Medical back problems with major complications
What 465 hospitals in the U.S. charged and were paid for a Medicare hospital stay for medical back problems with major complications (DRG 551), from 2024 Medicare claims.
Average charge
$86,481
Hospital list price billed
Average payment
$16,215
Medicare + patient + other payers
Medicare paid
$13,310
Average per stay
Volume
8,932
Medicare hospital stays
Hospitals in the U.S. billed an average of $86,481 for medical back problems with major complications, about 5.3 times the average total payment of $16,215.
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 $16,215Billed $86,481
About 19¢ 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
| Martin Memorial Health SystemsStuart, FL | $9,855 |
|---|---|
| Delray Medical CenterDelray Beach, FL | $10,444 |
| Methodist Stone Oak HospitalSan Antonio, TX | $10,757 |
| Mercy Medical Center-Des MoinesDes Moines, IA | $10,867 |
| Hillcrest HospitalCleveland, OH | $11,045 |
| Henrico Doctors' HospitalRichmond, VA | $11,076 |
| Sentara Virginia Beach General HospitalVirginia Beach, VA | $11,182 |
| Cjw Medical CenterRichmond, VA | $11,338 |
| Piedmont Healthcare SystemRock Hill, SC | $11,339 |
| Deaconess Hospital INCEvansville, IN | $11,394 |
Highest
| Stanford HospitalPalo Alto, CA | $41,325 |
|---|---|
| The Johns Hopkins HospitalBaltimore, MD | $39,759 |
| Scripps Memorial Hospital la JollaLa Jolla, CA | $36,532 |
| Grady Memorial HospitalAtlanta, GA | $32,958 |
| University of California Davis Medical CenterSacramento, CA | $30,791 |
| Westchester Medical CenterValhalla, NY | $30,102 |
| Brigham and Women's HosptialBoston, MA | $28,783 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | $27,758 |
| New York-Presbyterian HospitalNew York, NY | $25,797 |
| Regional One HealthMemphis, TN | $25,177 |
Medical back problems with major 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 | 5 | $78,304 | $16,185 | $11,656 – $23,095 |
| Arizona | 8 | $80,178 | $14,614 | $11,959 – $23,469 |
| Arkansas | 2 | $59,569 | $11,548 | $11,516 – $11,610 |
| California | 50 | $145,813 | $20,804 | $14,034 – $41,325 |
| Colorado | 3 | $147,312 | $12,369 | $12,246 – $12,527 |
| Connecticut | 6 | $63,655 | $18,607 | $15,200 – $20,692 |
| Delaware | 1 | $51,218 | $15,914 | – |
| Florida | 45 | $97,443 | $13,098 | $9,855 – $19,460 |
| Georgia | 9 | $107,094 | $19,572 | $11,828 – $32,958 |
| Hawaii | 1 | $67,159 | $18,920 | – |
| Idaho | 1 | $63,238 | $14,244 | – |
| Illinois | 21 | $63,539 | $14,955 | $10,596 – $30,777 |
| Indiana | 9 | $62,922 | $14,538 | $11,394 – $18,574 |
| Iowa | 5 | $60,004 | $13,404 | $10,450 – $19,771 |
| Kansas | 6 | $98,336 | $13,437 | $11,695 – $15,403 |
| Kentucky | 5 | $64,548 | $14,367 | $11,104 – $18,813 |
| Louisiana | 2 | $64,334 | $12,015 | $11,129 – $13,143 |
| Maine | 1 | $57,387 | $17,294 | – |
| Maryland | 9 | $28,282 | $25,553 | $12,969 – $48,825 |
| Massachusetts | 19 | $45,144 | $17,340 | $12,099 – $28,783 |
| Michigan | 15 | $43,079 | $14,472 | $11,517 – $21,402 |
| Minnesota | 12 | $52,013 | $15,100 | $11,580 – $27,758 |
| Mississippi | 3 | $38,147 | $11,748 | $11,228 – $12,341 |
| Missouri | 12 | $72,864 | $14,234 | $10,951 – $20,597 |
| Montana | 1 | $37,398 | $13,490 | – |
| Nebraska | 3 | $50,914 | $16,493 | $12,976 – $19,766 |
| Nevada | 8 | $144,857 | $15,154 | $13,066 – $19,081 |
| New Hampshire | 5 | $61,957 | $16,342 | $12,268 – $22,623 |
| New Jersey | 17 | $110,550 | $16,689 | $12,811 – $22,218 |
| New Mexico | 1 | $37,752 | $17,054 | – |
| New York | 30 | $116,358 | $20,711 | $13,217 – $34,439 |
| North Carolina | 13 | $57,482 | $16,801 | $11,825 – $38,618 |
| North Dakota | 2 | $57,474 | $14,816 | $13,939 – $16,003 |
| Ohio | 16 | $53,514 | $13,903 | $10,058 – $19,456 |
| Oklahoma | 5 | $60,047 | $13,345 | $10,549 – $18,997 |
| Oregon | 2 | $66,009 | $20,780 | $15,238 – $26,322 |
| Pennsylvania | 23 | $85,341 | $14,965 | $10,188 – $22,519 |
| Rhode Island | 1 | $44,576 | $17,894 | – |
| South Carolina | 7 | $99,688 | $14,733 | $11,339 – $20,698 |
| South Dakota | 1 | $46,219 | $13,041 | – |
| Tennessee | 13 | $75,447 | $15,936 | $9,643 – $25,177 |
| Texas | 34 | $95,932 | $13,646 | $9,519 – $19,599 |
| Utah | 2 | $46,414 | $13,468 | $11,933 – $15,291 |
| Vermont | 1 | $39,651 | $6,304 | – |
| Virginia | 14 | $71,273 | $14,531 | $11,076 – $31,688 |
| Washington | 9 | $81,740 | $17,107 | $13,534 – $23,493 |
| West Virginia | 1 | $46,996 | $15,415 | – |
| Wisconsin | 5 | $66,086 | $17,108 | $11,151 – $23,276 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 100 | $99,281 | $13,508 |
| NYU Hospitals CenterNew York, NY | 80 | $151,109 | $23,930 |
| New York-Presbyterian HospitalNew York, NY | 72 | $136,823 | $25,797 |
| South Shore HospitalSouth Weymouth, MA | 71 | $31,247 | $13,010 |
| Lehigh Valley HospitalAllentown, PA | 66 | $124,213 | $15,506 |
| North Shore University HospitalManhasset, NY | 54 | $133,212 | $20,868 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 52 | $247,954 | $22,177 |
| St John's Mercy Medical CenterSt Louis, MO | 49 | $59,688 | $13,112 |
| Christiana Care Health Services, INC.Newark, DE | 47 | $51,218 | $15,914 |
| Sarasota Memorial HospitalSarasota, FL | 47 | $70,047 | $12,583 |
| Vanderbilt University HospitalNashville, TN | 45 | $94,480 | $22,723 |
| Orlando Regional HealthcareOrlando, FL | 44 | $86,584 | $14,400 |
| University HospitalStony Brook, NY | 43 | $117,265 | $21,903 |
| Mount Sinai WestNew York, NY | 42 | $138,751 | $24,268 |
| Medical Center of PlanoPlano, TX | 42 | $135,786 | $12,202 |
Questions
How much does medical back problems with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for medical back problems with major complications (DRG 551) at 465 hospitals in the U.S. was billed at $86,481 on average, while the average total payment was $16,215, of which Medicare paid $13,310. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for medical back problems with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in Maryland ($25,553), California ($20,804), New York ($20,711) and lowest in Mississippi ($11,748), Colorado ($12,369), Florida ($13,098).
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 5.3 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.