Extensive operating room procedures unrelated to principal diagnosis with major complications in Maine
What 2 hospitals in Maine 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
$161,886
Hospital list price billed
Average payment
$42,712
Medicare + patient + other payers
Medicare paid
$37,910
Average per stay
Volume
50
Medicare hospital stays
Hospitals in Maine billed an average of $161,886 for extensive operating room procedures unrelated to principal diagnosis with major complications, about 3.8 times the average total payment of $42,712. That payment is 9% below the U.S. average 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 $42,712Billed $161,886
About 26¢ was paid for every $1 hospitals in Maine billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Maine:
Maine hospitals: extensive operating room procedures unrelated to principal diagnosis with major complications
Every Maine hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Maine Medical CenterPortland | 38 | $175,207 | $44,237 | $40,660 |
| Central Maine Medical CenterLewiston | 12 | $119,700 | $37,882 | $29,204 |
Extensive operating room procedures unrelated to principal diagnosis with major complications in other states
Questions
How much does extensive operating room procedures unrelated to principal diagnosis with major complications cost in Maine?
In 2024 Medicare data, a hospital stay for extensive operating room procedures unrelated to principal diagnosis with major complications (DRG 981) at 2 hospitals in Maine was billed at $161,886 on average, while the average total payment was $42,712, of which Medicare paid $37,910. 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 Maine, average charges were 3.8 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.