Other digestive system operating room procedures with major complications in Kentucky
What 2 hospitals in Kentucky 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
$187,165
Hospital list price billed
Average payment
$43,731
Medicare + patient + other payers
Medicare paid
$30,584
Average per stay
Volume
29
Medicare hospital stays
Hospitals in Kentucky billed an average of $187,165 for other digestive system operating room procedures with major complications, about 4.3 times the average total payment of $43,731. That payment is about the same as 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 $43,731Billed $187,165
About 23¢ was paid for every $1 hospitals in Kentucky billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Kentucky:
Kentucky hospitals: other digestive system operating room procedures with major complications
Every Kentucky hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| University of Kentucky HospLexington | 16 | $197,305 | $49,661 | $26,816 |
| Norton Healthcare PavilionLouisville | 13 | $174,686 | $36,433 | $35,221 |
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 Kentucky?
In 2024 Medicare data, a hospital stay for other digestive system operating room procedures with major complications (DRG 356) at 2 hospitals in Kentucky was billed at $187,165 on average, while the average total payment was $43,731, of which Medicare paid $30,584. 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 Kentucky, average charges were 4.3 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.