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

Other circulatory system operating room procedures in Wisconsin

What 3 hospitals in Wisconsin 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 $82,603 Hospital list price billed
Average payment $28,698 Medicare + patient + other payers
Medicare paid $25,914 Average per stay
State rank #5 of 21 1 = lowest average payment

Hospitals in Wisconsin billed an average of $82,603 for other circulatory system operating room procedures, about 2.9 times the average total payment of $28,698. That payment is 19% 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 $28,698Billed $82,603

About 35¢ was paid for every $1 hospitals in Wisconsin billed for this stay.

Wisconsin hospitals: other circulatory system operating room procedures

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

Hospital Stays Avg charge Avg payment Medicare paid
Appleton Med CtrAppleton 17 $33,499 $22,548 $21,186
Froedtert Mem Lutheran HsptlMilwaukee 13 $110,165 $28,676 $25,232
Marshfield Medical CenterMarshfield 11 $125,919 $38,227 $34,026
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Lowest and highest payments in Wisconsin

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

Appleton Med CtrAppleton, WI$22,548
Froedtert Mem Lutheran HsptlMilwaukee, WI$28,676
Marshfield Medical CenterMarshfield, WI$38,227

Highest

Marshfield Medical CenterMarshfield, WI$38,227
Froedtert Mem Lutheran HsptlMilwaukee, WI$28,676
Appleton Med CtrAppleton, WI$22,548

Other circulatory system operating room procedures in other states

Questions

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

In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 3 hospitals in Wisconsin was billed at $82,603 on average, while the average total payment was $28,698, of which Medicare paid $25,914. 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 Wisconsin, average charges were 2.9 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.