Lower extremity and humerus procedures except hip, foot and femur with major complications in New York
What 4 hospitals in New York 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
$275,996
Hospital list price billed
Average payment
$46,024
Medicare + patient + other payers
Medicare paid
$35,526
Average per stay
State rank
#12 of 13
1 = lowest average payment
Hospitals in New York billed an average of $275,996 for lower extremity and humerus procedures except hip, foot and femur with major complications, about 6.0 times the average total payment of $46,024. That payment is 35% 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 $46,024Billed $275,996
About 17¢ was paid for every $1 hospitals in New York billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in New York:
New York hospitals: lower extremity and humerus procedures except hip, foot and femur with major complications
Every New York hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| NYU Hospitals CenterNew York | 17 | $335,133 | $57,299 | $36,790 |
| New York-Presbyterian HospitalNew York | 15 | $254,463 | $40,617 | $35,343 |
| Erie County Medical CenterBuffalo | 13 | $96,425 | $40,494 | $35,534 |
| Westchester Medical CenterValhalla | 11 | $426,187 | $42,509 | $33,813 |
Lowest and highest payments in New York
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
| Erie County Medical CenterBuffalo, NY | $40,494 |
|---|---|
| New York-Presbyterian HospitalNew York, NY | $40,617 |
| Westchester Medical CenterValhalla, NY | $42,509 |
| NYU Hospitals CenterNew York, NY | $57,299 |
Highest
| NYU Hospitals CenterNew York, NY | $57,299 |
|---|---|
| Westchester Medical CenterValhalla, NY | $42,509 |
| New York-Presbyterian HospitalNew York, NY | $40,617 |
| Erie County Medical CenterBuffalo, NY | $40,494 |
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 New York?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492) at 4 hospitals in New York was billed at $275,996 on average, while the average total payment was $46,024, of which Medicare paid $35,526. 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 New York, average charges were 6.0 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.