Malignancy of hepatobiliary system or pancreas with complications
What 64 hospitals in the U.S. charged and were paid for a Medicare hospital stay for malignancy of hepatobiliary system or pancreas with complications (DRG 436), from 2024 Medicare claims.
Average charge
$68,480
Hospital list price billed
Average payment
$12,472
Medicare + patient + other payers
Medicare paid
$9,199
Average per stay
Volume
908
Medicare hospital stays
Hospitals in the U.S. billed an average of $68,480 for malignancy of hepatobiliary system or pancreas with complications, about 5.5 times the average total payment of $12,472.
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 $12,472Billed $68,480
About 18¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Sarasota Memorial HospitalSarasota, FL | $8,643 |
|---|---|
| Methodist HospitalSan Antonio, TX | $9,291 |
| North Florida Regional Medical CenterGainesville, FL | $10,236 |
| Christiana Care Health Services, INC.Newark, DE | $10,451 |
| Adventhealth OrlandoOrlando, FL | $11,041 |
| Beth Israel Deaconess Medical CenterBoston, MA | $15,149 |
| NYU Hospitals CenterNew York, NY | $16,181 |
| New York-Presbyterian HospitalNew York, NY | $18,304 |
Highest
| New York-Presbyterian HospitalNew York, NY | $18,304 |
|---|---|
| NYU Hospitals CenterNew York, NY | $16,181 |
| Beth Israel Deaconess Medical CenterBoston, MA | $15,149 |
| Adventhealth OrlandoOrlando, FL | $11,041 |
| Christiana Care Health Services, INC.Newark, DE | $10,451 |
| North Florida Regional Medical CenterGainesville, FL | $10,236 |
| Methodist HospitalSan Antonio, TX | $9,291 |
| Sarasota Memorial HospitalSarasota, FL | $8,643 |
Malignancy of hepatobiliary system or pancreas with complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 1 | $36,255 | $16,053 | – |
| Arizona | 1 | $31,422 | $14,464 | – |
| Arkansas | 1 | $37,963 | $7,764 | – |
| California | 6 | $149,206 | $18,452 | $12,572 – $23,949 |
| Delaware | 1 | $35,226 | $10,451 | – |
| Florida | 9 | $78,082 | $9,934 | $8,019 – $12,472 |
| Illinois | 3 | $37,097 | $8,731 | $7,576 – $9,715 |
| Indiana | 2 | $51,706 | $8,198 | $8,056 – $8,311 |
| Iowa | 1 | $64,527 | $12,418 | – |
| Kentucky | 2 | $46,821 | $10,006 | $8,538 – $11,683 |
| Maryland | 4 | $18,488 | $16,461 | $13,044 – $20,744 |
| Massachusetts | 3 | $51,225 | $14,637 | $14,242 – $15,149 |
| Michigan | 1 | $43,783 | $11,035 | – |
| Minnesota | 1 | $46,434 | $19,121 | – |
| Missouri | 2 | $60,161 | $12,959 | $8,122 – $16,760 |
| New Jersey | 4 | $68,384 | $11,394 | $8,920 – $16,229 |
| New York | 5 | $114,799 | $16,497 | $13,914 – $18,304 |
| North Carolina | 2 | $31,393 | $12,052 | $9,269 – $14,637 |
| Ohio | 4 | $49,528 | $11,740 | $10,242 – $13,014 |
| Pennsylvania | 4 | $65,950 | $10,525 | $9,647 – $11,739 |
| South Dakota | 1 | $46,620 | $9,514 | – |
| Tennessee | 3 | $59,671 | $11,911 | $8,950 – $16,376 |
| Texas | 1 | $86,482 | $9,291 | – |
| Virginia | 1 | $19,792 | $8,969 | – |
| Wisconsin | 1 | $45,200 | $11,683 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 32 | $98,305 | $11,041 |
| Methodist HospitalSan Antonio, TX | 26 | $86,482 | $9,291 |
| Christiana Care Health Services, INC.Newark, DE | 22 | $35,226 | $10,451 |
| North Florida Regional Medical CenterGainesville, FL | 22 | $141,304 | $10,236 |
| Sarasota Memorial HospitalSarasota, FL | 21 | $61,260 | $8,643 |
| Beth Israel Deaconess Medical CenterBoston, MA | 20 | $35,695 | $15,149 |
| New York-Presbyterian HospitalNew York, NY | 20 | $126,930 | $18,304 |
| NYU Hospitals CenterNew York, NY | 20 | $108,487 | $16,181 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 19 | $233,900 | $15,169 |
| Brigham and Women's HosptialBoston, MA | 19 | $69,180 | $14,242 |
| Massachusetts General HospitalBoston, MA | 18 | $49,528 | $14,484 |
| Inspira Medical Center Mullica HillElmer, NJ | 17 | $50,577 | $10,835 |
| Gulf Coast Medical Center Lee HealthFort Myers, FL | 16 | $57,184 | $8,019 |
| Norton Healthcare PavilionLouisville, KY | 16 | $42,368 | $8,538 |
| Cleveland Clinic - Main CampusCleveland, OH | 16 | $39,743 | $12,629 |
Questions
How much does malignancy of hepatobiliary system or pancreas with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for malignancy of hepatobiliary system or pancreas with complications (DRG 436) at 64 hospitals in the U.S. was billed at $68,480 on average, while the average total payment was $12,472, of which Medicare paid $9,199. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for malignancy of hepatobiliary system or pancreas with complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($18,452), New York ($16,497), Maryland ($16,461) and lowest in Illinois ($8,731), Florida ($9,934), Pennsylvania ($10,525).
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 the U.S., average charges were 5.5 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.