facebook tracking Other digestive system operating room procedures with major complications cost in California: 13 hospitals compared (DRG 356)

Other digestive system operating room procedures with major complications in California

What 13 hospitals in California 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.

DRG 356 Inpatient 2024 Medicare data
Average charge $385,828 Hospital list price billed
Average payment $56,976 Medicare + patient + other payers
Medicare paid $50,875 Average per stay
State rank #18 of 19 1 = lowest average payment

Hospitals in California billed an average of $385,828 for other digestive system operating room procedures with major complications, about 6.8 times the average total payment of $56,976. That payment is 29% above the U.S. average 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 $56,976Billed $385,828

About 15¢ was paid for every $1 hospitals in California billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in California:

California hospitals: other digestive system operating room procedures with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Cedars-Sinai Medical CenterLos Angeles 21 $699,078 $65,336 $55,400
El Camino HospitalMountain View 15 $399,007 $47,521 $46,595
Scripps Memorial Hospital la JollaLa Jolla 15 $358,218 $49,118 $38,960
Stanford HospitalPalo Alto 15 $602,013 $79,106 $71,317
University of California San Diego Medical CenterSan Diego 14 $340,286 $84,344 $65,373
Santa Barbara Cottage HospitalSanta Barbara 14 $227,006 $46,331 $44,702
St Johns Regional Medical CenterOxnard 12 $203,509 $36,608 $35,385
Hoag Memorial Hospital PresbyterianNewport Beach 12 $233,166 $41,714 $40,551
Sharp Memorial HospitalSan Diego 11 $575,045 $73,087 $63,692
Mercy Medical Center ReddingRedding 11 $301,824 $42,668 $41,450
Sutter Roseville Medical CenterRoseville 11 $178,413 $41,183 $39,705
UCSF Medical CenterSan Francisco 11 $361,963 $75,279 $65,985
Memorial Medical CenterModesto 11 $264,293 $47,716 $46,678
Advertisement

Lowest and highest payments in California

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

St Johns Regional Medical CenterOxnard, CA$36,608
Sutter Roseville Medical CenterRoseville, CA$41,183
Hoag Memorial Hospital PresbyterianNewport Beach, CA$41,714
Mercy Medical Center ReddingRedding, CA$42,668
Santa Barbara Cottage HospitalSanta Barbara, CA$46,331

Highest

University of California San Diego Medical CenterSan Diego, CA$84,344
Stanford HospitalPalo Alto, CA$79,106
UCSF Medical CenterSan Francisco, CA$75,279
Sharp Memorial HospitalSan Diego, CA$73,087
Cedars-Sinai Medical CenterLos Angeles, CA$65,336

Other digestive system operating room procedures with major complications in other states

Questions

How much does other digestive system operating room procedures with major complications cost in California?

In 2024 Medicare data, a hospital stay for other digestive system operating room procedures with major complications (DRG 356) at 13 hospitals in California was billed at $385,828 on average, while the average total payment was $56,976, of which Medicare paid $50,875. 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 California, average charges were 6.8 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.