Lower extremity and humerus procedures except hip, foot and femur with major complications in Massachusetts
What 5 hospitals in Massachusetts 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.
Average charge
$79,487
Hospital list price billed
Average payment
$42,167
Medicare + patient + other payers
Medicare paid
$36,985
Average per stay
State rank
#11 of 13
1 = lowest average payment
Hospitals in Massachusetts billed an average of $79,487 for lower extremity and humerus procedures except hip, foot and femur with major complications, about 1.9 times the average total payment of $42,167. That payment is 23% above 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 $42,167Billed $79,487
About 53¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Massachusetts:
Massachusetts hospitals: lower extremity and humerus procedures except hip, foot and femur with major complications
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Beth Israel Deaconess Medical CenterBoston | 18 | $58,065 | $42,336 | $35,323 |
| Lahey Clinic HospitalBurlington | 16 | $103,304 | $48,194 | $42,463 |
| Baystate Medical CenterSpringfield | 15 | $61,067 | $35,280 | $32,164 |
| Boston Medical Center CorporationBoston | 13 | $134,141 | $56,901 | $49,116 |
| South Shore HospitalSouth Weymouth | 12 | $43,678 | $26,523 | $25,056 |
Lowest and highest payments in Massachusetts
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
| South Shore HospitalSouth Weymouth, MA | $26,523 |
|---|---|
| Baystate Medical CenterSpringfield, MA | $35,280 |
| Beth Israel Deaconess Medical CenterBoston, MA | $42,336 |
| Lahey Clinic HospitalBurlington, MA | $48,194 |
| Boston Medical Center CorporationBoston, MA | $56,901 |
Highest
| Boston Medical Center CorporationBoston, MA | $56,901 |
|---|---|
| Lahey Clinic HospitalBurlington, MA | $48,194 |
| Beth Israel Deaconess Medical CenterBoston, MA | $42,336 |
| Baystate Medical CenterSpringfield, MA | $35,280 |
| South Shore HospitalSouth Weymouth, MA | $26,523 |
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 Massachusetts?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492) at 5 hospitals in Massachusetts was billed at $79,487 on average, while the average total payment was $42,167, of which Medicare paid $36,985. 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 1.9 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.