facebook tracking Hip and femur procedures except major joint with major complications cost in Maine: 3 hospitals compared (DRG 480)

Hip and femur procedures except major joint with major complications in Maine

What 3 hospitals in Maine charged and were paid for a Medicare hospital stay for hip and femur procedures except major joint with major complications (DRG 480), from 2024 Medicare claims.

DRG 480 Inpatient 2024 Medicare data
Average charge $89,388 Hospital list price billed
Average payment $24,269 Medicare + patient + other payers
Medicare paid $21,156 Average per stay
State rank #23 of 46 1 = lowest average payment

Hospitals in Maine billed an average of $89,388 for hip and femur procedures except major joint with major complications, about 3.7 times the average total payment of $24,269. That payment is 8% below the U.S. average of $26,284.

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 $24,269Billed $89,388

About 27¢ was paid for every $1 hospitals in Maine billed for this stay.

Maine hospitals: hip and femur procedures except major joint with major 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 44 $89,957 $26,209 $21,641
Eastern Maine Medical CenterBangor 24 $100,401 $21,907 $20,603
Central Maine Medical CenterLewiston 18 $73,314 $22,676 $20,706
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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

Eastern Maine Medical CenterBangor, ME$21,907
Central Maine Medical CenterLewiston, ME$22,676
Maine Medical CenterPortland, ME$26,209

Highest

Maine Medical CenterPortland, ME$26,209
Central Maine Medical CenterLewiston, ME$22,676
Eastern Maine Medical CenterBangor, ME$21,907

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

Questions

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

In 2024 Medicare data, a hospital stay for hip and femur procedures except major joint with major complications (DRG 480) at 3 hospitals in Maine was billed at $89,388 on average, while the average total payment was $24,269, of which Medicare paid $21,156. 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 3.7 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.