Non-extensive operating room procedures unrelated to principal diagnosis with major complications
What 120 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 major complications (DRG 987), from 2024 Medicare claims.
Average charge
$196,226
Hospital list price billed
Average payment
$41,021
Medicare + patient + other payers
Medicare paid
$32,476
Average per stay
Volume
1,872
Medicare hospital stays
Hospitals in the U.S. billed an average of $196,226 for non-extensive operating room procedures unrelated to principal diagnosis with major complications, about 4.8 times the average total payment of $41,021.
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 $41,021Billed $196,226
About 21¢ 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
| Delray Medical CenterDelray Beach, FL | $20,300 |
|---|---|
| Baptist Medical CenterJacksonville, FL | $23,071 |
| Adventhealth OrlandoOrlando, FL | $25,333 |
| Norton Healthcare PavilionLouisville, KY | $26,784 |
| Mem Hermann Southwest HospHouston, TX | $27,154 |
| Lehigh Valley HospitalAllentown, PA | $27,620 |
| New Hanover Regional Medical CenterWilmington, NC | $27,779 |
| ECU Health Medical CenterGreenville, NC | $29,569 |
| Baylor University Medical CenterDallas, TX | $30,804 |
| Hartford HospitalHartford, CT | $38,056 |
Highest
| New York-Presbyterian HospitalNew York, NY | $64,590 |
|---|---|
| Cedars-Sinai Medical CenterLos Angeles, CA | $63,653 |
| Beth Israel Deaconess Medical CenterBoston, MA | $61,476 |
| Massachusetts General HospitalBoston, MA | $60,490 |
| NYU Hospitals CenterNew York, NY | $56,361 |
| Cleveland Clinic - Main CampusCleveland, OH | $55,318 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | $48,603 |
| Northwestern Memorial HospitalChicago, IL | $43,771 |
| Mayo Clinic HospitalPhoenix, AZ | $39,602 |
| Hartford HospitalHartford, CT | $38,056 |
Non-extensive operating room procedures unrelated to principal diagnosis 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 | 2 | $278,881 | $48,006 | $38,484 – $55,488 |
| Arizona | 1 | $123,136 | $39,602 | – |
| California | 7 | $435,085 | $62,105 | $32,937 – $144,242 |
| Connecticut | 3 | $145,755 | $44,443 | $34,432 – $66,034 |
| Delaware | 1 | $100,803 | $34,877 | – |
| Florida | 10 | $181,282 | $28,272 | $20,300 – $50,147 |
| Georgia | 1 | $181,209 | $32,939 | – |
| Illinois | 7 | $157,313 | $38,066 | $24,083 – $48,306 |
| Kentucky | 2 | $139,215 | $24,782 | $20,944 – $26,784 |
| Maine | 1 | $107,800 | $36,278 | – |
| Maryland | 1 | $144,823 | $128,400 | – |
| Massachusetts | 8 | $133,330 | $46,567 | $27,074 – $61,476 |
| Michigan | 4 | $136,850 | $32,206 | $30,500 – $33,865 |
| Minnesota | 3 | $117,516 | $39,126 | $24,280 – $48,603 |
| Mississippi | 2 | $111,776 | $22,923 | $21,599 – $24,145 |
| Missouri | 4 | $120,033 | $35,727 | $26,786 – $49,400 |
| Nebraska | 1 | $144,825 | $37,652 | – |
| New Jersey | 6 | $266,617 | $41,002 | $27,340 – $60,603 |
| New Mexico | 1 | $84,009 | $28,245 | – |
| New York | 14 | $301,215 | $50,277 | $27,695 – $70,910 |
| North Carolina | 6 | $105,733 | $32,323 | $25,557 – $48,865 |
| Ohio | 4 | $176,691 | $42,400 | $24,931 – $55,318 |
| Oklahoma | 1 | $109,042 | $25,285 | – |
| Oregon | 2 | $138,348 | $41,822 | $39,471 – $43,812 |
| Pennsylvania | 8 | $250,965 | $40,175 | $27,494 – $65,782 |
| Rhode Island | 1 | $141,618 | $38,707 | – |
| South Carolina | 2 | $162,941 | $29,277 | $25,735 – $32,819 |
| South Dakota | 1 | $137,745 | $27,082 | – |
| Tennessee | 3 | $161,565 | $34,751 | $22,460 – $56,600 |
| Texas | 7 | $184,964 | $43,101 | $27,154 – $60,111 |
| Virginia | 2 | $101,424 | $30,296 | $28,209 – $32,150 |
| West Virginia | 1 | $162,460 | $32,366 | – |
| Wisconsin | 3 | $161,020 | $41,083 | $32,419 – $52,743 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| New York-Presbyterian HospitalNew York, NY | 37 | $404,355 | $64,590 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 34 | $121,450 | $48,603 |
| NYU Hospitals CenterNew York, NY | 34 | $359,204 | $56,361 |
| Adventhealth OrlandoOrlando, FL | 31 | $228,470 | $25,333 |
| Cleveland Clinic - Main CampusCleveland, OH | 29 | $262,737 | $55,318 |
| Baptist Medical CenterJacksonville, FL | 28 | $125,650 | $23,071 |
| Baylor University Medical CenterDallas, TX | 25 | $156,988 | $30,804 |
| Northwestern Memorial HospitalChicago, IL | 24 | $183,328 | $43,771 |
| Norton Healthcare PavilionLouisville, KY | 23 | $143,407 | $26,784 |
| ECU Health Medical CenterGreenville, NC | 23 | $75,937 | $29,569 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 22 | $665,067 | $63,653 |
| Hartford HospitalHartford, CT | 22 | $117,122 | $38,056 |
| Massachusetts General HospitalBoston, MA | 22 | $256,103 | $60,490 |
| New Hanover Regional Medical CenterWilmington, NC | 21 | $95,231 | $27,779 |
| Mayo Clinic HospitalPhoenix, AZ | 20 | $123,136 | $39,602 |
Questions
How much does non-extensive operating room procedures unrelated to principal diagnosis with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for non-extensive operating room procedures unrelated to principal diagnosis with major complications (DRG 987) at 120 hospitals in the U.S. was billed at $196,226 on average, while the average total payment was $41,021, of which Medicare paid $32,476. 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 major complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($62,105), New York ($50,277), Massachusetts ($46,567) and lowest in Florida ($28,272), Michigan ($32,206), North Carolina ($32,323).
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 4.8 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.