facebook tracking Non-extensive operating room procedures unrelated to principal diagnosis with major complications cost in South Carolina: 2 hospitals compared (DRG 987)

Non-extensive operating room procedures unrelated to principal diagnosis with major complications in South Carolina

What 2 hospitals in South Carolina 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.

DRG 987 Inpatient 2024 Medicare data
Average charge $162,941 Hospital list price billed
Average payment $29,277 Medicare + patient + other payers
Medicare paid $23,805 Average per stay
Volume 30 Medicare hospital stays

Hospitals in South Carolina billed an average of $162,941 for non-extensive operating room procedures unrelated to principal diagnosis with major complications, about 5.6 times the average total payment of $29,277. That payment is 29% below the U.S. average 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 $29,277Billed $162,941

About 18¢ was paid for every $1 hospitals in South Carolina billed for this stay.

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

South Carolina hospitals: non-extensive operating room procedures unrelated to principal diagnosis with major complications

Every South Carolina hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
Lexington Medical CenterWest Columbia 15 $170,060 $25,735 $23,483
Greenville Memorial HospitalGreenville 15 $155,823 $32,819 $24,127
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Non-extensive operating room procedures unrelated to principal diagnosis with major complications in other states

Questions

How much does non-extensive operating room procedures unrelated to principal diagnosis with major complications cost in South Carolina?

In 2024 Medicare data, a hospital stay for non-extensive operating room procedures unrelated to principal diagnosis with major complications (DRG 987) at 2 hospitals in South Carolina was billed at $162,941 on average, while the average total payment was $29,277, of which Medicare paid $23,805. 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 South Carolina, average charges were 5.6 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.