Other ear, nose, mouth and throat diagnoses with complications in New York
What 2 hospitals in New York 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
$66,902
Hospital list price billed
Average payment
$13,030
Medicare + patient + other payers
Medicare paid
$9,581
Average per stay
Volume
35
Medicare hospital stays
Hospitals in New York billed an average of $66,902 for other ear, nose, mouth and throat diagnoses with complications, about 5.1 times the average total payment of $13,030. That payment is 27% above 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 $13,030Billed $66,902
About 19¢ 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 ear, nose, mouth and throat diagnoses with 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 |
|---|---|---|---|---|
| New York-Presbyterian HospitalNew York | 18 | $66,442 | $12,679 | $9,654 |
| University HospitalStony Brook | 17 | $67,389 | $13,402 | $9,504 |
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 New York?
In 2024 Medicare data, a hospital stay for other ear, nose, mouth and throat diagnoses with complications (DRG 155) at 2 hospitals in New York was billed at $66,902 on average, while the average total payment was $13,030, of which Medicare paid $9,581. 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 5.1 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.