facebook tracking Hip and femur procedures except major joint with complications cost in Maine: 10 hospitals compared (DRG 481)

Hip and femur procedures except major joint with complications in Maine

What 10 hospitals in Maine charged and were paid for a Medicare hospital stay for hip and femur procedures except major joint with complications (DRG 481), from 2024 Medicare claims.

DRG 481 Inpatient 2024 Medicare data
Average charge $64,895 Hospital list price billed
Average payment $18,043 Medicare + patient + other payers
Medicare paid $15,150 Average per stay
State rank #32 of 50 1 = lowest average payment

Hospitals in Maine billed an average of $64,895 for hip and femur procedures except major joint with complications, about 3.6 times the average total payment of $18,043. That payment is 2% below the U.S. average of $18,473.

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 $18,043Billed $64,895

About 28¢ was paid for every $1 hospitals in Maine billed for this stay.

Maine hospitals: hip and femur procedures except major joint with 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 81 $71,942 $18,956 $15,328
Eastern Maine Medical CenterBangor 48 $65,259 $17,345 $13,066
Central Maine Medical CenterLewiston 30 $50,993 $16,568 $13,271
Maine General Medical CenterWaterville 18 $71,033 $21,418 $19,584
Mercy HospitalPortland 15 $63,630 $15,433 $14,345
St Joseph HospitalBangor 13 $68,215 $18,194 $16,814
York HospitalYork 13 $58,969 $13,919 $12,914
Mid Coast HospitalBrunswick 12 $55,983 $15,224 $13,592
Maine Coast Memorial HospitalEllsworth 11 $56,765 $21,904 $20,421
Penobscot Bay Medical CenterRockport 11 $61,951 $20,342 $19,007
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Lowest and highest payments in Maine

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

York HospitalYork, ME$13,919
Mid Coast HospitalBrunswick, ME$15,224
Mercy HospitalPortland, ME$15,433
Central Maine Medical CenterLewiston, ME$16,568
Eastern Maine Medical CenterBangor, ME$17,345

Highest

Maine Coast Memorial HospitalEllsworth, ME$21,904
Maine General Medical CenterWaterville, ME$21,418
Penobscot Bay Medical CenterRockport, ME$20,342
Maine Medical CenterPortland, ME$18,956
St Joseph HospitalBangor, ME$18,194

Hip and femur procedures except major joint with complications in other states

Questions

How much does hip and femur procedures except major joint with complications cost in Maine?

In 2024 Medicare data, a hospital stay for hip and femur procedures except major joint with complications (DRG 481) at 10 hospitals in Maine was billed at $64,895 on average, while the average total payment was $18,043, of which Medicare paid $15,150. 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 3.6 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.