Other musculoskeletal system and connective tissue operating room procedures with complications
What 338 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other musculoskeletal system and connective tissue operating room procedures with complications (DRG 516), from 2024 Medicare claims.
Average charge
$103,485
Hospital list price billed
Average payment
$18,981
Medicare + patient + other payers
Medicare paid
$15,648
Average per stay
Volume
6,436
Medicare hospital stays
Hospitals in the U.S. billed an average of $103,485 for other musculoskeletal system and connective tissue operating room procedures with complications, about 5.5 times the average total payment of $18,981.
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 $18,981Billed $103,485
About 18¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 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
| Missouri Baptist Medical CenterTown and Country, MO | $12,949 |
|---|---|
| Grandview Medical CenterBirmingham, AL | $13,079 |
| Methodist Stone Oak HospitalSan Antonio, TX | $13,148 |
| Sarasota Memorial Hospital - VeniceNorth Venice, FL | $13,411 |
| Jupiter Medical CenterJupiter, FL | $13,449 |
| Palos Community HospitalPalos Heights, IL | $13,601 |
| Huntsville HospitalHuntsville, AL | $13,742 |
| Cjw Medical CenterRichmond, VA | $13,908 |
| Rex HospitalRaleigh, NC | $13,989 |
| Shannon Medical CenterSan Angelo, TX | $14,016 |
Highest
| Stanford HospitalPalo Alto, CA | $34,641 |
|---|---|
| UCSF Medical CenterSan Francisco, CA | $33,602 |
| University of California Davis Medical CenterSacramento, CA | $33,530 |
| University of California San Diego Medical CenterSan Diego, CA | $33,178 |
| Beth Israel Deaconess Medical CenterBoston, MA | $28,510 |
| University HospitalStony Brook, NY | $28,055 |
| Massachusetts General HospitalBoston, MA | $27,380 |
| NYU Hospitals CenterNew York, NY | $27,373 |
| Rush University Medical CenterChicago, IL | $26,837 |
| Tampa General HospitalTampa, FL | $26,037 |
Other musculoskeletal system and connective tissue operating room procedures with 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 |
|---|---|---|---|---|
| Alabama | 3 | $114,724 | $15,651 | $13,079 – $20,465 |
| Alaska | 2 | $144,831 | $19,990 | $19,295 – $20,976 |
| Arizona | 4 | $118,979 | $24,403 | $17,246 – $30,814 |
| Arkansas | 3 | $54,168 | $15,266 | $13,734 – $18,069 |
| California | 34 | $168,945 | $25,209 | $17,679 – $62,839 |
| Colorado | 6 | $171,646 | $19,499 | $14,473 – $26,149 |
| Connecticut | 1 | $82,132 | $26,302 | – |
| Delaware | 1 | $72,990 | $18,123 | – |
| Florida | 35 | $120,316 | $16,538 | $13,171 – $26,126 |
| Georgia | 12 | $101,795 | $18,778 | $14,284 – $24,704 |
| Idaho | 3 | $83,352 | $15,963 | $15,469 – $16,592 |
| Illinois | 23 | $81,902 | $18,813 | $13,601 – $29,819 |
| Indiana | 6 | $78,571 | $16,244 | $15,142 – $24,485 |
| Iowa | 1 | $52,307 | $14,052 | – |
| Kansas | 7 | $95,194 | $16,085 | $14,043 – $20,415 |
| Kentucky | 4 | $51,989 | $14,003 | $13,278 – $14,412 |
| Louisiana | 2 | $83,537 | $14,921 | $14,483 – $15,213 |
| Maryland | 5 | $28,624 | $25,337 | $19,753 – $40,904 |
| Massachusetts | 10 | $69,050 | $22,890 | $16,416 – $33,613 |
| Michigan | 11 | $60,852 | $17,584 | $13,767 – $22,729 |
| Minnesota | 6 | $55,765 | $19,505 | $15,823 – $23,725 |
| Mississippi | 3 | $59,025 | $15,465 | $13,118 – $19,296 |
| Missouri | 6 | $84,403 | $17,239 | $12,949 – $24,014 |
| Nebraska | 5 | $70,476 | $16,269 | $14,032 – $20,499 |
| Nevada | 1 | $88,775 | $20,995 | – |
| New Hampshire | 1 | $87,076 | $22,750 | – |
| New Jersey | 6 | $108,771 | $21,986 | $17,205 – $32,356 |
| New York | 14 | $144,498 | $25,244 | $17,536 – $32,974 |
| North Carolina | 11 | $69,413 | $16,976 | $13,989 – $26,677 |
| North Dakota | 2 | $46,373 | $15,794 | $14,872 – $16,390 |
| Ohio | 15 | $86,403 | $17,671 | $14,241 – $24,382 |
| Oklahoma | 9 | $90,757 | $16,064 | $13,552 – $25,473 |
| Oregon | 3 | $66,676 | $20,508 | $16,851 – $23,639 |
| Pennsylvania | 12 | $104,203 | $20,311 | $14,512 – $30,134 |
| Rhode Island | 1 | $41,148 | $23,143 | – |
| South Carolina | 4 | $119,218 | $18,985 | $14,179 – $23,791 |
| South Dakota | 3 | $83,837 | $17,213 | $15,513 – $20,647 |
| Tennessee | 8 | $77,098 | $17,501 | $13,792 – $21,064 |
| Texas | 28 | $119,615 | $16,867 | $13,148 – $33,021 |
| Utah | 2 | $53,705 | $18,934 | $16,387 – $22,655 |
| Virginia | 13 | $131,488 | $16,711 | $13,878 – $29,501 |
| Washington | 5 | $99,945 | $21,462 | $16,259 – $26,624 |
| West Virginia | 1 | $94,668 | $17,867 | – |
| Wisconsin | 5 | $83,967 | $19,491 | $15,164 – $23,797 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 84 | $138,164 | $16,918 |
| Riverside Methodist HospitalColumbus, OH | 64 | $82,611 | $16,317 |
| Massachusetts General HospitalBoston, MA | 62 | $120,991 | $27,380 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 56 | $58,141 | $23,725 |
| New York-Presbyterian HospitalNew York, NY | 56 | $126,602 | $25,753 |
| Deaconess Hospital INCEvansville, IN | 55 | $56,624 | $15,142 |
| Cjw Medical CenterRichmond, VA | 55 | $246,548 | $13,908 |
| Evanston HospitalEvanston, IL | 53 | $58,688 | $17,544 |
| North Florida Regional Medical CenterGainesville, FL | 52 | $207,539 | $17,573 |
| Sarasota Memorial HospitalSarasota, FL | 51 | $112,318 | $15,254 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | 45 | $63,900 | $15,393 |
| Abbott Northwestern Hospital INCMinneapolis, MN | 44 | $45,156 | $16,176 |
| Saint Francis Hospital, INCTulsa, OK | 42 | $54,544 | $14,437 |
| Baptist Medical CenterJacksonville, FL | 41 | $86,928 | $16,102 |
| Stormont-Vail HealthcareTopeka, KS | 41 | $63,996 | $14,043 |
Questions
How much does other musculoskeletal system and connective tissue operating room procedures with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue operating room procedures with complications (DRG 516) at 338 hospitals in the U.S. was billed at $103,485 on average, while the average total payment was $18,981, of which Medicare paid $15,648. 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 operating room procedures with complications?
Among states with at least three hospitals reporting, the average total payment was highest in Maryland ($25,337), New York ($25,244), California ($25,209) and lowest in Kentucky ($14,003), Arkansas ($15,266), Mississippi ($15,465).
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 5.5 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.