Other digestive system diagnoses without complications
What 38 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other digestive system diagnoses without complications (DRG 395), from 2024 Medicare claims.
Average charge
$39,628
Hospital list price billed
Average payment
$7,117
Medicare + patient + other payers
Medicare paid
$4,584
Average per stay
Volume
517
Medicare hospital stays
Hospitals in the U.S. billed an average of $39,628 for other digestive system diagnoses without complications, about 5.6 times the average total payment of $7,117.
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 $7,117Billed $39,628
About 18¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Adventhealth OrlandoOrlando, FL | $6,432 |
|---|---|
| Orlando Regional HealthcareOrlando, FL | $8,356 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | $9,092 |
Highest
| Long Island Jewish Medical CenterNew Hyde Park, NY | $9,092 |
|---|---|
| Orlando Regional HealthcareOrlando, FL | $8,356 |
| Adventhealth OrlandoOrlando, FL | $6,432 |
Other digestive system diagnoses without complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Arizona | 1 | $40,407 | $4,764 | – |
| Delaware | 1 | $19,918 | $7,506 | – |
| Florida | 10 | $51,239 | $6,463 | $5,221 – $8,445 |
| Illinois | 2 | $17,357 | $6,233 | $4,915 – $7,363 |
| Kentucky | 1 | $21,513 | $4,567 | – |
| Maryland | 1 | $5,830 | $5,356 | – |
| Massachusetts | 5 | $19,111 | $7,501 | $5,312 – $10,718 |
| Nevada | 1 | $59,098 | $6,603 | – |
| New Jersey | 2 | $46,280 | $6,420 | $5,312 – $7,233 |
| New York | 6 | $49,184 | $9,337 | $5,622 – $15,183 |
| North Carolina | 2 | $20,541 | $8,267 | $5,469 – $11,065 |
| Pennsylvania | 3 | $37,302 | $6,900 | $6,104 – $8,111 |
| Texas | 2 | $55,933 | $6,271 | $5,960 – $6,693 |
| West Virginia | 1 | $20,715 | $8,285 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Orlando Regional HealthcareOrlando, FL | 24 | $74,247 | $8,356 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | 21 | $54,216 | $9,092 |
| Adventhealth OrlandoOrlando, FL | 20 | $36,205 | $6,432 |
| Methodist HospitalSan Antonio, TX | 19 | $46,403 | $5,960 |
| St Joseph's HospitalTampa, FL | 17 | $37,503 | $6,162 |
| Jfk Medical CenterAtlantis, FL | 17 | $85,071 | $6,274 |
| Massachusetts General HospitalBoston, MA | 17 | $30,019 | $9,130 |
| South Shore HospitalSouth Weymouth, MA | 15 | $12,114 | $5,312 |
| Englewood Hospital and Medical CenterEnglewood, NJ | 15 | $40,317 | $7,233 |
| New York-Presbyterian HospitalNew York, NY | 15 | $48,265 | $15,183 |
| Evanston HospitalEvanston, IL | 14 | $18,669 | $7,363 |
| Good Samaritan Hospital Medical CenterWest Islip, NY | 14 | $35,961 | $6,342 |
| Kingwood Medical CenterKingwood, TX | 14 | $68,866 | $6,693 |
| Scottsdale Healthcare-Shea Medical CenterScottsdale, AZ | 13 | $40,407 | $4,764 |
| Baptist Medical CenterJacksonville, FL | 13 | $35,541 | $5,455 |
Questions
How much does other digestive system diagnoses without complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other digestive system diagnoses without complications (DRG 395) at 38 hospitals in the U.S. was billed at $39,628 on average, while the average total payment was $7,117, of which Medicare paid $4,584. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other digestive system diagnoses without complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($9,337), Massachusetts ($7,501), Pennsylvania ($6,900) and lowest in Florida ($6,463), Pennsylvania ($6,900), Massachusetts ($7,501).
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 the U.S., average charges were 5.6 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.