Lower extremity and humerus procedures except hip, foot and femur with complications in Virginia
What 18 hospitals in Virginia charged and were paid for a Medicare hospital stay for lower extremity and humerus procedures except hip, foot and femur with complications (DRG 493), from 2024 Medicare claims.
Average charge
$106,827
Hospital list price billed
Average payment
$20,271
Medicare + patient + other payers
Medicare paid
$16,104
Average per stay
State rank
#14 of 40
1 = lowest average payment
Hospitals in Virginia billed an average of $106,827 for lower extremity and humerus procedures except hip, foot and femur with complications, about 5.3 times the average total payment of $20,271. That payment is 11% below the U.S. average of $22,820.
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 $20,271Billed $106,827
About 19¢ was paid for every $1 hospitals in Virginia billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Virginia:
Virginia hospitals: lower extremity and humerus procedures except hip, foot and femur with complications
Every Virginia hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Riverside Regional Medical CenterNewport News | 47 | $60,607 | $18,691 | $15,622 |
| Inova Fairfax HospitalFalls Church | 40 | $56,744 | $20,870 | $17,736 |
| Carilion Medical CenterRoanoke | 35 | $85,682 | $19,242 | $15,159 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 26 | $86,455 | $19,681 | $14,942 |
| Sentara Virginia Beach General HospitalVirginia Beach | 26 | $91,215 | $18,407 | $13,696 |
| Cjw Medical CenterRichmond | 26 | $327,566 | $17,634 | $14,393 |
| University of Virginia Medical CenterCharlottesville | 25 | $93,398 | $29,308 | $23,079 |
| Medical College of Virginia HospitalsRichmond | 22 | $132,000 | $29,095 | $18,227 |
| Winchester Medical Center INCWinchester | 21 | $52,393 | $20,108 | $17,117 |
| Mary Washington Hospital, INCFredericksburg | 18 | $46,592 | $17,371 | $15,740 |
| Sentara Norfolk General HospitalNorfolk | 17 | $103,090 | $24,430 | $16,894 |
| Henrico Doctors' HospitalRichmond | 15 | $313,520 | $17,200 | $15,219 |
| Inova Loudoun HospitalLeesburg | 14 | $67,496 | $22,128 | $12,466 |
| Sentara Bayside HospitalVirginia Beach | 13 | $71,712 | $16,068 | $14,674 |
| Sentara Leigh HospitalNorfolk | 12 | $65,152 | $17,011 | $15,693 |
| Lewisgale Medical CenterSalem | 12 | $243,659 | $20,110 | $16,985 |
| Sentara Williamsburg Regional Medical CenterWilliamsburg | 11 | $72,597 | $14,221 | $12,572 |
| Inova Mount Vernon HospitalAlexandria | 11 | $45,590 | $17,153 | $15,621 |
Lowest and highest payments in Virginia
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
| Sentara Williamsburg Regional Medical CenterWilliamsburg, VA | $14,221 |
|---|---|
| Sentara Bayside HospitalVirginia Beach, VA | $16,068 |
| Sentara Leigh HospitalNorfolk, VA | $17,011 |
| Inova Mount Vernon HospitalAlexandria, VA | $17,153 |
| Henrico Doctors' HospitalRichmond, VA | $17,200 |
Highest
| University of Virginia Medical CenterCharlottesville, VA | $29,308 |
|---|---|
| Medical College of Virginia HospitalsRichmond, VA | $29,095 |
| Sentara Norfolk General HospitalNorfolk, VA | $24,430 |
| Inova Loudoun HospitalLeesburg, VA | $22,128 |
| Inova Fairfax HospitalFalls Church, VA | $20,870 |
Lower extremity and humerus procedures except hip, foot and femur with complications in other states
Questions
How much does lower extremity and humerus procedures except hip, foot and femur with complications cost in Virginia?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with complications (DRG 493) at 18 hospitals in Virginia was billed at $106,827 on average, while the average total payment was $20,271, of which Medicare paid $16,104. 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 Virginia, average charges were 5.3 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.