Billed is the hospital's list price. Average payment is what Medicare, the patient and any other insurer paid in total. Medicare paid is Medicare's part. A Medicare category can group several related procedures, and these are averages, not a quote.
According to HospitalsInEachState.com's analysis of 2024 Medicare inpatient claims data from CMS, the average total payment for a hospital stay for intraocular procedures with complications (DRG 116) in Massachusetts was $25,793 (what Medicare and the patient, plus any other insurer, paid), of which Medicare paid $20,158, across 1 hospital. Hospitals billed $37,392 on average, their list charge. The payments are averages for original Medicare patients, not a price quote.
Hospitals in Massachusetts billed an average of $37,392 for intraocular procedures with complications, about 1.4 times the average total payment of $25,793. That payment is 18% above the U.S. average of $21,770.
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.
About 69¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Massachusetts hospitals: intraocular procedures with complications
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Use the column headings to sort.
| Massachusetts Eye and Ear InfirmaryBoston | 15 | $37,392 | $25,793 | $20,158 |
|---|
Intraocular procedures with complications in other states
Questions
How much does intraocular procedures with complications cost in Massachusetts?
In 2024 Medicare data, a hospital stay for intraocular procedures with complications (DRG 116) at 1 hospital in Massachusetts was billed at $37,392 on average, while the average total payment was $25,793, of which Medicare paid $20,158. 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 Massachusetts, average charges were 1.4 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.
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