Inborn and other disorders of metabolism
What 3 hospitals in the U.S. charged and were paid for a Medicare hospital stay for inborn and other disorders of metabolism (DRG 642), from 2024 Medicare claims.
Average charge
$174,805
Hospital list price billed
Average payment
$25,993
Medicare + patient + other payers
Medicare paid
$21,159
Average per stay
Volume
34
Medicare hospital stays
Hospitals in the U.S. billed an average of $174,805 for inborn and other disorders of metabolism, about 6.7 times the average total payment of $25,993.
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 $25,993Billed $174,805
About 15¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Inborn and other disorders of metabolism cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Massachusetts | 1 | $156,311 | $24,005 | – |
| Minnesota | 1 | $205,050 | $40,495 | – |
| Missouri | 1 | $160,304 | $12,160 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| University of Minnesota Medical Center, FairviewMinneapolis, MN | 12 | $205,050 | $40,495 |
| Massachusetts General HospitalBoston, MA | 11 | $156,311 | $24,005 |
| St Lukes Hospital of Kansas CityKansas City, MO | 11 | $160,304 | $12,160 |
Questions
How much does inborn and other disorders of metabolism cost in the U.S.?
In 2024 Medicare data, a hospital stay for inborn and other disorders of metabolism (DRG 642) at 3 hospitals in the U.S. was billed at $174,805 on average, while the average total payment was $25,993, of which Medicare paid $21,159. 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 the U.S., average charges were 6.7 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.