Other circulatory system operating room procedures in Pennsylvania
What 10 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for other circulatory system operating room procedures (DRG 264), from 2024 Medicare claims.
Average charge
$204,299
Hospital list price billed
Average payment
$35,789
Medicare + patient + other payers
Medicare paid
$30,988
Average per stay
State rank
#14 of 21
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $204,299 for other circulatory system operating room procedures, about 5.7 times the average total payment of $35,789. That payment is about the same as 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 $35,789Billed $204,299
About 18¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Pennsylvania hospitals: other circulatory system operating room procedures
Every Pennsylvania hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Lancaster General HospitalLancaster | 19 | $122,895 | $26,545 | $25,025 |
| Lehigh Valley HospitalAllentown | 19 | $128,331 | $27,419 | $25,456 |
| Thomas Jefferson University HospitalPhiladelphia | 16 | $394,982 | $72,592 | $54,365 |
| Penn Presbyterian Medical CenterPhiladelphia | 15 | $178,308 | $31,583 | $29,569 |
| Hamot Medical CenterErie | 13 | $126,709 | $28,580 | $26,950 |
| Hospital of the Univ of PaPhiladelphia | 13 | $404,822 | $59,010 | $48,880 |
| UPMC Presbyterian ShadysidePittsburgh | 12 | $409,593 | $27,898 | $22,302 |
| Abington Memorial HospitalAbington | 12 | $77,987 | $25,737 | $23,830 |
| St Luke's Hospital BethlehemBethlehem | 11 | $130,775 | $28,863 | $27,020 |
| UPMC Pinnacle HospitalsHarrisburg | 11 | $76,280 | $26,000 | $23,659 |
Lowest and highest payments in Pennsylvania
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
| Abington Memorial HospitalAbington, PA | $25,737 |
|---|---|
| UPMC Pinnacle HospitalsHarrisburg, PA | $26,000 |
| Lancaster General HospitalLancaster, PA | $26,545 |
| Lehigh Valley HospitalAllentown, PA | $27,419 |
| UPMC Presbyterian ShadysidePittsburgh, PA | $27,898 |
Highest
| Thomas Jefferson University HospitalPhiladelphia, PA | $72,592 |
|---|---|
| Hospital of the Univ of PaPhiladelphia, PA | $59,010 |
| Penn Presbyterian Medical CenterPhiladelphia, PA | $31,583 |
| St Luke's Hospital BethlehemBethlehem, PA | $28,863 |
| Hamot Medical CenterErie, PA | $28,580 |
Other circulatory system operating room procedures in other states
Questions
How much does other circulatory system operating room procedures cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 10 hospitals in Pennsylvania was billed at $204,299 on average, while the average total payment was $35,789, of which Medicare paid $30,988. 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 Pennsylvania, average charges were 5.7 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.