39,808 – $65,195 |
| New Jersey | 29 | $300,155 | $47,085 | $37,329 – $64,509 |
| New Mexico | 3 | $102,167 | $45,999 | $30,864 – $65,012 |
| New York | 39 | $300,059 | $60,614 | $33,346 – $91,753 |
| North Carolina | 20 | $162,592 | $44,430 | $31,057 – $64,304 |
| North Dakota | 3 | $108,427 | $36,257 | $29,812 – $40,332 |
| Ohio | 19 | $176,854 | $42,631 | $25,571 – $73,883 |
| Oklahoma | 8 | $183,779 | $34,773 | $25,126 – $52,709 |
| Oregon | 6 | $118,203 | $51,381 | $36,445 – $65,005 |
| Pennsylvania | 30 | $288,181 | $49,864 | $28,372 – $96,365 |
| Rhode Island | 1 | $192,298 | $62,024 | – |
| South Carolina | 10 | $184,259 | $36,276 | $25,927 – $67,138 |
| South Dakota | 3 | $169,769 | $42,026 | $39,901 – $45,874 |
| Tennessee | 17 | $152,013 | $35,718 | $24,377 – $50,264 |
| Texas | 47 | $237,101 | $40,126 | $26,249 – $75,289 |
| Utah | 5 | $142,382 | $40,918 | $27,035 – $56,559 |
| Vermont | 1 | $158,959 | $37,544 | – |
| Virginia | 21 | $171,951 | $42,032 | $31,477 – $65,768 |
| Washington | 15 | $212,410 | $49,578 | $36,752 – $90,481 |
| West Virginia | 6 | $181,277 | $38,228 | $22,760 – $42,964 |
| Wisconsin | 5 | $234,638 | $53,997 | $37,090 – $65,599 |
| Wyoming | 1 | $141,646 | $45,050 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| New York-Presbyterian HospitalNew York, NY | 138 | $434,541 | $79,113 |
| NYU Hospitals CenterNew York, NY | 111 | $461,664 | $72,112 |
| Adventhealth OrlandoOrlando, FL | 110 | $315,263 | $43,363 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 86 | $741,573 | $71,603 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 80 | $174,617 | $70,649 |
| Massachusetts General HospitalBoston, MA | 79 | $255,017 | $67,027 |
| St Charles Medical Center - BendBend, OR | 75 | $83,141 | $48,526 |
| Baptist Medical CenterJacksonville, FL | 67 | $229,765 | $36,522 |
| Stanford HospitalPalo Alto, CA | 65 | $790,784 | $102,982 |
| Norton Healthcare PavilionLouisville, KY | 62 | $207,030 | $33,364 |
| Sarasota Memorial HospitalSarasota, FL | 58 | $235,827 | $33,479 |
| North Shore University HospitalManhasset, NY | 57 | $356,689 | $57,260 |
| Yale-New Haven HospitalNew Haven, CT | 56 | $207,306 | $63,659 |
| Mercy Health Center, INCOklahoma City, OK | 56 | $72,148 | $25,126 |
| Baylor University Medical CenterDallas, TX | 56 | $150,025 | $46,075 |
Questions
How much does extensive operating room procedures unrelated to principal diagnosis with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for extensive operating room procedures unrelated to principal diagnosis with major complications (DRG 981) at 680 hospitals in the U.S. was billed at $226,646 on average, while the average total payment was $47,051, of which Medicare paid $40,277. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for extensive operating room procedures unrelated to principal diagnosis with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in Maryland ($69,594), California ($62,446), New York ($60,614) and lowest in Mississippi ($30,485), Arkansas ($32,494), Oklahoma ($34,773).
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 the U.S., average charges were 4.8 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.