Lower extremity and humerus procedures except hip, foot and femur with major complications in Tennessee
What 2 hospitals in Tennessee 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
$153,283
Hospital list price billed
Average payment
$35,744
Medicare + patient + other payers
Medicare paid
$26,267
Average per stay
Volume
26
Medicare hospital stays
Hospitals in Tennessee billed an average of $153,283 for lower extremity and humerus procedures except hip, foot and femur with major complications, about 4.3 times the average total payment of $35,744. That payment is 4% 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 $35,744Billed $153,283
About 23¢ was paid for every $1 hospitals in Tennessee billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Tennessee:
Tennessee hospitals: lower extremity and humerus procedures except hip, foot and femur with major complications
Every Tennessee hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Vanderbilt University HospitalNashville | 15 | $171,406 | $39,380 | $28,649 |
| Erlanger Medical CenterChattanooga | 11 | $128,570 | $30,788 | $23,020 |
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 Tennessee?
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 Tennessee was billed at $153,283 on average, while the average total payment was $35,744, of which Medicare paid $26,267. 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 Tennessee, average charges were 4.3 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.