Other ear, nose, mouth and throat diagnoses with major complications
What 4 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other ear, nose, mouth and throat diagnoses with major complications (DRG 154), from 2024 Medicare claims.
Average charge
$114,946
Hospital list price billed
Average payment
$20,618
Medicare + patient + other payers
Medicare paid
$16,412
Average per stay
Volume
55
Medicare hospital stays
Hospitals in the U.S. billed an average of $114,946 for other ear, nose, mouth and throat diagnoses with major complications, about 5.6 times the average total payment of $20,618.
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 $20,618Billed $114,946
About 18¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them:
Other ear, nose, mouth and throat diagnoses with major complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| California | 1 | $175,947 | $25,358 | – |
| Connecticut | 1 | $55,569 | $21,838 | – |
| Florida | 1 | $73,799 | $14,307 | – |
| New York | 1 | $148,757 | $21,164 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 17 | $148,757 | $21,164 |
| Yale-New Haven HospitalNew Haven, CT | 13 | $55,569 | $21,838 |
| Adventhealth OrlandoOrlando, FL | 13 | $73,799 | $14,307 |
| Stanford HospitalPalo Alto, CA | 12 | $175,947 | $25,358 |
Questions
How much does other ear, nose, mouth and throat diagnoses with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other ear, nose, mouth and throat diagnoses with major complications (DRG 154) at 4 hospitals in the U.S. was billed at $114,946 on average, while the average total payment was $20,618, of which Medicare paid $16,412. 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 the U.S., average charges were 5.6 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.