Other circulatory system operating room procedures in Kentucky
What 3 hospitals in Kentucky charged and were paid for a Medicare hospital stay for other circulatory system operating room procedures (DRG 264), from 2024 Medicare claims.
Average charge
$93,613
Hospital list price billed
Average payment
$23,326
Medicare + patient + other payers
Medicare paid
$20,690
Average per stay
State rank
#1 of 21
1 = lowest average payment
Hospitals in Kentucky billed an average of $93,613 for other circulatory system operating room procedures, about 4.0 times the average total payment of $23,326. That payment is 34% below 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 $23,326Billed $93,613
About 25¢ was paid for every $1 hospitals in Kentucky billed for this stay.
Kentucky hospitals: other circulatory system operating room procedures
Every Kentucky hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Norton Healthcare PavilionLouisville | 34 | $90,453 | $23,026 | $21,655 |
| St Elizabeth Med Center-SouthEdgewood | 19 | $85,809 | $21,126 | $18,446 |
| University of Kentucky HospLexington | 11 | $116,860 | $28,051 | $21,581 |
Lowest and highest payments in Kentucky
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
| St Elizabeth Med Center-SouthEdgewood, KY | $21,126 |
|---|---|
| Norton Healthcare PavilionLouisville, KY | $23,026 |
| University of Kentucky HospLexington, KY | $28,051 |
Highest
| University of Kentucky HospLexington, KY | $28,051 |
|---|---|
| Norton Healthcare PavilionLouisville, KY | $23,026 |
| St Elizabeth Med Center-SouthEdgewood, KY | $21,126 |
Other circulatory system operating room procedures in other states
Questions
How much does other circulatory system operating room procedures cost in Kentucky?
In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 3 hospitals in Kentucky was billed at $93,613 on average, while the average total payment was $23,326, of which Medicare paid $20,690. 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 Kentucky, average charges were 4.0 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.