facebook tracking Other circulatory system operating room procedures cost in Michigan: 4 hospitals compared (DRG 264)

Other circulatory system operating room procedures in Michigan

What 4 hospitals in Michigan 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 $117,059 Hospital list price billed
Average payment $32,644 Medicare + patient + other payers
Medicare paid $29,971 Average per stay
State rank #7 of 21 1 = lowest average payment

Hospitals in Michigan billed an average of $117,059 for other circulatory system operating room procedures, about 3.6 times the average total payment of $32,644. That payment is 8% 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 $32,644Billed $117,059

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

Michigan hospitals: other circulatory system operating room procedures

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

Hospital Stays Avg charge Avg payment Medicare paid
Spectrum Health - Butterworth CampusGrand Rapids 12 $170,900 $50,263 $44,524
Providence Hospital and Medical CentersSouthfield 11 $78,415 $26,712 $25,094
Trinity Health Ann Arbor HospitalAnn Arbor 11 $84,235 $28,945 $27,457
William Beaumont Hospital-TroyTroy 11 $129,790 $23,052 $21,489
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Lowest and highest payments in Michigan

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.

Other circulatory system operating room procedures in other states

Questions

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

In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 4 hospitals in Michigan was billed at $117,059 on average, while the average total payment was $32,644, of which Medicare paid $29,971. 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 Michigan, 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.