facebook tracking Lower extremity and humerus procedures except hip, foot and femur with major complications cost in Texas: 7 hospitals compared (DRG 492)

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

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.

DRG 492 Inpatient 2024 Medicare data
Average charge $186,862 Hospital list price billed
Average payment $31,432 Medicare + patient + other payers
Medicare paid $27,124 Average per stay
State rank #6 of 13 1 = lowest average payment

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.

Paid $31,432Billed $186,862

About 17¢ was paid for every $1 hospitals in Texas billed for this stay.

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

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
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Lowest and highest payments in Texas

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

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

Highest

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

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 Texas?

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.

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 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.