facebook tracking Extensive operating room procedures unrelated to principal diagnosis with major complications cost in New Mexico: 3 hospitals compared (DRG 981)

Extensive operating room procedures unrelated to principal diagnosis with major complications in New Mexico

What 3 hospitals in New Mexico 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.

DRG 981 Inpatient 2024 Medicare data
Average charge $102,167 Hospital list price billed
Average payment $45,999 Medicare + patient + other payers
Medicare paid $42,876 Average per stay
State rank #28 of 42 1 = lowest average payment

Hospitals in New Mexico billed an average of $102,167 for extensive operating room procedures unrelated to principal diagnosis with major complications, about 2.2 times the average total payment of $45,999. That payment is 2% 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 $45,999Billed $102,167

About 45¢ was paid for every $1 hospitals in New Mexico billed for this stay.

New Mexico hospitals: extensive operating room procedures unrelated to principal diagnosis with major complications

Every New Mexico hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
Presbyterian HospitalAlbuquerque 18 $82,787 $30,864 $29,271
UNM HospitalAlbuquerque 12 $126,288 $65,012 $58,125
St Vincent HospitalSanta Fe 11 $107,566 $50,024 $48,503
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Lowest and highest payments in New Mexico

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

Presbyterian HospitalAlbuquerque, NM$30,864
St Vincent HospitalSanta Fe, NM$50,024
UNM HospitalAlbuquerque, NM$65,012

Highest

UNM HospitalAlbuquerque, NM$65,012
St Vincent HospitalSanta Fe, NM$50,024
Presbyterian HospitalAlbuquerque, NM$30,864

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 New Mexico?

In 2024 Medicare data, a hospital stay for extensive operating room procedures unrelated to principal diagnosis with major complications (DRG 981) at 3 hospitals in New Mexico was billed at $102,167 on average, while the average total payment was $45,999, of which Medicare paid $42,876. 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 New Mexico, average charges were 2.2 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.