facebook tracking Other circulatory system diagnoses with complications cost in Maine: 2 hospitals compared (DRG 315)

Other circulatory system diagnoses with complications in Maine

What 2 hospitals in Maine charged and were paid for a Medicare hospital stay for other circulatory system diagnoses with complications (DRG 315), from 2024 Medicare claims.

DRG 315 Inpatient 2024 Medicare data
Average charge $31,395 Hospital list price billed
Average payment $8,715 Medicare + patient + other payers
Medicare paid $7,338 Average per stay
Volume 35 Medicare hospital stays

Hospitals in Maine billed an average of $31,395 for other circulatory system diagnoses with complications, about 3.6 times the average total payment of $8,715. That payment is 16% below the U.S. average of $10,367.

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 $8,715Billed $31,395

About 28¢ was paid for every $1 hospitals in Maine billed for this stay.

Maine hospitals: other circulatory system diagnoses with complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Maine Medical CenterPortland 22 $28,753 $9,268 $7,818
Eastern Maine Medical CenterBangor 13 $35,866 $7,781 $6,527
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Other circulatory system diagnoses with complications in other states

Questions

How much does other circulatory system diagnoses with complications cost in Maine?

In 2024 Medicare data, a hospital stay for other circulatory system diagnoses with complications (DRG 315) at 2 hospitals in Maine was billed at $31,395 on average, while the average total payment was $8,715, of which Medicare paid $7,338. 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 Maine, average charges were 3.6 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.