facebook tracking Major bladder procedures with complications cost in Pennsylvania: 4 hospitals compared (DRG 654)

Major bladder procedures with complications in Pennsylvania

What 4 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for major bladder procedures with complications (DRG 654), from 2024 Medicare claims.

DRG 654 Inpatient 2024 Medicare data
Average charge $206,613 Hospital list price billed
Average payment $31,228 Medicare + patient + other payers
Medicare paid $24,859 Average per stay
State rank #2 of 7 1 = lowest average payment

Hospitals in Pennsylvania billed an average of $206,613 for major bladder procedures with complications, about 6.6 times the average total payment of $31,228. That payment is 7% below the U.S. average of $33,454.

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 $31,228Billed $206,613

About 15¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.

Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Pennsylvania:

Pennsylvania hospitals: major bladder procedures with complications

Every Pennsylvania hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
Hospital of the Univ of PaPhiladelphia 29 $237,705 $34,990 $26,540
UPMC Presbyterian ShadysidePittsburgh 14 $226,823 $25,261 $21,845
Thomas Jefferson University HospitalPhiladelphia 14 $179,826 $31,442 $23,377
Milton S Hershey Medical CenterHershey 12 $139,146 $28,847 $26,045
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Lowest and highest payments in Pennsylvania

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

UPMC Presbyterian ShadysidePittsburgh, PA$25,261
Milton S Hershey Medical CenterHershey, PA$28,847
Thomas Jefferson University HospitalPhiladelphia, PA$31,442
Hospital of the Univ of PaPhiladelphia, PA$34,990

Highest

Hospital of the Univ of PaPhiladelphia, PA$34,990
Thomas Jefferson University HospitalPhiladelphia, PA$31,442
Milton S Hershey Medical CenterHershey, PA$28,847
UPMC Presbyterian ShadysidePittsburgh, PA$25,261

Major bladder procedures with complications in other states

Questions

How much does major bladder procedures with complications cost in Pennsylvania?

In 2024 Medicare data, a hospital stay for major bladder procedures with complications (DRG 654) at 4 hospitals in Pennsylvania was billed at $206,613 on average, while the average total payment was $31,228, of which Medicare paid $24,859. 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 Pennsylvania, average charges were 6.6 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.