Lower extremity and humerus procedures except hip, foot and femur without complications in Massachusetts
What 5 hospitals in Massachusetts charged and were paid for a Medicare hospital stay for lower extremity and humerus procedures except hip, foot and femur without complications (DRG 494), from 2024 Medicare claims.
Average charge
$62,093
Hospital list price billed
Average payment
$19,647
Medicare + patient + other payers
Medicare paid
$17,187
Average per stay
State rank
#10 of 13
1 = lowest average payment
Hospitals in Massachusetts billed an average of $62,093 for lower extremity and humerus procedures except hip, foot and femur without complications, about 3.2 times the average total payment of $19,647. That payment is 8% above the U.S. average of $18,176.
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 $19,647Billed $62,093
About 32¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Massachusetts:
Massachusetts hospitals: lower extremity and humerus procedures except hip, foot and femur without complications
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Massachusetts General HospitalBoston | 24 | $97,632 | $22,116 | $19,473 |
| Baystate Medical CenterSpringfield | 23 | $36,341 | $19,467 | $17,302 |
| South Shore HospitalSouth Weymouth | 14 | $31,813 | $16,330 | $12,883 |
| Southcoast Hospital Group, INCFall River | 12 | $48,727 | $15,724 | $14,092 |
| Umass Memorial Medical Center INCWorcester | 12 | $89,065 | $22,847 | $20,513 |
Lowest and highest payments in Massachusetts
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
| Southcoast Hospital Group, INCFall River, MA | $15,724 |
|---|---|
| South Shore HospitalSouth Weymouth, MA | $16,330 |
| Baystate Medical CenterSpringfield, MA | $19,467 |
| Massachusetts General HospitalBoston, MA | $22,116 |
| Umass Memorial Medical Center INCWorcester, MA | $22,847 |
Highest
| Umass Memorial Medical Center INCWorcester, MA | $22,847 |
|---|---|
| Massachusetts General HospitalBoston, MA | $22,116 |
| Baystate Medical CenterSpringfield, MA | $19,467 |
| South Shore HospitalSouth Weymouth, MA | $16,330 |
| Southcoast Hospital Group, INCFall River, MA | $15,724 |
Lower extremity and humerus procedures except hip, foot and femur without complications in other states
Questions
How much does lower extremity and humerus procedures except hip, foot and femur without complications cost in Massachusetts?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur without complications (DRG 494) at 5 hospitals in Massachusetts was billed at $62,093 on average, while the average total payment was $19,647, of which Medicare paid $17,187. 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 Massachusetts, average charges were 3.2 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.