Other digestive system operating room procedures with complications in Pennsylvania
What 2 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for other digestive system operating room procedures with complications (DRG 357), from 2024 Medicare claims.
Average charge
$217,930
Hospital list price billed
Average payment
$27,268
Medicare + patient + other payers
Medicare paid
$19,893
Average per stay
Volume
23
Medicare hospital stays
Hospitals in Pennsylvania billed an average of $217,930 for other digestive system operating room procedures with complications, about 8.0 times the average total payment of $27,268. That payment is 21% above the U.S. average of $22,570.
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 $27,268Billed $217,930
About 13¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: other digestive system operating room procedures with complications
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 |
|---|---|---|---|---|
| Hospital of the Univ of PaPhiladelphia | 12 | $201,209 | $27,274 | $22,142 |
| UPMC Presbyterian ShadysidePittsburgh | 11 | $236,171 | $27,261 | $17,439 |
Other digestive system operating room procedures with complications in other states
Questions
How much does other digestive system operating room procedures with complications cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for other digestive system operating room procedures with complications (DRG 357) at 2 hospitals in Pennsylvania was billed at $217,930 on average, while the average total payment was $27,268, of which Medicare paid $19,893. 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 8.0 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.