What 7 hospitals in Texas 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.
Hospitals in Texas billed an average of $186,862 for lower extremity and humerus procedures except hip, foot and femur with major complications, about 5.9 times the average total payment of $31,432. That payment is 8% 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.
About 17¢ was paid for every $1 hospitals in Texas billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Texas:
Every Texas hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Texas Health Harris Methodist Fort WorthFort Worth | 18 | $145,319 | $25,174 | $23,288 |
| University Medical CenterLubbock | 17 | $154,456 | $30,458 | $29,011 |
| Medical Center of PlanoPlano | 16 | $276,467 | $22,491 | $21,635 |
| Memorial Hermann Texas Medical CenterHouston | 15 | $166,440 | $32,997 | $30,323 |
| Mem Hermann Southwest HospHouston | 13 | $152,006 | $28,292 | $26,872 |
| University Health SystemSan Antonio | 12 | $166,754 | $60,545 | $36,409 |
| Methodist HospitalSan Antonio | 11 | $265,563 | $26,002 | $24,274 |
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.
| Medical Center of PlanoPlano, TX | $22,491 |
|---|---|
| Texas Health Harris Methodist Fort WorthFort Worth, TX | $25,174 |
| Methodist HospitalSan Antonio, TX | $26,002 |
| Mem Hermann Southwest HospHouston, TX | $28,292 |
| University Medical CenterLubbock, TX | $30,458 |
| University Health SystemSan Antonio, TX | $60,545 |
|---|---|
| Memorial Hermann Texas Medical CenterHouston, TX | $32,997 |
| University Medical CenterLubbock, TX | $30,458 |
| Mem Hermann Southwest HospHouston, TX | $28,292 |
| Methodist HospitalSan Antonio, TX | $26,002 |
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492) at 7 hospitals in Texas was billed at $186,862 on average, while the average total payment was $31,432, of which Medicare paid $27,124. Your own cost depends on your insurance, deductible and the hospital.
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 Texas, average charges were 5.9 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.