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Nervous system neoplasms without major complications in Pennsylvania

What 2 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for nervous system neoplasms without major complications (DRG 055), from 2024 Medicare claims.

DRG 055 Inpatient 2024 Medicare data
Average charge $100,470 Hospital list price billed
Average payment $13,999 Medicare + patient + other payers
Medicare paid $10,218 Average per stay
Volume 23 Medicare hospital stays

Hospitals in Pennsylvania billed an average of $100,470 for nervous system neoplasms without major complications, about 7.2 times the average total payment of $13,999. That payment is about the same as the U.S. average of $14,062.

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 $13,999Billed $100,470

About 14¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Pennsylvania:

Pennsylvania hospitals: nervous system neoplasms without major 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
Lehigh Valley HospitalAllentown 12 $53,512 $10,335 $7,335
Hospital of the Univ of PaPhiladelphia 11 $151,697 $17,997 $13,364
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Nervous system neoplasms without major complications in other states

Questions

How much does nervous system neoplasms without major complications cost in Pennsylvania?

In 2024 Medicare data, a hospital stay for nervous system neoplasms without major complications (DRG 055) at 2 hospitals in Pennsylvania was billed at $100,470 on average, while the average total payment was $13,999, of which Medicare paid $10,218. 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 7.2 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.