Other digestive system operating room procedures with major complications
What 135 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other digestive system operating room procedures with major complications (DRG 356), from 2024 Medicare claims.
Average charge
$218,547
Hospital list price billed
Average payment
$44,107
Medicare + patient + other payers
Medicare paid
$37,267
Average per stay
Volume
2,095
Medicare hospital stays
Hospitals in the U.S. billed an average of $218,547 for other digestive system operating room procedures with major complications, about 5.0 times the average total payment of $44,107.
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 $44,107Billed $218,547
About 20¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 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 | $29,125 |
|---|---|
| Greenville Memorial HospitalGreenville, SC | $32,403 |
| Huntsville HospitalHuntsville, AL | $32,814 |
| Methodist HospitalSan Antonio, TX | $33,205 |
| Riverside Methodist HospitalColumbus, OH | $33,897 |
| New Hanover Regional Medical CenterWilmington, NC | $34,543 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $35,168 |
| Baptist Medical CenterJacksonville, FL | $36,551 |
| University of Iowa Hospital & ClinicsIowa City, IA | $43,446 |
| Lehigh Valley HospitalAllentown, PA | $43,957 |
Highest
| Yale-New Haven HospitalNew Haven, CT | $74,487 |
|---|---|
| Cleveland Clinic - Main CampusCleveland, OH | $69,451 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | $67,197 |
| Cedars-Sinai Medical CenterLos Angeles, CA | $65,336 |
| Massachusetts General HospitalBoston, MA | $60,128 |
| NYU Hospitals CenterNew York, NY | $58,535 |
| Brigham and Women's HosptialBoston, MA | $55,616 |
| New York-Presbyterian HospitalNew York, NY | $52,344 |
| University of Kansas HospitalKansas City, KS | $44,146 |
| Lehigh Valley HospitalAllentown, PA | $43,957 |
Other digestive system operating room procedures with major 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 |
|---|---|---|---|---|
| Alabama | 1 | $202,744 | $32,814 | – |
| Arizona | 3 | $197,513 | $39,569 | $32,556 – $49,739 |
| California | 13 | $385,828 | $56,976 | $36,608 – $84,344 |
| Colorado | 1 | $236,737 | $33,869 | – |
| Connecticut | 1 | $299,477 | $74,487 | – |
| Delaware | 1 | $133,695 | $39,932 | – |
| Florida | 11 | $236,941 | $37,018 | $29,125 – $47,123 |
| Georgia | 1 | $173,867 | $36,368 | – |
| Hawaii | 1 | $165,993 | $42,054 | – |
| Idaho | 1 | $115,362 | $37,391 | – |
| Illinois | 5 | $199,967 | $38,962 | $30,119 – $49,271 |
| Indiana | 4 | $161,875 | $35,958 | $28,987 – $49,882 |
| Iowa | 1 | $202,698 | $43,446 | – |
| Kansas | 2 | $306,722 | $39,557 | $30,763 – $44,146 |
| Kentucky | 2 | $187,165 | $43,731 | $36,433 – $49,661 |
| Louisiana | 1 | $140,551 | $28,204 | – |
| Maryland | 1 | $39,876 | $36,889 | – |
| Massachusetts | 8 | $163,553 | $55,297 | $32,780 – $75,183 |
| Michigan | 3 | $170,724 | $44,825 | $34,727 – $55,990 |
| Minnesota | 3 | $165,202 | $56,673 | $39,593 – $67,197 |
| Mississippi | 2 | $114,924 | $35,337 | $29,577 – $41,097 |
| Missouri | 3 | $171,388 | $40,409 | $27,132 – $57,370 |
| Nebraska | 2 | $129,515 | $35,126 | $30,612 – $42,104 |
| Nevada | 1 | $193,988 | $37,276 | – |
| New Hampshire | 1 | $178,240 | $51,382 | – |
| New Jersey | 3 | $271,979 | $43,154 | $39,720 – $50,883 |
| New York | 6 | $387,391 | $64,716 | $47,546 – $110,681 |
| North Carolina | 7 | $134,725 | $38,137 | $27,931 – $50,816 |
| Ohio | 5 | $164,486 | $40,513 | $27,381 – $69,451 |
| Oklahoma | 3 | $200,925 | $34,609 | $26,567 – $44,241 |
| Oregon | 1 | $112,887 | $43,247 | – |
| Pennsylvania | 7 | $301,548 | $43,320 | $34,628 – $57,626 |
| South Carolina | 3 | $185,249 | $41,702 | $32,403 – $59,928 |
| South Dakota | 2 | $159,076 | $34,778 | $28,674 – $40,882 |
| Tennessee | 4 | $153,913 | $36,797 | $26,451 – $49,390 |
| Texas | 9 | $246,192 | $38,655 | $33,144 – $46,850 |
| Vermont | 1 | $124,787 | $24,384 | – |
| Virginia | 5 | $156,657 | $42,491 | $30,079 – $52,420 |
| Washington | 2 | $150,571 | $37,739 | $37,727 – $37,755 |
| West Virginia | 1 | $167,843 | $45,408 | – |
| Wisconsin | 2 | $169,699 | $51,277 | $51,069 – $51,500 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Mayo Clinic - Saint Marys HospitalRochester, MN | 38 | $177,239 | $67,197 |
| NYU Hospitals CenterNew York, NY | 32 | $355,370 | $58,535 |
| Riverside Methodist HospitalColumbus, OH | 31 | $153,530 | $33,897 |
| Massachusetts General HospitalBoston, MA | 30 | $225,767 | $60,128 |
| Adventhealth OrlandoOrlando, FL | 23 | $262,225 | $29,125 |
| University of Iowa Hospital & ClinicsIowa City, IA | 23 | $202,698 | $43,446 |
| University of Kansas HospitalKansas City, KS | 23 | $296,586 | $44,146 |
| Yale-New Haven HospitalNew Haven, CT | 22 | $299,477 | $74,487 |
| Baptist Medical CenterJacksonville, FL | 22 | $201,685 | $36,551 |
| Huntsville HospitalHuntsville, AL | 21 | $202,744 | $32,814 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 21 | $699,078 | $65,336 |
| New York-Presbyterian HospitalNew York, NY | 21 | $339,432 | $52,344 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | 21 | $156,460 | $35,168 |
| New Hanover Regional Medical CenterWilmington, NC | 21 | $132,618 | $34,543 |
| Greenville Memorial HospitalGreenville, SC | 21 | $150,349 | $32,403 |
Questions
How much does other digestive system operating room procedures with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other digestive system operating room procedures with major complications (DRG 356) at 135 hospitals in the U.S. was billed at $218,547 on average, while the average total payment was $44,107, of which Medicare paid $37,267. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other digestive system operating room procedures with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($64,716), California ($56,976), Minnesota ($56,673) and lowest in Oklahoma ($34,609), Indiana ($35,958), Tennessee ($36,797).
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 5.0 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.