Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with major complications in Pennsylvania
What 4 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with major complications (DRG 562), from 2024 Medicare claims.
Average charge
$46,458
Hospital list price billed
Average payment
$12,772
Medicare + patient + other payers
Medicare paid
$10,163
Average per stay
State rank
#5 of 12
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $46,458 for fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with major complications, about 3.6 times the average total payment of $12,772. That payment is 13% below the U.S. average of $14,612.
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 $12,772Billed $46,458
About 27¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh 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 |
|---|---|---|---|---|
| Lancaster General HospitalLancaster | 16 | $38,525 | $12,661 | $9,273 |
| Reading Hospital and Med CtrWest Reading | 14 | $49,829 | $13,079 | $10,748 |
| Abington Memorial HospitalAbington | 13 | $52,367 | $12,619 | $10,865 |
| Jefferson Health- NortheastPhiladelphia | 12 | $46,700 | $12,731 | $9,907 |
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
| Abington Memorial HospitalAbington, PA | $12,619 |
|---|---|
| Lancaster General HospitalLancaster, PA | $12,661 |
| Jefferson Health- NortheastPhiladelphia, PA | $12,731 |
| Reading Hospital and Med CtrWest Reading, PA | $13,079 |
Highest
| Reading Hospital and Med CtrWest Reading, PA | $13,079 |
|---|---|
| Jefferson Health- NortheastPhiladelphia, PA | $12,731 |
| Lancaster General HospitalLancaster, PA | $12,661 |
| Abington Memorial HospitalAbington, PA | $12,619 |
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with major complications in other states
Questions
How much does fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with major complications cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with major complications (DRG 562) at 4 hospitals in Pennsylvania was billed at $46,458 on average, while the average total payment was $12,772, of which Medicare paid $10,163. 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 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.