Lower extremity and humerus procedures except hip, foot and femur without complications in Ohio
What 4 hospitals in Ohio 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
$95,455
Hospital list price billed
Average payment
$16,444
Medicare + patient + other payers
Medicare paid
$13,878
Average per stay
State rank
#5 of 13
1 = lowest average payment
Hospitals in Ohio billed an average of $95,455 for lower extremity and humerus procedures except hip, foot and femur without complications, about 5.8 times the average total payment of $16,444. That payment is 10% below 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 $16,444Billed $95,455
About 17¢ was paid for every $1 hospitals in Ohio billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Ohio:
Ohio hospitals: lower extremity and humerus procedures except hip, foot and femur without complications
Every Ohio hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Mercy St Vincent Medical CenterToledo | 14 | $174,328 | $17,179 | $14,094 |
| Cleveland Clinic - Akron GeneralAkron | 11 | $51,525 | $15,101 | $13,375 |
| University Hospitals of ClevelandCleveland | 11 | $89,014 | $19,752 | $16,248 |
| Bethesda North HospitalCincinnati | 11 | $45,441 | $13,542 | $11,736 |
Lowest and highest payments in Ohio
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
| Bethesda North HospitalCincinnati, OH | $13,542 |
|---|---|
| Cleveland Clinic - Akron GeneralAkron, OH | $15,101 |
| Mercy St Vincent Medical CenterToledo, OH | $17,179 |
| University Hospitals of ClevelandCleveland, OH | $19,752 |
Highest
| University Hospitals of ClevelandCleveland, OH | $19,752 |
|---|---|
| Mercy St Vincent Medical CenterToledo, OH | $17,179 |
| Cleveland Clinic - Akron GeneralAkron, OH | $15,101 |
| Bethesda North HospitalCincinnati, OH | $13,542 |
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 Ohio?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur without complications (DRG 494) at 4 hospitals in Ohio was billed at $95,455 on average, while the average total payment was $16,444, of which Medicare paid $13,878. 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 Ohio, average charges were 5.8 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.