Other circulatory system operating room procedures in Massachusetts
What 6 hospitals in Massachusetts charged and were paid for a Medicare hospital stay for other circulatory system operating room procedures (DRG 264), from 2024 Medicare claims.
Average charge
$152,532
Hospital list price billed
Average payment
$45,954
Medicare + patient + other payers
Medicare paid
$34,878
Average per stay
State rank
#20 of 21
1 = lowest average payment
Hospitals in Massachusetts billed an average of $152,532 for other circulatory system operating room procedures, about 3.3 times the average total payment of $45,954. That payment is 29% 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 $45,954Billed $152,532
About 30¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Massachusetts hospitals: other circulatory system operating room procedures
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Massachusetts General HospitalBoston | 47 | $228,730 | $62,705 | $39,615 |
| South Shore HospitalSouth Weymouth | 17 | $37,663 | $24,139 | $22,891 |
| Southcoast Hospital Group, INCFall River | 14 | $59,488 | $25,218 | $23,535 |
| Baystate Medical CenterSpringfield | 14 | $49,385 | $34,925 | $31,733 |
| Brigham and Women's HosptialBoston | 13 | $213,585 | $44,639 | $39,733 |
| Umass Memorial Medical Center INCWorcester | 12 | $179,570 | $49,736 | $44,950 |
Lowest and highest payments in Massachusetts
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
| South Shore HospitalSouth Weymouth, MA | $24,139 |
|---|---|
| Southcoast Hospital Group, INCFall River, MA | $25,218 |
| Baystate Medical CenterSpringfield, MA | $34,925 |
| Brigham and Women's HosptialBoston, MA | $44,639 |
| Umass Memorial Medical Center INCWorcester, MA | $49,736 |
Highest
| Massachusetts General HospitalBoston, MA | $62,705 |
|---|---|
| Umass Memorial Medical Center INCWorcester, MA | $49,736 |
| Brigham and Women's HosptialBoston, MA | $44,639 |
| Baystate Medical CenterSpringfield, MA | $34,925 |
| Southcoast Hospital Group, INCFall River, MA | $25,218 |
Other circulatory system operating room procedures in other states
Questions
How much does other circulatory system operating room procedures cost in Massachusetts?
In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 6 hospitals in Massachusetts was billed at $152,532 on average, while the average total payment was $45,954, of which Medicare paid $34,878. 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 Massachusetts, average charges were 3.3 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.