facebook tracking Other musculoskeletal system and connective tissue diagnoses with complications cost in Ohio: 2 hospitals compared (DRG 565)

Other musculoskeletal system and connective tissue diagnoses with complications in Ohio

What 2 hospitals in Ohio charged and were paid for a Medicare hospital stay for other musculoskeletal system and connective tissue diagnoses with complications (DRG 565), from 2024 Medicare claims.

DRG 565 Inpatient 2024 Medicare data
Average charge $49,104 Hospital list price billed
Average payment $9,323 Medicare + patient + other payers
Medicare paid $5,920 Average per stay
Volume 37 Medicare hospital stays

Hospitals in Ohio billed an average of $49,104 for other musculoskeletal system and connective tissue diagnoses with complications, about 5.3 times the average total payment of $9,323. That payment is 10% below the U.S. average of $10,350.

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 $9,323Billed $49,104

About 19¢ was paid for every $1 hospitals in Ohio billed for this stay.

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

Ohio hospitals: other musculoskeletal system and connective tissue diagnoses with complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Miami Valley HospitalDayton 25 $45,885 $8,928 $5,818
Toledo Hospital theToledo 12 $55,811 $10,147 $6,133
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Other musculoskeletal system and connective tissue diagnoses with complications in other states

Questions

How much does other musculoskeletal system and connective tissue diagnoses with complications cost in Ohio?

In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue diagnoses with complications (DRG 565) at 2 hospitals in Ohio was billed at $49,104 on average, while the average total payment was $9,323, of which Medicare paid $5,920. 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 Ohio, average charges were 5.3 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.