Other musculoskeletal system and connective tissue diagnoses with major complications
What 52 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other musculoskeletal system and connective tissue diagnoses with major complications (DRG 564), from 2024 Medicare claims.
Average charge
$84,324
Hospital list price billed
Average payment
$17,025
Medicare + patient + other payers
Medicare paid
$14,263
Average per stay
Volume
715
Medicare hospital stays
Hospitals in the U.S. billed an average of $84,324 for other musculoskeletal system and connective tissue diagnoses with major complications, about 5.0 times the average total payment of $17,025.
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 $17,025Billed $84,324
About 20¢ 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:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Methodist HospitalSan Antonio, TX | $12,200 |
|---|---|
| South Shore HospitalSouth Weymouth, MA | $13,035 |
| Community Medical CenterToms River, NJ | $13,694 |
| Cape Cod HospitalHyannis, MA | $16,136 |
| NYU Hospitals CenterNew York, NY | $21,790 |
| New York-Presbyterian HospitalNew York, NY | $27,986 |
Highest
| New York-Presbyterian HospitalNew York, NY | $27,986 |
|---|---|
| NYU Hospitals CenterNew York, NY | $21,790 |
| Cape Cod HospitalHyannis, MA | $16,136 |
| Community Medical CenterToms River, NJ | $13,694 |
| South Shore HospitalSouth Weymouth, MA | $13,035 |
| Methodist HospitalSan Antonio, TX | $12,200 |
Other musculoskeletal system and connective tissue 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 | 2 | $179,442 | $19,263 | $16,845 – $22,053 |
| Connecticut | 4 | $57,016 | $17,502 | $13,850 – $19,273 |
| Florida | 4 | $75,566 | $12,382 | $11,324 – $14,374 |
| Illinois | 4 | $43,961 | $12,629 | $11,368 – $14,077 |
| Maine | 1 | $130,453 | $69,409 | – |
| Maryland | 2 | $21,579 | $19,982 | $17,044 – $22,920 |
| Massachusetts | 8 | $46,691 | $17,125 | $12,586 – $36,808 |
| Michigan | 1 | $59,124 | $16,685 | – |
| Nebraska | 1 | $41,770 | $11,112 | – |
| New Jersey | 9 | $98,213 | $15,380 | $12,169 – $19,048 |
| New York | 7 | $154,563 | $22,582 | $13,764 – $27,986 |
| Ohio | 1 | $56,618 | $12,746 | – |
| Oklahoma | 1 | $64,405 | $11,836 | – |
| Pennsylvania | 4 | $66,229 | $12,921 | $12,205 – $13,820 |
| Rhode Island | 1 | $38,915 | $14,267 | – |
| Tennessee | 1 | $44,892 | $10,291 | – |
| Texas | 1 | $104,969 | $12,200 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 27 | $141,028 | $21,790 |
| Methodist HospitalSan Antonio, TX | 23 | $104,969 | $12,200 |
| South Shore HospitalSouth Weymouth, MA | 22 | $24,961 | $13,035 |
| New York-Presbyterian HospitalNew York, NY | 21 | $193,507 | $27,986 |
| Cape Cod HospitalHyannis, MA | 20 | $24,470 | $16,136 |
| Community Medical CenterToms River, NJ | 20 | $103,814 | $13,694 |
| Saint Clare's HospitalDenville, NJ | 17 | $40,312 | $15,189 |
| Jersey Shore University Medical CenterNeptune City, NJ | 16 | $133,138 | $15,914 |
| Miami Valley HospitalDayton, OH | 16 | $56,618 | $12,746 |
| Hollywood Community Hospital of HollywoodLos Angeles, CA | 15 | $99,640 | $16,845 |
| Adventhealth OrlandoOrlando, FL | 15 | $75,489 | $11,888 |
| Sarasota Memorial HospitalSarasota, FL | 15 | $64,148 | $11,997 |
| Northwest Community HospitalArlington Heights, IL | 15 | $34,097 | $11,368 |
| Beverly Hospital CorporationBeverly, MA | 15 | $30,275 | $13,205 |
| Lancaster General HospitalLancaster, PA | 15 | $45,733 | $12,423 |
Questions
How much does other musculoskeletal system and connective tissue diagnoses with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue diagnoses with major complications (DRG 564) at 52 hospitals in the U.S. was billed at $84,324 on average, while the average total payment was $17,025, of which Medicare paid $14,263. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other musculoskeletal system and connective tissue diagnoses with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($22,582), Connecticut ($17,502), Massachusetts ($17,125) and lowest in Florida ($12,382), Illinois ($12,629), Pennsylvania ($12,921).
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 5.0 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.