Extensive operating room procedures unrelated to principal diagnosis with major complications in Pennsylvania
What 30 hospitals in Pennsylvania 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
$288,181
Hospital list price billed
Average payment
$49,864
Medicare + patient + other payers
Medicare paid
$41,613
Average per stay
State rank
#35 of 42
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $288,181 for extensive operating room procedures unrelated to principal diagnosis with major complications, about 5.8 times the average total payment of $49,864. That payment is 6% above 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 $49,864Billed $288,181
About 17¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: extensive operating room procedures unrelated to principal diagnosis with major 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 |
|---|---|---|---|---|
| Lehigh Valley HospitalAllentown | 49 | $340,748 | $45,420 | $37,809 |
| UPMC Presbyterian ShadysidePittsburgh | 42 | $508,555 | $51,581 | $42,677 |
| Lancaster General HospitalLancaster | 38 | $152,814 | $35,564 | $33,670 |
| Thomas Jefferson University HospitalPhiladelphia | 35 | $347,464 | $74,524 | $58,080 |
| Abington Memorial HospitalAbington | 35 | $157,784 | $39,099 | $34,938 |
| Hospital of the Univ of PaPhiladelphia | 33 | $737,253 | $96,365 | $77,451 |
| Geisinger Medical CenterDanville | 26 | $297,845 | $51,595 | $35,155 |
| St Luke's Hospital BethlehemBethlehem | 26 | $280,479 | $38,651 | $36,375 |
| Reading Hospital and Med CtrWest Reading | 24 | $191,064 | $41,228 | $39,174 |
| Hamot Medical CenterErie | 22 | $311,510 | $40,487 | $34,387 |
| Temple University HospitalPhiladelphia | 21 | $496,511 | $59,782 | $53,012 |
| Milton S Hershey Medical CenterHershey | 21 | $281,550 | $77,247 | $47,096 |
| York HospitalYork | 20 | $169,611 | $45,962 | $34,613 |
| UPMC Pinnacle HospitalsHarrisburg | 20 | $158,539 | $37,815 | $35,479 |
| Saint Vincent Health CenterErie | 18 | $220,535 | $44,776 | $38,391 |
| Albert Einstein Medical CenterPhiladelphia | 18 | $324,786 | $83,478 | $67,849 |
| St Mary Medical CenterLanghorne | 18 | $132,373 | $36,949 | $35,425 |
| Main Line Hospital PaoliPaoli | 17 | $208,749 | $29,481 | $28,788 |
| Jefferson Health- NortheastPhiladelphia | 16 | $149,865 | $34,262 | $28,826 |
| Doylestown HospitalDoylestown | 16 | $125,929 | $28,372 | $27,734 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia | 16 | $300,151 | $51,157 | $47,450 |
| Jefferson Einstein Montgomery HospitalEast Norriton | 15 | $158,380 | $40,522 | $35,526 |
| Allegheny General HospitalPittsburgh | 14 | $368,484 | $67,923 | $56,094 |
| Main Line Hospital LankenauWynnewood | 14 | $300,564 | $41,990 | $38,520 |
| Robert Packer HospitalSayre | 13 | $128,125 | $44,286 | $34,919 |
| Chester County HospitalWest Chester | 13 | $126,849 | $36,971 | $27,301 |
| Penn Presbyterian Medical CenterPhiladelphia | 13 | $447,019 | $55,827 | $52,644 |
| Western Pennsylvania Hosp Forbes Regional CampusMonroeville | 12 | $177,676 | $40,378 | $37,351 |
| Dubois Regional Medical CenterDubois | 11 | $101,511 | $31,559 | $28,979 |
| St Luke's Hospital - Anderson CampusEaston | 11 | $192,763 | $47,823 | $27,803 |
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
| Doylestown HospitalDoylestown, PA | $28,372 |
|---|---|
| Main Line Hospital PaoliPaoli, PA | $29,481 |
| Dubois Regional Medical CenterDubois, PA | $31,559 |
| Jefferson Health- NortheastPhiladelphia, PA | $34,262 |
| Lancaster General HospitalLancaster, PA | $35,564 |
Highest
| Hospital of the Univ of PaPhiladelphia, PA | $96,365 |
|---|---|
| Albert Einstein Medical CenterPhiladelphia, PA | $83,478 |
| Milton S Hershey Medical CenterHershey, PA | $77,247 |
| Thomas Jefferson University HospitalPhiladelphia, PA | $74,524 |
| Allegheny General HospitalPittsburgh, PA | $67,923 |
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 Pennsylvania?
In 2024 Medicare data, a hospital stay for extensive operating room procedures unrelated to principal diagnosis with major complications (DRG 981) at 30 hospitals in Pennsylvania was billed at $288,181 on average, while the average total payment was $49,864, of which Medicare paid $41,613. 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 5.8 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.