facebook tracking Lower extremity and humerus procedures except hip, foot and femur with major complications cost in Iowa: 2 hospitals compared (DRG 492)

Lower extremity and humerus procedures except hip, foot and femur with major complications in Iowa

What 2 hospitals in Iowa charged and were paid for a Medicare hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492), from 2024 Medicare claims.

DRG 492 Inpatient 2024 Medicare data
Average charge $168,539 Hospital list price billed
Average payment $31,166 Medicare + patient + other payers
Medicare paid $23,298 Average per stay
Volume 23 Medicare hospital stays

Hospitals in Iowa billed an average of $168,539 for lower extremity and humerus procedures except hip, foot and femur with major complications, about 5.4 times the average total payment of $31,166. That payment is 9% below the U.S. average of $34,208.

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 $31,166Billed $168,539

About 18¢ was paid for every $1 hospitals in Iowa billed for this stay.

Iowa hospitals: lower extremity and humerus procedures except hip, foot and femur with major complications

Every Iowa hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
University of Iowa Hospital & ClinicsIowa City 12 $192,225 $39,424 $25,935
Mercy Medical Center-Des MoinesDes Moines 11 $142,700 $22,157 $20,422
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Lower extremity and humerus procedures except hip, foot and femur with major complications in other states

Questions

How much does lower extremity and humerus procedures except hip, foot and femur with major complications cost in Iowa?

In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492) at 2 hospitals in Iowa was billed at $168,539 on average, while the average total payment was $31,166, of which Medicare paid $23,298. 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 Iowa, average charges were 5.4 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.