Lower extremity and humerus procedures except hip, foot and femur without complications in Wisconsin
What 1 hospital in Wisconsin 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
$88,061
Hospital list price billed
Average payment
$20,438
Medicare + patient + other payers
Medicare paid
$14,723
Average per stay
Volume
23
Medicare hospital stays
Hospitals in Wisconsin billed an average of $88,061 for lower extremity and humerus procedures except hip, foot and femur without complications, about 4.3 times the average total payment of $20,438. That payment is 12% 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 $20,438Billed $88,061
About 23¢ was paid for every $1 hospitals in Wisconsin billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Wisconsin:
Wisconsin hospitals: lower extremity and humerus procedures except hip, foot and femur without complications
Every Wisconsin hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| University of Wi Hospitals & Clinics AuthorityMadison | 23 | $88,061 | $20,438 | $14,723 |
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 Wisconsin?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur without complications (DRG 494) at 1 hospital in Wisconsin was billed at $88,061 on average, while the average total payment was $20,438, of which Medicare paid $14,723. 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 Wisconsin, 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.