Other digestive system operating room procedures with major complications in Virginia
What 5 hospitals in Virginia 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
$156,657
Hospital list price billed
Average payment
$42,491
Medicare + patient + other payers
Medicare paid
$34,817
Average per stay
State rank
#12 of 19
1 = lowest average payment
Hospitals in Virginia billed an average of $156,657 for other digestive system operating room procedures with major complications, about 3.7 times the average total payment of $42,491. That payment is 4% below 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 $42,491Billed $156,657
About 27¢ was paid for every $1 hospitals in Virginia billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Virginia:
Virginia hospitals: other digestive system operating room procedures with major complications
Every Virginia hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Winchester Medical Center INCWinchester | 17 | $69,035 | $34,203 | $30,753 |
| University of Virginia Medical CenterCharlottesville | 17 | $157,324 | $52,420 | $43,054 |
| Inova Fairfax HospitalFalls Church | 17 | $153,543 | $49,609 | $38,417 |
| Carilion Medical CenterRoanoke | 11 | $204,811 | $30,079 | $27,125 |
| Bon Secours - Memorial Regional MedicalMechanicsville | 11 | $247,702 | $41,366 | $30,494 |
Lowest and highest payments in Virginia
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
| Carilion Medical CenterRoanoke, VA | $30,079 |
|---|---|
| Winchester Medical Center INCWinchester, VA | $34,203 |
| Bon Secours - Memorial Regional MedicalMechanicsville, VA | $41,366 |
| Inova Fairfax HospitalFalls Church, VA | $49,609 |
| University of Virginia Medical CenterCharlottesville, VA | $52,420 |
Highest
| University of Virginia Medical CenterCharlottesville, VA | $52,420 |
|---|---|
| Inova Fairfax HospitalFalls Church, VA | $49,609 |
| Bon Secours - Memorial Regional MedicalMechanicsville, VA | $41,366 |
| Winchester Medical Center INCWinchester, VA | $34,203 |
| Carilion Medical CenterRoanoke, VA | $30,079 |
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 Virginia?
In 2024 Medicare data, a hospital stay for other digestive system operating room procedures with major complications (DRG 356) at 5 hospitals in Virginia was billed at $156,657 on average, while the average total payment was $42,491, of which Medicare paid $34,817. 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 Virginia, average charges were 3.7 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.