facebook tracking Other digestive system operating room procedures with major complications cost in Washington: 2 hospitals compared (DRG 356)

Other digestive system operating room procedures with major complications in Washington

What 2 hospitals in Washington 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 $150,571 Hospital list price billed
Average payment $37,739 Medicare + patient + other payers
Medicare paid $34,127 Average per stay
Volume 34 Medicare hospital stays

Hospitals in Washington billed an average of $150,571 for other digestive system operating room procedures with major complications, about 4.0 times the average total payment of $37,739. That payment is 14% 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 $37,739Billed $150,571

About 25¢ was paid for every $1 hospitals in Washington billed for this stay.

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

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Kadlec Regional Medical CenterRichland 19 $156,987 $37,727 $35,754
Providence Sacred Heart Medical CenterSpokane 15 $142,444 $37,755 $32,066
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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 Washington?

In 2024 Medicare data, a hospital stay for other digestive system operating room procedures with major complications (DRG 356) at 2 hospitals in Washington was billed at $150,571 on average, while the average total payment was $37,739, of which Medicare paid $34,127. 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 Washington, average charges were 4.0 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.