facebook tracking Major small and large bowel procedures without complications cost in New Mexico: 2 hospitals compared (DRG 331)

Major small and large bowel procedures without complications in New Mexico

What 2 hospitals in New Mexico charged and were paid for a Medicare hospital stay for major small and large bowel procedures without complications (DRG 331), from 2024 Medicare claims.

DRG 331 Inpatient 2024 Medicare data
Average charge $54,498 Hospital list price billed
Average payment $15,367 Medicare + patient + other payers
Medicare paid $13,134 Average per stay
Volume 29 Medicare hospital stays

Hospitals in New Mexico billed an average of $54,498 for major small and large bowel procedures without complications, about 3.5 times the average total payment of $15,367. That payment is 4% below the U.S. average of $16,035.

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 $15,367Billed $54,498

About 28¢ was paid for every $1 hospitals in New Mexico billed for this stay.

New Mexico hospitals: major small and large bowel procedures without complications

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

Hospital Stays Avg charge Avg payment Medicare paid
St Vincent HospitalSanta Fe 16 $68,692 $17,602 $16,004
Presbyterian HospitalAlbuquerque 13 $37,027 $12,617 $9,601
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Major small and large bowel procedures without complications in other states

Questions

How much does major small and large bowel procedures without complications cost in New Mexico?

In 2024 Medicare data, a hospital stay for major small and large bowel procedures without complications (DRG 331) at 2 hospitals in New Mexico was billed at $54,498 on average, while the average total payment was $15,367, of which Medicare paid $13,134. 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 New Mexico, average charges were 3.5 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.