facebook tracking Other musculoskeletal system and connective tissue diagnoses with complications cost in Virginia: 7 hospitals compared (DRG 565)

Other musculoskeletal system and connective tissue diagnoses with complications in Virginia

What 7 hospitals in Virginia 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 $51,653 Hospital list price billed
Average payment $9,880 Medicare + patient + other payers
Medicare paid $6,461 Average per stay
State rank #6 of 13 1 = lowest average payment

Hospitals in Virginia billed an average of $51,653 for other musculoskeletal system and connective tissue diagnoses with complications, about 5.2 times the average total payment of $9,880. That payment is 5% 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 $9,880Billed $51,653

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

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

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Inova Fairfax HospitalFalls Church 19 $31,098 $11,212 $7,219
Cjw Medical CenterRichmond 17 $96,594 $8,379 $5,165
Carilion Medical CenterRoanoke 13 $38,031 $9,869 $6,509
Mary Washington Hospital, INCFredericksburg 11 $21,549 $7,938 $6,395
Medical College of Virginia HospitalsRichmond 11 $69,543 $15,223 $7,509
Riverside Regional Medical CenterNewport News 11 $29,116 $8,579 $6,103
Reston Hospital CenterReston 11 $68,550 $7,812 $6,473
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Lowest and highest payments in Virginia

Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

Reston Hospital CenterReston, VA$7,812
Mary Washington Hospital, INCFredericksburg, VA$7,938
Cjw Medical CenterRichmond, VA$8,379
Riverside Regional Medical CenterNewport News, VA$8,579
Carilion Medical CenterRoanoke, VA$9,869

Highest

Medical College of Virginia HospitalsRichmond, VA$15,223
Inova Fairfax HospitalFalls Church, VA$11,212
Carilion Medical CenterRoanoke, VA$9,869
Riverside Regional Medical CenterNewport News, VA$8,579
Cjw Medical CenterRichmond, VA$8,379

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 Virginia?

In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue diagnoses with complications (DRG 565) at 7 hospitals in Virginia was billed at $51,653 on average, while the average total payment was $9,880, of which Medicare paid $6,461. 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 Virginia, average charges were 5.2 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.