Other ear, nose, mouth and throat diagnoses with complications in Massachusetts
What 2 hospitals in Massachusetts charged and were paid for a Medicare hospital stay for other ear, nose, mouth and throat diagnoses with complications (DRG 155), from 2024 Medicare claims.
Average charge
$22,835
Hospital list price billed
Average payment
$10,378
Medicare + patient + other payers
Medicare paid
$7,575
Average per stay
Volume
25
Medicare hospital stays
Hospitals in Massachusetts billed an average of $22,835 for other ear, nose, mouth and throat diagnoses with complications, about 2.2 times the average total payment of $10,378. That payment is about the same as the U.S. average of $10,280.
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 $10,378Billed $22,835
About 45¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Massachusetts:
Massachusetts hospitals: other ear, nose, mouth and throat diagnoses with complications
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| South Shore HospitalSouth Weymouth | 13 | $14,322 | $7,811 | $6,430 |
| Umass Memorial Medical Center INCWorcester | 12 | $32,058 | $13,160 | $8,816 |
Other ear, nose, mouth and throat diagnoses with complications in other states
Questions
How much does other ear, nose, mouth and throat diagnoses with complications cost in Massachusetts?
In 2024 Medicare data, a hospital stay for other ear, nose, mouth and throat diagnoses with complications (DRG 155) at 2 hospitals in Massachusetts was billed at $22,835 on average, while the average total payment was $10,378, of which Medicare paid $7,575. 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 Massachusetts, average charges were 2.2 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.