Non-extensive operating room procedures unrelated to principal diagnosis with complications
What 50 hospitals in the U.S. charged and were paid for a Medicare hospital stay for non-extensive operating room procedures unrelated to principal diagnosis with complications (DRG 988), from 2024 Medicare claims.
Average charge
$100,303
Hospital list price billed
Average payment
$19,534
Medicare + patient + other payers
Medicare paid
$15,280
Average per stay
Volume
667
Medicare hospital stays
Hospitals in the U.S. billed an average of $100,303 for non-extensive operating room procedures unrelated to principal diagnosis with complications, about 5.1 times the average total payment of $19,534.
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 $19,534Billed $100,303
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:
Non-extensive operating room procedures unrelated to principal diagnosis 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 |
|---|---|---|---|---|
| Arizona | 1 | $65,330 | $26,386 | – |
| California | 3 | $257,562 | $24,929 | $19,367 – $31,207 |
| Delaware | 1 | $57,344 | $15,559 | – |
| Florida | 5 | $102,455 | $13,043 | $10,799 – $15,714 |
| Georgia | 1 | $91,202 | $15,522 | – |
| Illinois | 1 | $62,299 | $14,649 | – |
| Kansas | 1 | $70,282 | $11,766 | – |
| Maine | 1 | $47,688 | $18,454 | – |
| Maryland | 2 | $30,123 | $27,248 | $26,030 – $28,465 |
| Massachusetts | 4 | $79,731 | $21,661 | $20,914 – $22,177 |
| Michigan | 2 | $141,658 | $30,954 | $13,017 – $46,131 |
| Minnesota | 2 | $61,223 | $18,135 | $13,432 – $21,009 |
| New Jersey | 3 | $117,144 | $18,588 | $15,507 – $20,956 |
| New York | 5 | $141,445 | $24,299 | $19,534 – $27,471 |
| North Carolina | 1 | $72,408 | $15,794 | – |
| Ohio | 2 | $67,490 | $18,072 | $13,148 – $21,441 |
| Oklahoma | 2 | $58,308 | $13,734 | $13,529 – $13,996 |
| Pennsylvania | 3 | $124,561 | $18,114 | $15,142 – $20,499 |
| South Carolina | 1 | $77,500 | $12,210 | – |
| Tennessee | 1 | $84,242 | $20,990 | – |
| Texas | 4 | $63,577 | $20,400 | $16,380 – $30,988 |
| Virginia | 1 | $76,157 | $13,209 | – |
| West Virginia | 1 | $58,474 | $14,163 | – |
| Wisconsin | 2 | $82,879 | $19,511 | $19,303 – $19,688 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| New York-Presbyterian HospitalNew York, NY | 25 | $142,970 | $23,940 |
| University HospitalStony Brook, NY | 20 | $165,452 | $27,471 |
| Sarasota Memorial HospitalSarasota, FL | 19 | $76,024 | $12,338 |
| Cleveland Clinic - Main CampusCleveland, OH | 19 | $68,864 | $21,441 |
| Stanford HospitalPalo Alto, CA | 18 | $326,899 | $31,207 |
| Adventhealth OrlandoOrlando, FL | 18 | $111,043 | $15,714 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 18 | $53,901 | $21,009 |
| Mayo Clinic HospitalPhoenix, AZ | 17 | $65,330 | $26,386 |
| Baptist Medical CenterJacksonville, FL | 17 | $115,154 | $13,294 |
| Christiana Care Health Services, INC.Newark, DE | 16 | $57,344 | $15,559 |
| Saint Francis Hospital, INCTulsa, OK | 14 | $55,551 | $13,529 |
| Scott & White Memorial HospitalTemple, TX | 14 | $75,457 | $17,202 |
| Massachusetts General HospitalBoston, MA | 13 | $103,190 | $21,975 |
| Beth Israel Deaconess Medical CenterBoston, MA | 13 | $47,936 | $21,463 |
| Umass Memorial Medical Center INCWorcester, MA | 13 | $77,674 | $22,177 |
Questions
How much does non-extensive operating room procedures unrelated to principal diagnosis with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for non-extensive operating room procedures unrelated to principal diagnosis with complications (DRG 988) at 50 hospitals in the U.S. was billed at $100,303 on average, while the average total payment was $19,534, of which Medicare paid $15,280. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for non-extensive operating room procedures unrelated to principal diagnosis with complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($24,929), New York ($24,299), Massachusetts ($21,661) and lowest in Florida ($13,043), Pennsylvania ($18,114), New Jersey ($18,588).
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 5.1 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.