facebook tracking Kidney and urinary tract neoplasms with major complications cost: hospital prices by state (DRG 686)

Kidney and urinary tract neoplasms with major complications

What 4 hospitals in the U.S. charged and were paid for a Medicare hospital stay for kidney and urinary tract neoplasms with major complications (DRG 686), from 2024 Medicare claims.

DRG 686 Inpatient 2024 Medicare data
Average charge $164,554 Hospital list price billed
Average payment $26,031 Medicare + patient + other payers
Medicare paid $21,677 Average per stay
Volume 49 Medicare hospital stays

Hospitals in the U.S. billed an average of $164,554 for kidney and urinary tract neoplasms with major complications, about 6.3 times the average total payment of $26,031.

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 $26,031Billed $164,554

About 16¢ was paid for every $1 hospitals in the U.S. billed for this stay.

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

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Kidney and urinary tract neoplasms with major complications 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
Florida 1 $183,078 $16,527 –
Massachusetts 1 $58,713 $28,406 –
New York 2 $200,784 $29,413 $26,510 – $31,901

Hospitals that treat the most Medicare patients for this

HospitalStaysAvg chargeAvg payment
New York-Presbyterian HospitalNew York, NY14$250,546$31,901
Adventhealth OrlandoOrlando, FL12$183,078$16,527
NYU Hospitals CenterNew York, NY12$142,729$26,510
Beth Israel Deaconess Medical CenterBoston, MA11$58,713$28,406

Questions

How much does kidney and urinary tract neoplasms with major complications cost in the U.S.?

In 2024 Medicare data, a hospital stay for kidney and urinary tract neoplasms with major complications (DRG 686) at 4 hospitals in the U.S. was billed at $164,554 on average, while the average total payment was $26,031, of which Medicare paid $21,677. 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 6.3 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.