facebook tracking Other circulatory system operating room procedures cost in Georgia: 3 hospitals compared (DRG 264)

Other circulatory system operating room procedures in Georgia

What 3 hospitals in Georgia charged and were paid for a Medicare hospital stay for other circulatory system operating room procedures (DRG 264), from 2024 Medicare claims.

DRG 264 Inpatient 2024 Medicare data
Average charge $231,933 Hospital list price billed
Average payment $36,026 Medicare + patient + other payers
Medicare paid $24,294 Average per stay
State rank #16 of 21 1 = lowest average payment

Hospitals in Georgia billed an average of $231,933 for other circulatory system operating room procedures, about 6.4 times the average total payment of $36,026. That payment is 1% above the U.S. average of $35,518.

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 $36,026Billed $231,933

About 16¢ was paid for every $1 hospitals in Georgia billed for this stay.

Georgia hospitals: other circulatory system operating room procedures

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

Hospital Stays Avg charge Avg payment Medicare paid
Doctors HospitalAugusta 17 $265,769 $30,943 $18,651
Wellstar Kennestone HospitalMarietta 15 $201,261 $34,353 $27,126
Northeast Georgia Medical Center, INCGainesville 13 $223,078 $44,603 $28,406
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Lowest and highest payments in Georgia

Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

Doctors HospitalAugusta, GA$30,943
Wellstar Kennestone HospitalMarietta, GA$34,353
Northeast Georgia Medical Center, INCGainesville, GA$44,603

Highest

Northeast Georgia Medical Center, INCGainesville, GA$44,603
Wellstar Kennestone HospitalMarietta, GA$34,353
Doctors HospitalAugusta, GA$30,943

Other circulatory system operating room procedures in other states

Questions

How much does other circulatory system operating room procedures cost in Georgia?

In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 3 hospitals in Georgia was billed at $231,933 on average, while the average total payment was $36,026, of which Medicare paid $24,294. 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 Georgia, average charges were 6.4 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.