facebook tracking Fractures of hip and pelvis without major complications cost in Montana: 2 hospitals compared (DRG 536)

Fractures of hip and pelvis without major complications in Montana

What 2 hospitals in Montana charged and were paid for a Medicare hospital stay for fractures of hip and pelvis without major complications (DRG 536), from 2024 Medicare claims.

DRG 536 Inpatient 2024 Medicare data
Average charge $20,082 Hospital list price billed
Average payment $6,805 Medicare + patient + other payers
Medicare paid $4,555 Average per stay
Volume 26 Medicare hospital stays

Hospitals in Montana billed an average of $20,082 for fractures of hip and pelvis without major complications, about 3.0 times the average total payment of $6,805. That payment is 10% below the U.S. average of $7,596.

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 $6,805Billed $20,082

About 34¢ was paid for every $1 hospitals in Montana billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Montana:

Montana hospitals: fractures of hip and pelvis without major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Benefis Hospitals INCGreat Falls 13 $21,176 $6,042 $4,577
St Vincent HealthcareBillings 13 $18,987 $7,568 $4,533
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Fractures of hip and pelvis without major complications in other states

Questions

How much does fractures of hip and pelvis without major complications cost in Montana?

In 2024 Medicare data, a hospital stay for fractures of hip and pelvis without major complications (DRG 536) at 2 hospitals in Montana was billed at $20,082 on average, while the average total payment was $6,805, of which Medicare paid $4,555. 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 Montana, average charges were 3.0 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.