facebook tracking Other digestive system operating room procedures with major complications cost in New York: 6 hospitals compared (DRG 356)

Other digestive system operating room procedures with major complications in New York

What 6 hospitals in New York 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 $387,391 Hospital list price billed
Average payment $64,716 Medicare + patient + other payers
Medicare paid $52,779 Average per stay
State rank #19 of 19 1 = lowest average payment

Hospitals in New York billed an average of $387,391 for other digestive system operating room procedures with major complications, about 6.0 times the average total payment of $64,716. That payment is 47% 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 $64,716Billed $387,391

About 17¢ was paid for every $1 hospitals in New York billed for this stay.

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

New York hospitals: other digestive system operating room procedures with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
NYU Hospitals CenterNew York 32 $355,370 $58,535 $49,837
New York-Presbyterian HospitalNew York 21 $339,432 $52,344 $47,165
Mount Sinai HospitalNew York 14 $534,757 $110,681 $85,298
Montefiore Medical CenterBronx 13 $405,636 $76,323 $50,300
Westchester Medical CenterValhalla 13 $576,252 $53,337 $47,826
Albany Medical Center HospitalAlbany 11 $139,784 $47,546 $39,451
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Lowest and highest payments in New York

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

Albany Medical Center HospitalAlbany, NY$47,546
New York-Presbyterian HospitalNew York, NY$52,344
Westchester Medical CenterValhalla, NY$53,337
NYU Hospitals CenterNew York, NY$58,535
Montefiore Medical CenterBronx, NY$76,323

Highest

Mount Sinai HospitalNew York, NY$110,681
Montefiore Medical CenterBronx, NY$76,323
NYU Hospitals CenterNew York, NY$58,535
Westchester Medical CenterValhalla, NY$53,337
New York-Presbyterian HospitalNew York, NY$52,344

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 New York?

In 2024 Medicare data, a hospital stay for other digestive system operating room procedures with major complications (DRG 356) at 6 hospitals in New York was billed at $387,391 on average, while the average total payment was $64,716, of which Medicare paid $52,779. 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 New York, average charges were 6.0 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.