Local excision and removal of internal fixation devices except hip and femur without complications/
What 4 hospitals in the U.S. charged and were paid for a Medicare hospital stay for local excision and removal of internal fixation devices except hip and femur without complications/ (DRG 497), from 2024 Medicare claims.
Average charge
$58,649
Hospital list price billed
Average payment
$13,761
Medicare + patient + other payers
Medicare paid
$11,062
Average per stay
Volume
72
Medicare hospital stays
Hospitals in the U.S. billed an average of $58,649 for local excision and removal of internal fixation devices except hip and femur without complications/, about 4.3 times the average total payment of $13,761.
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 $13,761Billed $58,649
About 23¢ 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:
Local excision and removal of internal fixation devices except hip and femur without 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 |
|---|---|---|---|---|
| California | 1 | $61,102 | $14,348 | – |
| New York | 1 | $83,342 | $17,592 | – |
| Oklahoma | 2 | $37,263 | $10,260 | $8,898 – $11,349 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Sherman Oaks HospitalSherman Oaks, CA | 24 | $61,102 | $14,348 |
| Hospital for Special SurgeryNew York, NY | 21 | $83,342 | $17,592 |
| St Anthony HospitalOklahoma City, OK | 15 | $36,376 | $11,349 |
| Tulsa Spine & Specialty HospitalTulsa, OK | 12 | $38,372 | $8,898 |
Questions
How much does local excision and removal of internal fixation devices except hip and femur without complications/ cost in the U.S.?
In 2024 Medicare data, a hospital stay for local excision and removal of internal fixation devices except hip and femur without complications/ (DRG 497) at 4 hospitals in the U.S. was billed at $58,649 on average, while the average total payment was $13,761, of which Medicare paid $11,062. 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 4.3 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.