facebook tracking Lower extremity and humerus procedures except hip, foot and femur with major complications cost in North Carolina: 3 hospitals compared (DRG 492)

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

What 3 hospitals in North Carolina 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 $149,423 Hospital list price billed
Average payment $31,674 Medicare + patient + other payers
Medicare paid $23,367 Average per stay
State rank #7 of 13 1 = lowest average payment

Hospitals in North Carolina billed an average of $149,423 for lower extremity and humerus procedures except hip, foot and femur with major complications, about 4.7 times the average total payment of $31,674. That payment is 7% 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 $31,674Billed $149,423

About 21¢ was paid for every $1 hospitals in North Carolina billed for this stay.

Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in North Carolina:

Major complications $31,674 DRG 492 · this page Complications $22,820 DRG 493 · U.S. average No complications $18,176 DRG 494 · U.S. average

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Memorial Mission Hospital and Asheville Surgery CeAsheville 20 $145,172 $27,379 $21,914
Carolinas Medical Center/Behav HealthCharlotte 15 $172,470 $38,755 $25,310
Wakemed, Raleigh CampusRaleigh 11 $125,725 $29,827 $23,359
Lower extremity and humerus procedures except hip, foot and femur with major complications: all states All North Carolina hospitals North Carolina hospital finances
Advertisement

Lowest and highest payments in North Carolina

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.

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

Colorado · $32,433 Georgia · $31,586 Iowa · $31,166 Missouri · $31,051 New Jersey · $33,291 Texas · $31,432 Utah · $32,082 Washington · $30,135

Questions

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

In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492) at 3 hospitals in North Carolina was billed at $149,423 on average, while the average total payment was $31,674, of which Medicare paid $23,367. 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 North Carolina, average charges were 4.7 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.